Postvaccinal Encephalitis a Report of 45 Cases in New York City

Greenberg, Morris; Appelbaum, Emanuel

doi:10.1097/00000441-194811000-00012

Cited by 21 publications

(6 citation statements)

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“…Vaccinia necrosum in immunocompromised patients was a life-threatening complication, as was eczema necrosum in patients with atopic dermatitis. 22 Initially patients experi-enced fever, headache, drowsiness, dizziness, disorientation, confusion, vomiting, and pains in the neck and back. Current estimates of the lifetime prevalence of atopic dermatitis is 10 -15%.…”

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“…21 Finally, the magnitude of risk of secondary vaccinia virus spread from the vaccinee to nonvaccinated compromised individuals is unknown. 22 Cranial nerve palsies and spinal cord signs usually improved but persistent sequelae included hemiparesis, seizures, mental retardation, and psychiatric symptoms. 20 Web sites for clinical evaluation tools and specimen collection guidance, and availability of therapies for the military [USAMRIID 301-619 -2257; 888-USA-RIID] are listed in an MMWR Dispatch.…”

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confidence: 99%

“…20 Web sites for clinical evaluation tools and specimen collection guidance, and availability of therapies for the military [USAMRIID 301-619 -2257; 888-USA-RIID] are listed in an MMWR Dispatch. 22 Death often occurred 2-3 weeks after onset of encephalitis. Postvaccinal encephalopathy (PVE), a related condition, may be seen in children less than 2 years of age.…”

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Smallpox and smallpox vaccination

Booss¹,

Davis²

2003

Neurology

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Compulsory vaccination was discontinued in the U.S. in 1972; the world was declared free of smallpox infection in 1980. Since that time, no new smallpox infections have been recognized, and only limited numbers of military and laboratory personnel have been vaccinated. As a result, the majority of the U.S. and the world population have no or diminished immunity to smallpox. Widespread vaccination, beginning with the military and health care workers, is now being undertaken. Public health strategies for immunizing the general population include preexposure voluntary vaccination, case surveillance with ring vaccination, and mass vaccination at the time of attack. Cutaneous complications of vaccination occur in immunosuppressed subjects and in those with atopic dermatitis. Among the most serious complications is postvaccinal encephalomyelitis (PVEM). A related condition, postvaccinial encephalopathy (PVE), may be seen in children less than two years of age. There are no markers to predict who will develop PVEM. In the past, mortality was high, ranging from 10 to 50%. The neuropathology of PVEM suggested an immune-mediated attack on the CNS, but the target of the immune response is unknown. Comprehensive programs are needed for surveillance and confirming case definitions for neurologic complications. Multi-institutional controlled trials of antiviral and immune modulating therapy of PVEM should be considered. Neurologists should be actively involved in the planning process for vaccination programs and in the treatment of neurologic complications.

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Smallpox and smallpox vaccination

Booss¹,

Davis²

2003

Neurology

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“…We excluded 3 studies 16,20,37 because they did not give the total number of people vaccinated; 3 because they used a select population, such as military recruits or adult travelers, which we felt would not apply to the general population 32,33,38 ; and 3 completed before 1950 because of the marked differences in health care at that time. 29,42 (For example, the infant mortality rate in the United States fell, dramatically, between 1940 and 1950, from 47.0 deaths to 29.2 deaths per 1,000 live births. 43 ) Lastly, 1 study was excluded from statistical consideration because its overwhelming size would unduly influence the data.…”

Section: Incidence Of the Neurologic Complicationsmentioning

confidence: 99%

Anticipating Smallpox and Monkeypox Outbreaks

Abrahams

Kaufman

2004

The Neurologist

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“…Gurvich, Movsesyants and Stepenenkova (1975) isolated virus from cerebrospinal fluid from 5 non-lethal PVE cases. But there are much more reports of negative virus isolation from the central nervous system of PVE cases (Greenberg and Applebaum, 1948;Verlinde, 1951;Terzin et al, 1974;Kurata, Aoyama and Kitamura, 1977). Okudaira et al (1973) and Kurata, Aoyama and Kitamura (1977) demonstrated the presence of vaccinia virus antigen in meninges and neurons in the brains of fatal PVE cases by immunofluorescence (IF) staining, with several cases giving positive IF staining only after treatment with NaSCN to dissociate the antigen-antibody complex (Dandliker et al, 1967).…”

Section: Introductionmentioning

confidence: 99%