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DOI: 10.1055/s-2002-33052
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662
The Smallpox Vaccine and Postvaccinal Encephalitis
Publication History
Publication Date:
12 August 2002 (online)
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ABSTRACT
Smallpox is one of the deadliest infectious diseases in history. The discovery by Edward Jenner that inoculation with a droplet of pus from a cow with cowpox protected a person from smallpox resulted in the successful vaccination of millions of people. There were, however, complications associated with smallpox vaccination; the most serious complication was postvaccinal encephalitis, which was reported to occur with an incidence of 1 in 110,000 vaccinations and a case-fatality rate of 50%. Before we become complacent with the idea that we will respond to a bioterrorism attack with a mass immunization program for smallpox, it is important to be reminded of the risk and clinical manifestations of postvaccinal encephalitis and the efficacy of antivaccinia gamma-globulin in preventing this complication. The first case of postvaccinal encephalitis as a complication of the Jennerian cowpox inoculation was observed in 1905. A century later, there is no effective therapy.
KEYWORDS
Smallpox - postvaccinal encephalitis - antivaccinia gamma-globulin - history of medicine
REFERENCES
- 1 Henderson D A, Inglesby T V, Bartlett J G. Smallpox as a biological weapon: medical and public health management. JAMA . 1999; 281 2127-2137
- 2 Henderson D A, Fenner F. Recent events and observations pertaining to smallpox virus destruction in 2002. CID . 2001; 33 1057-1059
-
3 Fifty-Second World Health Assembly. Smallpox eradication: destruction of variola virus stocks 1999; Resolution 52.10
- 4 Broad W J, Miller J. Government report say 3 nations hide stocks of smallpox. New York Times . 1999; June 13 1
- 5 Recommendations of the Advisory Committee on Immunization practices (ACIP), 2001. Vaccinia (smallpox) vaccine MMWR . 2001; 50(RR10) 1-21
- 6 Preston R. Updating the smallpox vaccine. New Yorker . 2000; January 17 27-29
- 7 Lane J M, Ruben F L, Abrutyn E, Millar J D. Deaths attributable to smallpox vaccination, 1959 to 1966, and 1968. JAMA . 1970; 212 441-444
- 8 Lane J M, Ruben F L, Neff J M, Millar J D. Complications of smallpox vaccination, 1968; results of ten statewide surveys. J Infect Dis . 1970; 122 303-309
- 9 Neff J M, Lane J M, Pert J H. Complications of smallpox vaccination: I. National Survey in the United States, 1963. N Engl J Med . 1967; 276 125-132
- 10 Lane J M, Millar J D. Routine childhood vaccination against smallpox reconsidered. N Engl J Med . 1969; 281 1220-1224
- 11 Lane J M, Ruben F L, Neff J M, Millar J D. Complications of smallpox vaccination, 1968; national surveillance in the United States. N Engl J Med . 1969; 281 1201-1208
- 12 Neff J M, Levine R H, Lane J M. Complications of smallpox vaccination United States 1963; results obtained by four statewide surveys. Pediatr . 1967; 39 916-922
- 13 Greenberg M. Complications of vaccination against smallpox. Am J Dis Child . 1948; 76 492-502
- 14 Rivers T M. Viruses. JAMA . 1929; 92 1147-1152
- 15 Nanning W. Prophylactic effect of antivaccinia gamma-globulin against post-vaccinal encephalitis. Bull Wld Hlth Org . 1962; 27 317-324
- 16 Rosenthal S R, Merchlinsky M, Kleppinger C, Goldenthal K L. Developing new smallpox vaccines. Emerg Infect Dis . 2001; 7 920-926
- 17 Vaccinia (smallpox) vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001 MMWR . 2001; 50(RR10) 1-25
- 18 Henderson D A, Inglesby T V, Bartlett J G. Smallpox as a biological weapon: medical and public health management. JAMA . 1999; 281 2127-2137
- 19 Preston R. The demon in the freezer. New Yorker . 1999; July 12 44-61
- 20 Bray M, Martinez M, Smee D F, Kefauver D, Thompson E, Huggins J W. Cidofovir protects mice against lethal aerosol or intranasal cowpox virus challenge. J Infect Dis . 2000; 1811-19
- 21 Institute of Medicine. Assessment of future scientific needs for live variola virus. Washington: National Academy Press 1999