Breastfed Baby Exposed to Smallpox Vaccine Virus

Reuters Top News ^ | Thu February 12, 2004 06:01 PM ET | Paul Simao

[EvaClement]

ATLANTA (Reuters) - A U.S. soldier's wife who was accidentally exposed to the live virus in the smallpox vaccine likely passed it on to her baby through breast-feeding, according to military authorities.

The incident, which occurred in May 2003 as the U.S. military was inoculating hundreds of thousands of soldiers against smallpox, is the first documented case of third-hand transmission of vaccinia virus through breast-feeding.

Vaccinia is not smallpox, but a pox-like virus related to the rare and deadly virus. Cases of accidental transmission are rare, usually occurring through direct contact with a vaccinated person's unhealed vaccination site.

In a report released on Thursday by the U.S. Centers for Disease Control and Prevention, a team of Army doctors reported that the unidentified mother developed lesions near her nipples about a week after her husband was vaccinated.

Although the husband had a "major reaction" to the jab, the couple had continued to sleep together and the wife had not stopped breast-feeding their baby. About two weeks later, lesions appeared on the infant's face and tongue.

Lab tests confirmed that mother and daughter had been exposed to vaccinia. Neither had been vaccinated for smallpox.

Military officials are not exactly sure how the wife, who had handled laundry possibly contaminated with vaccinia, was infected. They are, however, fairly certain that the baby got the virus through breast-feeding .

The report urged breastfeeding mothers living with people who have been vaccinated against smallpox to be aware of the possibility of exposure to vaccinia and take care not to spread it to their infants.

The Department of Defense, which has confirmed 18 cases of inadvertent vaccinia transmission since December 2002, has been advising vaccinated persons to cover up their vaccination sites, wash their hands regularly and limit contact with infants.

The United States ended routine vaccinations for smallpox in 1972, but decided in 2002 to resume them for soldiers and some health-care workers as fears grew that the virus could be used as a weapon by radical groups or countries like Iraq.

Smallpox kills about 30 percent of its victims and scars the remainder for life.

[EvaClement]

A word of caution for those vaccinated against smallpox and for the people around them.

[Steve Eisenberg]

A word of caution for those vaccinated against smallpox and for the people around them.

Yes, although vaccinia is rarely a serious disease, and there is no indication here that the baby got it bad. As for the statement the soldier got a "major reaction," this story says no:

Contact vaccinia in soldier's baby linked to breast-feeding

I would go by the above over the Reuters OP.

[EvaClement]

Thanks, yes, this article is much better. E.C.

http://www.cidrap.umn.edu/cidrap/content/bt/smallpox/news/feb1204vaccinia.html

Contact vaccinia in soldier's baby linked to breast-feeding
Feb 12, 2004 (CIDRAP News) – A recent case of vaccinia virus transmission from a soldier to his wife and then to their breast-feeding baby suggests a need for greater precautions by smallpox vaccine recipients and breast-feeding mothers who live together, according to a case report published this week.

The case, reported in the Feb 11 Journal of the American Medical Association, is the first documented instance of vaccinia transmission from a mother to her baby while breast-feeding, according to the three US Army physicians who wrote the article.

Vinaya Garde, MD, and her two coauthors suggest that vaccine recipients should not share a bed with breast-feeding mothers and should do their own laundry, and also that breast-feeding mothers in such households should wash their hands before breast-feeding. Current federal guidelines say that smallpox shot recipients who live with a breast-feeding mother should follow standard hand hygiene and site-protection precautions.

The report says that a 27-year-old soldier was vaccinated May 4, 2003, and had a normal skin reaction, with no drainage from the dressing and little itching. He reported following standard precautions to prevent the spread of vaccinia, but his wife did all the laundry. In mid-May the wife experienced vesicular skin lesions on the areolas of both breasts, but she didn't recognize them as possible vaccinia and continued to breast-feed.

