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Friday, February 28, 2003
Last modified at 11:45 p.m. on Thursday, February 27, 2003 3 become ill after smallpox vaccination http://www.jacksonville.com/tu-online/stories/022803/met_11872441.shtml
By P. Douglas Filaroski Times-Union staff writer
Three Floridians became ill after recent smallpox vaccinations, including a nurse whose body rash marks the nation's first serious reaction.
The 39-year-old woman is recovering after being treated as an outpatient for a suspected case of vaccinia rash.
A 60-year-old Florida man with a history of hypertension was treated at a hospital for chest pains and another resident suffered an inflamed gallbladder that required surgery, officials said.
Both were reported to federal health officials even though neither is a typical reaction to smallpox vaccine, given routinely in the United States prior to 1972.
Officials declined to name the individuals or the counties where they had been vaccinated.
"It has been several decades since individuals were vaccinated against smallpox, and we must therefore report on even the most unlikely associated clinical events," Florida Health Secretary John Agwunobi said.
The case of generalized vaccinia -- a known reaction -- comes as the tally of voluntary vaccinations in the nation reached 7,354 this week.
As of Monday, Florida had vaccinated 1,186 -- second among 37 states where vaccinations began as a precaution against possible bioterror attacks.
Officials had estimated between 15 and 50 people in a million would have life-threatening reactions, including one or two in a million who would die.
The Centers for Disease Control and Prevention describes generalized vaccinia as occurring when the live virus used in the vaccine enters the bloodstream.
The virus spreads through the body and sores break out on parts away from the vaccination site.
The nurse in the nation's first case since vaccinations resumed in January complained of pain, tiredness and headache nine days after being vaccinated.
The next day, she developed a rash on her chest that spread to her back and included pustules. She was treated with antihistamines and officials said the rash faded.
"Our surveillance system is very good. It's working," Eric Mast, a CDC immunization expert, said during a teleconference in Atlanta yesterday.
Mast said the reports came from local health department surveillance workers. Duval County Health Department spokeswoman Patricia Frank said none of the three was vaccinated in Northeast Florida.
Florida Epidemiologist Steven Wiersma called the nurse's case a mild illness. He said the woman was recovering at home and not expected to have lasting effects.
The man who experienced chest pain became ill while exercising four days after vaccination. He reported to an emergency department.
Doctors cleared a clogged artery with angioplasty and he was released from the hospital two days later, officials said.
The individual who underwent gallbladder surgery also is doing well, Agwunobi said.
Both the nurse and the man with heart pain had been vaccinated for smallpox prior to 1972, which officials said reduces the risk of adverse reactions.
The heart case is listed by the CDC as another "event of concern" and the gallbladder case had yet to be classified.
Because the live virus is scratched onto the skin's surface, health officials were concerned about unintentional spread through body to body contact.
Accidental spread can occur when a person touched the vaccination site then touched another person or body part. If spread to the eyes, sight damage or blindness can occur.
Wiersma said he didn't believe the nurse had spread the virus to anyone else.
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