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Virus in smallpox inoculation spreads

The Atlanta Journal-Constitution

An armed services member who was vaccinated against smallpox passed the vaccine virus on to his wife, who then passed it to their baby during breast-feeding, the Centers for Disease Control and Prevention said Thursday, marking the first time on record that the vaccine has caused problems in two generations of contacts.

All three have recovered, the agency said.

The agency disclosed the May 2003 case in an update on the Department of Defense campaign to protect members of the armed services against smallpox infection in case the disease is used as a weapon.

Smallpox was eradicated from the globe in 1979. The last U.S. case occurred in 1949; vaccination against the disease ended in the United States in 1972, in part because of the number of reactions and illnesses caused by the vaccination.

The vaccine produces immunity by infecting the recipient with a live virus, vaccinia, which is from the same family as smallpox but causes much less serious disease. In rare cases — approximately two to six per 100,000 vaccinations — the virus can spread from the vaccinated person to his or her intimate contacts.

So far, the agency said, 578,286 military personnel have been vaccinated against the disease since December 2002; 28 adults and two children developed uncomplicated illnesses after contact with a vaccinated person. Twenty of the adults were spouses or had intimate contact with the military member; the rest were friends.

In the baby's case, which occurred in Alaska, the serviceman's wife developed small breast sores two weeks after his vaccination. She was initially diagnosed with mastitis. After the baby developed small blisterlike lesions on the lip and cheek, the two were re-examined at a military referral hospital and diagnosed with vaccinia. The lesions healed and neither mother nor baby required further treatment.

The wife had been careful to avoid contact with the vaccination site on her husband's arm, but may have been infected by contact with towels or bed linen, the CDC said.

In a separate case in July, the agency added, a service member who recently had been vaccinated was wrestling at a military gym with another service member when the bandage covering his vaccination lesion came off. The wrestling partner, plus a third service member with whom the second one wrestled, developed face, neck and arm lesions six days later. All three recovered.