A few days later she saw a physician and was treated for mastitis, which didn't help, the report says. She stopped breast-feeding May 29 because of pain. The same day, a papule developed on her five-month-old baby's philtrum (groove above upper lip), and a similar lesion appeared on the baby's left cheek. A pediatrician examined the infant Jun 2 and noted an ulcer on her tongue in addition to the other lesions.

Lab tests of samples from both mother and baby were positive for vaccinia. To keep the baby's lesions from spreading further, she was isolated and put in soft restraints when not in her mother 's arms, and the lesions were covered with film dressings, the report says. Because the sore on the baby's philtrum continued to weep after 7 days, it was aired under heat lamps 2 to 3 hours a day. The lesions had all crusted over by 13 days after onset, and the baby was released from the hospital after a 12-day stay.

The mother's lesions healed slowly, which was attributed to excessive moisture. She was advised to dry the sores with a blow-dryer three times a day. The lesions were entirely healed by the time of follow-up on Jul 7.

Because of the timing of the lesions, the authors concluded that the virus spread from the vaccinee to his wife and then from her to the infant. They said it was unclear how the virus passed from the soldier to his wife but speculate that she might not have washed her hands between doing laundry and breast-feeding.

Current CDC guidelines caution against smallpox vaccination for breast-feeding mothers and advise vaccinees in the same household to wash their hands after direct contact with the vaccination site or anything that has touched it, according to the report. But in view of this case, the authors state, "We recommend that the CDC revise its guidelines to state that vaccine recipients should not sleep in the same bed as a breastfeeding mother, that vaccine recipients handle their own laundry, and that breastfeeding mothers in these households be reminded to wash their hands prior to breastfeeding."

The authors also note that they considered treating the baby with vaccinia immune globulin (VIG) or cidofovir, but she didn't meet any of the CDC criteria for treatment of a vaccinia complication. Further, none of the available therapies for such complications are licensed for use in children, which underscores the importance of prevention, they observe.

Garde V, Harper D, Fairchok MP. Tertiary contact vaccinia in a breastfeeding infant. JAMA 2004 Feb 11;291(6):725-7 [ Abstract]

[BlackVeil]

I wonder if there is really any smallpox virus in Iraq. They don't seem to have the capacity for such advanced breeding of toxins. It must be somewhere else.

There is a lot we are not being told about the bio-weapons threat. I think that there are forces menacing the USA, but it is being kept secret. The anthrax attacks have never been explained.

[getgoing]

health warning for our military families?

[msdrby]

No offense to anyone in the Army, but this is yet another reason to NOT trust Army hospitals.

[Triple Word Score]

I knew a guy years ago who was waiting for a million-dollar settlement he'd won from the Army--it was winding through appeals. He had a bruise on his leg that wouldn't heal, and it gave him pain for months. The Army docs kept giving him ibuprofin and telling him he was goldbricking, go back to duty--they never even did so much as an X-ray. While home on leave, the leg fractured for no apparent reason, and at the civilian hospital, they took the leg off at the hip that same night--bone cancer, and it was spreading. He was in critical condition for awhile. When the Army found out where he was they charged him with being AWOL or maybe even desertion, I forget. There were other charges too that had to do with seeking outside medical attention without permission or some such nonsense. The Army docs disputed that he could possibly have cancer.

They removed him from the civilian hospital by force and put him in jail instead of in a hospital, which he still needed. The family got a lawyer, and got their Senators and Congresscritters involved....he got a discharge and then sued. Anyway, of course I only knew his side of the story.

[msdrby]

That is terrible. Much worse than my story.

Where I was stationed, the Army hospital was no longer allowed to have a maternity ward because of the infant mortality rate. They were forced to contract with the civilian hospital for many pediatric issues as well.

My infant son had ear infections that the army docs just gave him antibiotic after antibiotic for. Of course, the infections never cleared up because he was at that point immune to the antibiotics. I kept getting in trouble with my command (which wasn't Army) because of having to stay at home with him due to the side effects of all the antibiotics. They claimed that they could not give him tubes until his infection cleared, but when it was finally clear, they refused to give him tubes because he no longer had an infection.

