1/35. Accidental vaccinia of the vulva. Vaccinia of the vulva in a 32-year-old married woman is described. The vaccination was apparently due to a heteroinoculation from her husband during sexual contact. Clinically it presented as an indurated ulcer with a few isolated umbilicated vesicles and was associated with an acute biological false-positive serological reactions. ( info) |
2/35. Perianal vaccinia: a case report. Accidental perianal vaccinia is a rare condition, presenting acutely with severe pain and characteristic superficial ulceration. There is no specific treatment, and complete resolution occurs. A case is described of autogenous perianal vaccinia occurring in an adult. ( info) |
3/35. Laboratory acquired infection with recombinant vaccinia virus containing an immunomodulating construct. Handling of vaccinia virus represents a risk for laboratory-acquired infections, especially in individuals without completed vaccination. We report the case of a Vaccinia infection in a previously vaccinated researcher working with various genetically modified strains. We could confirm the infection by electron microscopy, positive cell culture, virus-specific PCR, sequence analysis, and viral neutralization test. The isolated virus carried a functionally inactivated cytohesin-1 gene of human origin, which had been shown to impair leukocyte adhesion by interacting with the LFA/ICAM-1 axis. The immunomodulating nature of the inserted construct might thus have added to the infectivity of the virus. We emphasize on the necessity of Vaccinia vaccination in laboratory staff working in the field. ( info) |
4/35. smallpox vaccine adverse events among civilians--united states, February 25-March 3, 2003. During the civilian smallpox vaccination program, CDC, the food and Drug Administration, and state health departments are conducting surveillance for vaccine-associated adverse events. In the first stage of the program, active surveillance is being conducted for potentially life-threatening, moderate-to-severe, and other serious adverse events and for vaccinia transmission to contacts of vaccinees (Table). Nonserious events are reported through passive surveillance and are expected to be underreported. This report summarizes smallpox vaccine adverse events reported among civilians vaccinated as of February 28, 2003, and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) as of March 3. ( info) |
5/35. Update on adverse events following civilian smallpox vaccination--united states, 2003. During January 24-April 4, 2003, smallpox vaccine was administered to 31,297 civilian health-care and public health workers in 54 jurisdictions as part of an effort to prepare the united states for a possible terrorist attack using smallpox virus. This report updates information on all vaccine-associated adverse events among civilians vaccinated since the beginning of the smallpox vaccination program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) as of April 4. ( info) |
6/35. Update: Adverse events following civilian smallpox vaccination--united states, 2003. During January 24-April 18, 2003, smallpox vaccine was administered to 33,444 civilian health-care and public health workers in 54 jurisdictions to prepare the united states for a possible terrorist attack using smallpox virus. This report updates information on vaccine-associated adverse events among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) as of April 18. ( info) |
| We report the accidental needlestick inoculation of a laboratory worker with vaccinia virus. Although the patient had previously been vaccinated against smallpox, severe lesions appeared on the fingers. Western blot and polymerase chain reaction-restriction fragment length polymorphism were used to analyze the virus recovered from the lesions. The vaccinia virus-specific immunoglobulin g levels were measured by enzyme-linked immunosorbent assay. Our study supports the need for vaccination for laboratory workers that routinely handle orthopoxvirus. ( info) |
8/35. Update: cardiac and other adverse events following civilian smallpox vaccination--united states, 2003. During January 24-June 20, 2003, smallpox vaccine was administered to 37,802 civilian health-care and public health workers in 55 jurisdictions to prepare the united states for a possible terrorist attack using smallpox virus. This report updates information on vaccine-associated adverse events among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) as of June 20. Two cases of dilated cardiomyopathy (DCM) were diagnosed 3 months after vaccination. For the potential relation between smallpox vaccine and DCM to be assessed, identification of additional cases of DCM among vaccinees will be essential. physicians who treat smallpox vaccine recipients are encouraged to evaluate and report patients with symptoms compatible with DCM, including those that occur several months after vaccination. ( info) |
9/35. Disseminated vaccinia false alarm. We report the case of a 6-year-old girl who presented in December 2002 with fever and a vesicular rash. Initially she was diagnosed with stevens-johnson syndrome. The differential diagnosis was expanded, however, when an exposure to a person who was believed to be vaccinated recently against smallpox was revealed. We describe the sequence of events that ensued and the workup for a possible case of disseminated virus. ( info) |
10/35. Tertiary contact vaccinia in a breastfeeding infant. On May 4, 2003, a US Army soldier received primary smallpox vaccination and experienced a primary uptake reaction at the inoculation site on days 6 through 8. The vaccinee reported observing all of the standard precautions to avoid household spread. In mid May, his breastfeeding wife developed vesicles on both areolas. On May 29, their infant daughter developed a papule on her philtrum. Contact vaccinia was confirmed by positive polymerase chain reaction and culture for vaccinia of both the maternal and infant lesions. This is the first documented case of inadvertent contact vaccinia transmission from a mother to her infant through direct skin-to-skin and skin-to-mucous membrane contact while breastfeeding. The mechanism of transfer from the vaccinee to the spouse is uncertain. This report demonstrates that breastfeeding infants living in close contact with smallpox vaccinees are at potential risk for contact vaccinia, even if the vaccinee is not the breastfeeding mother, and highlights the need for special precautions to prevent secondary transfer to breastfeeding mothers. ( info) |