title: Eczema vaccinatum resulting from the transmission of vaccinia virus from a smallpox vaccinee: an investigation of potential fomites in the home environment.
abstract: 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. These findings have implications for smallpox preparedness, especially in situations where some household members are not candidates for vaccination.
authors.affiliation: Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. edith.lederman@med.navy.mil
authors.forename: Edith
authors.initials: E
authors.lastname: Lederman
authors.forename: Roque
authors.initials: R
authors.lastname: Miramontes
authors.forename: John
authors.initials: J
authors.lastname: Openshaw
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Olson
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Karem
authors.forename: John
authors.initials: J
authors.lastname: Marcinak
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Panares
authors.forename: Wayne
authors.initials: W
authors.lastname: Staggs
authors.forename: Donna
authors.initials: D
authors.lastname: Allen
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Weber
authors.forename: Surabhi
authors.initials: S
authors.lastname: Vora
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
authors.forename: Christine M
authors.initials: CM
authors.lastname: Hughes
authors.forename: Russell
authors.initials: R
authors.lastname: Regnery
authors.forename: Limone
authors.initials: L
authors.lastname: Collins
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Diaz
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
authors.forename: Inger
authors.initials: I
authors.lastname: Damon
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D050456:Fomites / Q000821:virology*; D006801:Humans; D007617:Kaposi Varicelliform Eruption / Q000635:transmission*; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D012900:Smallpox Vaccine / Q000009:adverse effects*; D014616:Vaccinia virus / Q000302:isolation & purification*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral; D012900:Smallpox Vaccine