Eczema vaccinatum resulting from the transmission of vaccinia virus from a smallpox vaccinee: an investigation of potential fomites in the home environment.

“On March 3, 2007, a 2-year-old boy was hospitalized with eczema vaccinatum. His two siblings, one with eczema, were subsequently removed from the home. Swabs of household items obtained on March 13th were analyzed for orthopoxvirus DNA signatures with real-time PCR. Virus culture was attempted on positive specimens. Eight of 25 household samples were positive by PCR for orthopoxvirus; of these, three yielded viable vaccinia virus in culture. Both siblings were found to have serologic evidence of orthopoxvirus exposure.” Vaccine 2009
https://www.ncbi.nlm.nih.gov/m/pubmed/19027813


How Contagious Is Vaccinia?

“A report on vaccine-related deaths in the United States during the 1960s found that 12 of the 68 deaths occurred in unvaccinated persons exposed to recently vaccinated family members or friends, a finding that demonstrates the potential gravity of the problem. Numerous reports have described the spread of vaccinia virus within families. The majority are in- stances of single transmission, usually from a recently vaccinated child to an unvaccinated younger sibling.” The new England Journal & Medizine 2002
http://www.nejm.org/doi/pdf/10.1056/NEJMra022500


Severe eczema vaccinatum in a household contact of a smallpox vaccinee.

“A 28-month-old child with refractory atopic dermatitis developed eczema vaccinatum after exposure to his father, a member of the US military who had recently received smallpox vaccine. The father had a history of inactive eczema but reportedly reacted normally to the vaccine. The child’s mother also developed contact vaccinia infection.” Clinical Infectious Diseases 2008
https://www.ncbi.nlm.nih.gov/m/pubmed/18419490


Transmission of vaccinia virus, possibly through sexual contact, to a woman at high risk for adverse complications.

Severe adverse events, including eczema vaccinatum (EV), can result after smallpox vaccination. Persons at risk for EV include those with underlying dermatologic conditions, such as atopic dermatitis. We investigated a case of vaccinia infection, possibly acquired during sexual contact with a recently vaccinated military service member, in a female Maryland resident with atopic dermatitis.
https://www.ncbi.nlm.nih.gov/m/pubmed/24306023


The relationship between vaccine refusal and self-report of atopic disease in children

“Parents who refuse vaccinations reported less asthma and allergies in their unvaccinated children. Although this relationship was independent of measured confounders, it could be due to differences in other unmeasured lifestyle factors or systematic bias. Further research is needed to verify these results and investigate which exposures are driving the associations between vaccination refusal and allergic disease.” Journal of Allergy and Clinical Immunology 2005  
http://www.sciencedirect.com/science/article/pii/S0091674905000266


Timing of routine infant vaccinations and risk of food allergy and eczema at one year of age.

CONCLUSIONS: There was no overall association between delayed DTaP and food allergy; however, children with delayed DTaP had less eczema and less use of eczema medication. Timing of routine infant immunizations may affect susceptibility to allergic disease..” Allergy 2016
https://www.ncbi.nlm.nih.gov/m/pubmed/26707796/


Widespread eczema vaccinatum acquired by contacts. A report of an autopsy case

A 4-month-old male infant predisposed to allergic dermatitis acquired wide-spread eczema vaccinatum by contacts with a recently vaccinated sibling. He died of acute purulent peritonitis following a perforation of multiple duodenal ulcers. Acta Pathologica Japonica 1979 https://www.ncbi.nlm.nih.gov/m/pubmed/377910

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