The smallpox vaccine and postvaccinal encephalitis.
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.
Roos
Karen L
KL
Indiana University School of Medicine, Indianapolis, Indiana, USA.
Eckerman
Nancy L
NL
D000818:Animals; D000914:Antibodies, Viral / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D023482:Bioterrorism; D000077404:Cidofovir; D000075202:Contraindications; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004673:Encephalomyelitis, Acute Disseminated / Q000209:etiology / Q000266:history* / Q000517:prevention & control; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D012899:Smallpox / Q000401:mortality / Q000517:prevention & control / Q000635:transmission; D012900:Smallpox Vaccine / Q000009:adverse effects* / Q000266:history; D014611:Vaccination / Q000009:adverse effects*; D005719:gamma-Globulins / Q000627:therapeutic use
D000914:Antibodies, Viral; D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D012900:Smallpox Vaccine; D005719:gamma-Globulins; D003596:Cytosine; D000077404:Cidofovir