After 10 documented cases in 8 months, the Army finally agreed to let me take him to see a civilian doc. He was almost entirely deaf, and got admitted ASAP to have tubes put in and adenoids removed. After the civilian doctor performed the operation, she said that the fluid behind his ear drums was a solid mass, much like Elmer's paste. He recovered most of his hearing, but does have some irreversible damage.

Another time, my son had a stomach virus, and was vomiting. I took him to the emergency room (same hospital - I had no choice) because he wouldn't take liquids. They hooked him up to an IV and sent us home in a couple of hours. They told me to only bring him back if he got worse. I took him back again for the same reason the next day. They did the same thing, IV and a Popsicle, then sent us home. Said he would be fine for daycare the next day, that he was just dehydrated. While at the daycare, he had Gran Mal seizures. I was already at the hospital for a routine eye appt., so I met him at the emergency room. While we were there he had more seizures. Within minutes, they shipped him off to the same civilian hospital that had done his ears. We ended up staying in the pediatric ward for the rest for the week for observation. The pediatrician was appalled that the Army hospital sent us home in the first place.

After that, I my CO gave me permission to take my son to the doctor of my choice, regardless of the commandant's orders.

[EvaClement]

I received the following from another venue:
"All of our soldiers were vaccinated against small pox recently. My husband's health care provider decided to wait to give him his vaccine until he arrived in Iraq because our 5 year old has eczema. The soldiers here who had babies at home or breast feeding wives were also told to wait until they got to Iraq. I wonder what this soldier's army health care team were thinking? Mary"

I have, well, let's just say, a close relative, who had a debilitating injury due to the incompetence of a superior officer while he was on a training exercise in the military. Said relative will pay the price for that injury everyday for the rest of his life, and the superior officer was never even reprimanded nor did he acknowledge his error/apologize.

E.C.

[Ragtime Cowgirl]

Thanks for the post and the pings.

Thank you, also, for posting the more detailed and less sensationalistic article, Eva. Our military families have enough to be concerned with. Facts will do.

[Ragtime Cowgirl]

There is a lot of info available on WMDs. Too much, maybe.

Precursors, dual-use chems make some bio and chem weapons quite easy to mix at the last minute...deliver using missiles fitted with reservoirs, which Saddam had, or planes with sprayers...as Saddam had previously used to mass-murder Iraqis ~ over 40 villages ~ using chems - and then remember that he was attempting to buy long range missiles, was financing terrorists. Saddam was a threat to Israel, to us - the civilized world.

A few links:

8 FAS (Fed Am Scientist) Report: Iraqi Precursor Chemicals Stored Separately for Weapon-side Mixing

8 Iraq Rebuilt Weapons Factories, Officials Say
8 Rats or Humans? Inside Saddam's Extermination Plant

[Triple Word Score]

Myself--I've rarely had less than good care at my military hospitals. We mostly use Air Force clinics, though, which may be a huge part of the difference. When we used an Army hospital in Germany, we had civilian providers. Got super care there, from them.

It's going off base and getting care from Tricare providers that has been so awful for me. Tricare takes so long to pay the doctors! And fewer and fewer specialists will even take Tricare as a result. There's obvious discrimination in the level of care provided to Tricare patients because doctors are so underpaid by our plan.

[EvaClement]

From another venue again: "This is an effect of vaccines that is not in the public mind. When I was studying the effects of vaccinations several years ago, one thing that I learned was that when polio vaccine was administered (live vaccine only, I believe), the infant/child shed the vaccine in bowel movements for some time. This would make diaper hygiene critical, but when you think of disposable diapers, it forms a scarier possibility. In the case of disposables, feces will end up in the landfill. Is this something we want just lying around? I can't believe these possibilities are not made more public." JP, Ontario

[Triple Word Score]

Fortunately, people who are not immune to polio don't hang out in landfills much in this country.

There are places where that isn't true, but disposable diapers aren't so common there....