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Dad's Vaccination Hospitalizes Boy, 2 (smallpox)

http://www.indystar.com/apps/pbcs.dll/article?AID=/20070409/LOCAL/704090445/-1/NLETTER07

Associated Press

CHICAGO -- A 2-year-old Indiana boy who contracted a rare and life-threatening infection from his soldier father's smallpox vaccination is recovering and should be upgraded from critical condition soon, according to a published report.

Doctors have relied on some untested measures to save the boy's life, including skin grafts and an experimental drug that has never been used to treat a human patient, the Chicago Tribune reported in its Sunday editions. The boy's pox lesions left him with the equivalent of second-degree burns, requiring grafts to let the underlying skin heal.

"He's really on the road to recovery," said Dr. John Marcinak, an associate professor in the University of Chicago's section of pediatric infectious diseases.

The boy has been in pediatric intensive care at the University of Chicago's Comer Children's Hospital for the past month with a virulent rash over 80 percent of his body. He developed the rash after coming in contact with his father, who had recently been vaccinated for smallpox before he was to be deployed overseas by the Army.

The boy is not suffering from smallpox, but from the related vaccinia virus which is used to convey immunity to the much deadlier disease. The infection is a rare condition called eczema vaccinatum, which has not been reported since at least 1990, when the military ended a previous program of smallpox vaccination. Smallpox was declared eradicated in 1980.
The boy, whose name and hometown have not been released at his family's request, will remain isolated as long as he has infectious pox lesions, which doctors predicted would be gone within two weeks. The boy's mother, who developed milder lesions, has recovered completely, Marcinak said.

The federal Centers for Disease Control and Prevention and the U.S. Defense Department still consult with doctors but are no longer in daily contact with the hospital about the case, officials said. Health officials say there is no infection risk for the general population because the vaccinia virus can be spread only through close physical contact.

The child suffered from eczema, which is a known risk factor for vaccinia infection, doctors said. People with eczema are warned not to have close physical contact with the recently vaccinated because the condition allows the virus to enter the skin.

The military began smallpox vaccinations again in 2002 because of bioterrorism fears.

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