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Reuters Health	Print Format

Patient OK after smallpox shot-linked eye infection

March 03, 2003
By Keith Mulvihill

NEW YORK (Reuters Health) - A Los Angeles patient who developed an eye infection with the virus found in the smallpox vaccine was a close contact of a recently vaccinated individual who is in the military, according to the Los Angeles County Department of Health Services.

The infection with the vaccinia virus was not life threatening and is not surprising, according to Dr. Jonathan Fielding, director of public health in the department.

While it is not known exactly how long the adult patient, who has not been identified, has been infected, Fielding told Reuters Health that sometime during the third week of February the person started to show symptoms and was hospitalized around the 21st of February.

"I don't even know if the person is still in the hospital, I haven't checked yet today," he said during a telephone interview Monday.

Nonetheless, the person was "getting better and that is what is most important...the infection was not life threatening," added Fielding.

After being admitted to the hospital, doctors learned that the individual had "close contact" with a member of the military who had recently been vaccinated with the smallpox vaccine.

Extensive testing reveled that the individual was infected with vaccinia, the live virus related to smallpox used in the current smallpox vaccine.

According to Fielding, the patient's symptoms were marked by conjunctivitis, which is evidence of an infection in the eye. The person, whose age or gender has not been released, experienced excessive tearing of the eye, swelling near and around the eye and "visual disturbances," noted Fielding.

"The prognosis is good," he added. "The individual has been improving after receiving anti-viral drops."

So far, Fielding's team is not exactly sure how the person became infected.

"We don't know exactly if the person contracted the infection from touching the vaccination site or a towel used by the vaccinee, these are all hypothesis, we don't know exactly how it happened," he said.

It is not clear if the individual had a weak immune system or another condition that might have made him or her more vulnerable to infection, Fielding noted.

Still, the current case should not be cause for alarm, he added.

Based on data from 1960s when the vaccine was given routinely, transmission and infection with the vaccinia virus through close contact occurred in 2 to 6 people per 100,000 people who received the vaccine, according to Fielding.

"So this (new case) is not surprising," he added.

There is no treatment for smallpox, which kills about one third of those infected. The disease begins with flu-like symptoms, followed by a rash, then pus-filled lesions on the face and body. Vaccination within a few days of exposure to the virus can prevent disease or reduce symptoms.

However, the smallpox vaccine itself carries risks. When smallpox vaccination was routine, about 1,000 people per million had significant side effects such as an allergic reaction at the site of vaccination or spread of the vaccinia virus to other parts of the body.

And for every million people vaccinated, one or two may die, according to the US Centers for Disease Control and Prevention.

Copyright 2003 Reuters. Click for Restrictions.

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