In April 1983, seven cases of contact vaccinia infection were
identified in Nevada following exposure to a recently vaccinated
military dependent. On April 14, the vaccinee, an 11-year-old
girl,
mistakenly received a smallpox vaccination during immunization
clearance for travel to Germany. The vaccinee had a "primary"
reaction.
The primary pustule was present when the vaccinee attended a
slumber party with seven other girls on April 17. Activities
included
exchanging and wearing articles of clothing. On April 22, the
other
seven girls presented at a U.S. Air Force clinic with primary
lesions
distributed widely on their bodies. The girls were quarantined at
their homes for 14 days, during which the lesions resolved. The
illnesses were mild. No additional cases were reported.
Reported by HA Wesche, Major, USAF, NC, Chief, Environmental
Health,
Nellis Air Force Base, Nevada; AK Cheng, Col, USAF, MC, Chief,
Preventive Medicine Br, Brooks Air Force Base, Texas; Div of
Immunization, Center for Prevention Svcs, CDC.
Editorial Note
Editorial Note: This outbreak demonstrates again that there are
risks
associated with smallpox vaccination and illustrates the relative
ease
of person-to-person transmission of vaccinia virus. Although these
cases were mild, vaccinia infection can be fatal, especially in
individuals with compromised immunologic mechanisms. The last
reported outbreak of contact-spread vaccinia followed exposure to a
recently vaccinated member of the Canadian armed forces in
Newfoundland in 1981 (1).
In May 1980, the World Health Organization declared the world
free
of smallpox. The January 1982 revision of the International Health
Regulations removed smallpox from the list of quarantinable
diseases.
As a result, the revised International Certificate of Vaccination
does
not include smallpox vaccination. Smallpox vaccination should not
be
given for international travel.
Civilian smallpox vaccination is now recommended only for
laboratory workers directly involved with smallpox virus or closely
related orthopox viruses (e.g., monkeypox, vaccinia) (2) and should
not be used in attempts to treat or prevent diseases such as
herpes.
Wyeth Laboratories, the only licensed producer of smallpox vaccine
in
the United States, discontinued distribution for general use in May
1983 (3).
References
Laboratory Centre for Disease Control. Vaccinia
outbreak--Newfoundland. CDWR 1981;7:29-31.
CDC. Smallpox vaccine no longer available for
civilians--United
States. MMWR 1983; 32:387.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
