Abstract
The recent outbreak in the Midwest of monkeypox, as well as the continued fears of a terrorist-induced epidemic of smallpox, prompted the authors' review of the literature regarding past and current experiences with smallpox vaccination. The smallpox vaccine, which is highly effective in preventing the spread of both these orthopoxvirus infectious illnesses, might be administered to numerous health care workers and, in the event of a smallpox attack, millions of other citizens. However, vaccinees would be at risk for several vaccine-related neurologic complications. According to prior reports, neurologic complications have occurred in 2.5 per million US individuals, with the most common being postvaccinal encephalomyelitis (PVEM). In older children and adults, PVEM causes stupor and coma, seizures, paraparesis, and other neurologic and mental abnormalities, and, in 16% of cases, permanent neurologic sequelae. The overall mortality rate of neurologic complications is approximately 1.5 per million vaccinees. Risk factors for PVEM were age younger than 1 year and no previous smallpox vaccination, but not a prior episode of PVEM or other preexisting neurologic illnesses. Neither the current smallpox vaccination campaigns in Israel ...Continue Reading
References
Aug 6, 1977·The Medical Journal of Australia·B J Feery
Jan 1, 1992·Vaccine·E B Gurvich
Aug 1, 1987·The Journal of Infectious Diseases·Z JezekM Mutombo
Aug 27, 1973·JAMA : the Journal of the American Medical Association·W Ehrengut
Apr 1, 1974·The Journal of Hygiene·A L TerzinV Mudrić
Nov 27, 1969·The New England Journal of Medicine·J M LaneJ D Millar
Oct 1, 1965·Postgraduate Medical Journal·E H Brown
Jan 19, 1967·The New England Journal of Medicine·J M NeffD A Henderson
Jun 1, 1969·Postgraduate Medical Journal·P B Croft
Mar 1, 1970·American Journal of Epidemiology·L H RatnerC N Vicéns
Apr 20, 1970·JAMA : the Journal of the American Medical Association·J M LaneJ D Millar
Oct 1, 1970·The Journal of Infectious Diseases·J M LaneJ D Millar
Apr 22, 1967·British Medical Journal·H MillerK Shapira
May 18, 1999·British Medical Bulletin·D L HeymannK Esteves
Mar 30, 2002·The New England Journal of Medicine·Joel G Breman, D A Henderson
Jun 22, 2002·Lancet·Anne BuvéGladys Mutangadura
Aug 1, 2002·Journal of Clinical Microbiology·Hermann MeyerPierre Formenty
Dec 25, 2002·Neurology·Olivier T RutschmannUNKNOWN Immunization Panel of the Multiple Sclerosis Council for Clinical Practice Guidelines
Mar 26, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John BartlettThomas V Inglesby
Apr 23, 2003·Archives of Neurology·Dennis J CleriRichard B Porwancher
Apr 23, 2003·Neurology·John Booss, Larry E Davis
Jul 23, 2003·Archives of Neurology·Augusto Miravalle, Karen L Roos
Aug 20, 2003·Nature Medicine·Richard WeltzinThomas P Monath
Feb 1, 1955·A.M.A. Archives of Neurology and Psychiatry·V B DOLGOPOLR ARONOFF
Mar 1, 1964·Brain : a Journal of Neurology·J D SPILLANE, C E WELLS
Nov 28, 1964·British Medical Journal·A BONACCORSIA JORI
Jan 23, 2004·The New England Journal of Medicine·Kurt D ReedInger K Damon
May 4, 2004·Journal of the American College of Cardiology·Dimitri C CassimatisMarina N Vernalis
Nov 1, 1948·The American Journal of the Medical Sciences·M GREENBERG, E APPELBAUM
Citations
Aug 29, 2006·PLoS Medicine·Mirjam KretzschmarRafael Mikolajczyk
Jan 5, 2010·Vaccine·Wenbo YuZhiwei Chen
Nov 10, 2009·Biologicals : Journal of the International Association of Biological Standardization·Cheryl X ZhangSteven A Rubin
Jun 9, 2006·Antiviral Research·Xuesen FanPaul F Torrence