title: Myocarditis, pericarditis, and dilated cardiomyopathy after smallpox vaccination among civilians in the United States, January-October 2003.
abstract: Myocarditis was reported after smallpox vaccination in Europe and Australia, but no association had been reported with the US vaccine. We conducted surveillance to describe and determine the frequency of myocarditis and/or pericarditis (myo/pericarditis) among civilians vaccinated during the US smallpox vaccination program between January and October 2003. We developed surveillance case definitions for myocarditis, pericarditis, and dilated cardiomyopathy after smallpox vaccination. We identified 21 myo/pericarditis cases among 37,901 vaccinees (5.5 per 10,000); 18 (86%) were revacinees, 14 (67%) were women, and the median age was 48 years (range, 25-70 years). The median time from vaccination to onset of symptoms was 11 days (range, 2-42 days). Myo/pericarditis severity was mild, with no fatalities, although 9 patients (43%) were hospitalized. Three additional vaccinees were found to have dilated cardiomyopathy, recognized within 3 months after vaccination. We describe an association between smallpox vaccination, using the US vaccinia strain, and myo/pericarditis among civilians.
authors.affiliation: Centers for Disease Control and Prevention and 2Department of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Juliette
authors.initials: J
authors.lastname: Morgan
authors.forename: Martha H
authors.initials: MH
authors.lastname: Roper
authors.forename: Laurence
authors.initials: L
authors.lastname: Sperling
authors.forename: Richard A
authors.initials: RA
authors.lastname: Schieber
authors.forename: James D
authors.initials: JD
authors.lastname: Heffelfinger
authors.forename: Christine G
authors.initials: CG
authors.lastname: Casey
authors.forename: Jacqueline W
authors.initials: JW
authors.lastname: Miller
authors.forename: Scott
authors.initials: S
authors.lastname: Santibanez
authors.forename: Barbara
authors.initials: B
authors.lastname: Herwaldt
authors.forename: Paige
authors.initials: P
authors.lastname: Hightower
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Moro
authors.forename: Beth F
authors.initials: BF
authors.lastname: Hibbs
authors.forename: Nancy H
authors.initials: NH
authors.lastname: Levine
authors.forename: Louisa E
authors.initials: LE
authors.lastname: Chapman
authors.forename: John
authors.initials: J
authors.lastname: Iskander
authors.forename: J Michael
authors.initials: JM
authors.lastname: Lane
authors.forename: Melinda
authors.initials: M
authors.lastname: Wharton
authors.forename: Gina T
authors.initials: GT
authors.lastname: Mootrey
authors.forename: David L
authors.initials: DL
authors.lastname: Swerdlow
mesh_terms: D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006282:Health Personnel; D006801:Humans; D007117:Immunization, Secondary / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects; D008875:Middle Aged; D009205:Myocarditis / Q000453:epidemiology* / Q000209:etiology; D010493:Pericarditis / Q000453:epidemiology* / Q000209:etiology; D018571:Sentinel Surveillance; D012900:Smallpox Vaccine / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: C078786:DryVax vaccine; D012900:Smallpox Vaccine