Analysis of cases reported as generalized vaccinia during the US military smallpox vaccination program, December 2002 to December 2004

Lewis, Felisa S.; Norton, Scott A.; Bradshaw, R. Dana; Lapa, Joyce A.; Grabenstein, John D.

doi:10.1016/j.jaad.2006.04.017

Cited by 20 publications

(8 citation statements)

References 21 publications

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“…Historically, generalized vaccinia was diagnosed solely on a clinical basis as a benign vesicular, pustular or maculopapular eruption in healthy skin at areas distant to the initial site of vaccination, presumably through hematologic spread of the virus; however, in recent years stricter diagnostic criteria require that vaccinia must be confirmed in these lesions by viral culture, immunohistopathology or polymerase chain reaction . Owing to the stricter criteria, recent studies have downplayed the true incidence of generalized vaccinia, as many of the cases thought to be generalized vaccinia more likely represented post‐vaccinial non‐viral folliculitis. Understanding the cutaneous histopathology is thus vital to help clinicians differentiate among diagnostic possibilities (and in the case of military personnel, to potentially help determine whether he or she is fit for deployment).…”

Section: Discussionmentioning

confidence: 99%

“…1 -3 The papulovesicular eruption was first characterized as a neutrophil-rich folliculitis in 2003, 2 but also was reported subsequently as 'vacciniaassociated folliculitis' 3 or 'post-vaccinial non-viral pustulosis'. 4 Perhaps the most accurate descriptor is post-vaccinial non-viral folliculitis, a term which addresses the timing (post-vaccinial), the lack of vaccinia virus isolation from culture (non-viral), and the histopathology (folliculitis). To date, however, there is minimal information in the literature regarding the histopathology of this papulovesicular (also described as papulopustular) eruption.…”

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confidence: 99%

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Expanding the histologic findings in smallpox‐related post‐vaccinial non‐viral folliculitis

et al. 2012

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Postvaccinial non-viral folliculitis has been recognized in the past decade as a new adverse cutaneous reaction to the smallpox vaccination. Contrary to more serious smallpox vaccine reactions, postvaccinial non-viral folliculitis has a benign course resolving spontaneously within approximately seven days. We describe additional histopathological findings associated with postvaccinial non-viral folliculitis, which has only been described once previously. New findings include the presence of neutrophilic or lymphohistiocytic infiltrates that concentrate around the hair follicles. We compare our findings to the follicular nature of varicella and herpes zoster infections, generating the hypothesis of deposition of vaccinia protein within folliculosebaceous units as a potential pathophysiologic mechanism behind postvaccinial non-viral folliculitis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Expanding the histologic findings in smallpox‐related post‐vaccinial non‐viral folliculitis

et al. 2012

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“…In Europe, only cowpox virus is known to circulate in the nature and to cause human infections. However, laboratory and vaccine use of vaccinia virus [Lewis et al, 2006] including recombinant vaccine viruses used, for example, for wildlife rabies vaccination [Rupprecht et al, 2001] has also caused human infections and/or complications and vaccinia virus has escaped to natural reservoirs on several occasions [Dumbell and Richardson, 1993;Damaso et al, 2000;de Souza Trindade et al, 2003]. Moreover, imported OPVs are always a possibility as seen during the emergence of monkeypox virus in the USA in 2003 [Anonymous, 2003;Reed et al, 2004].…”

Section: Discussionmentioning

confidence: 99%

Detection of human orthopoxvirus infections and differentiation of smallpox virus with real‐time PCR

Putkuri

Piiparinen

Vaheri

et al. 2008

Journal of Medical Virology

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We developed a real-time PCR protocol to detect orthopoxviruses (OPVs) from different clinical specimens and to separate variola virus from other OPVs. In our protocol, we used automated nucleic acid extraction system together with realtime PCR to create a simple, safe and fast procedure to obtain an initial result. The sensitivity was better by using designed hybridization probes as compared to SYBR green I for detection. The detection limit ranged from 13 to 1,300 copies per 20 ml reaction volume depending on the sample type. The PCR detected all OPVs pathogenic to human (variola, cowpox, monkeypox, vaccinia) as well as camelpox and ectromelia viruses. Amplification of variola virus sequences could be distinguished from other OPVs by melting curve analysis. We also demonstrated the applicability of the assay in human cases of cowpox and vaccinia virus infections.

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“…Those mild physical symptoms were more frequently reported during visits with vaccinees not previously vaccinated. Whether coronary artery disease and/ or myopericarditis eventually resulted from the smallpox vaccinations is more controversial [58][59][60].…”

Section: Adverse Events Of Vaccinationmentioning

confidence: 99%

Countermeasures and vaccination against terrorism using smallpox: pre-event and post-event smallpox vaccination and its contraindications

Sato

2010

Environ Health Prev Med

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Smallpox, when used as a biological weapon, presents a serious threat to civilian populations. Core components of the public health management of a terrorism attack using smallpox are: vaccination (ring vaccination and mass vaccination), adverse event monitoring, confirmed and suspected smallpox case management, contact management, identifying, tracing, monitoring contacts, and quarantine. Above all, pre-event and post-event vaccination is an indispensable part of the strategies. Since smallpox patients are most infectious from onset of the rash through the first 7-10 days of the rash, vaccination should be administered promptly within a limited time frame. However, vaccination can accompany complications, such as postvaccinial encephalitis, progressive vaccinia, eczema vaccinatum, and generalized vaccinia. Therefore, vaccination is not recommended for certain groups. Public health professionals, as well as physicians and government officials, should also be well equipped with all information necessary for appropriate and effective smallpox management in the face of such a bioterrorism attack.

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Analysis of cases reported as generalized vaccinia during the US military smallpox vaccination program, December 2002 to December 2004

Cited by 20 publications

References 21 publications

Expanding the histologic findings in smallpox‐related post‐vaccinial non‐viral folliculitis

Expanding the histologic findings in smallpox‐related post‐vaccinial non‐viral folliculitis

Detection of human orthopoxvirus infections and differentiation of smallpox virus with real‐time PCR

Countermeasures and vaccination against terrorism using smallpox: pre-event and post-event smallpox vaccination and its contraindications

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