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Prevention of vaccinia infection in a laboratory worker
1College of Medicine, University of Arizona, Drachman Hall, 1295 North Mabel, Tucson, AZ 85719, USA.
Abstract:
Because smallpox may be a weapon, immunization programs have been restarted and research continues with vaccinia (smallpox vaccine). Ocular complications occur in 5 to 9% of those who contract smallpox and in 10 to 20 per million vaccinia recipients through self-inoculation or from contact with vaccinated individuals. Both variola virus (smallpox) and vaccinia virus (smallpox vaccine) are orthopoxviruses that can cause conjunctival and eyelid infections, cornea ulceration, keratitis, iritis, optic neuritis, and loss of vision. Clinicians should maintain a high index of suspicion for smallpox vaccine-associated reactions in vaccinia researchers, the immunized, and their close contacts. A researcher sprayed vaccinia in her eye. Timely irrigation may have prevented a viral infection. The possibility that this individual had self-immunized herself with smallpox vaccine via the conjunctiva and preventive measures are discussed. Greater precautionary measures need to be taken to prevent laboratory accidents. Antiviral ophthalmic medication and vaccinia-immune globulin medication are treatment options.
Insights
Smallpox vaccine (vaccinia) can cause serious eye infections in researchers and close contacts. Increased laboratory safety measures are crucial to prevent accidental exposure and potential vision loss.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Virology
Background:
- Smallpox (variola virus) eradication efforts have led to renewed interest in vaccinia virus (smallpox vaccine) research and immunization.
- Orthopoxviruses, including variola and vaccinia, pose risks for ocular complications.
Observation:
- Ocular complications from smallpox affect 5-9% of cases, while vaccinia recipients experience them at 10-20 per million via self-inoculation or contact.
- A researcher experienced accidental ocular exposure to vaccinia virus.
Findings:
- Vaccinia virus can cause severe ocular infections such as conjunctivitis, keratitis, iritis, and optic neuritis, potentially leading to vision loss.
- Prompt irrigation following ocular exposure may prevent infection.
Implications:
- Clinicians must suspect vaccine-associated ocular reactions in individuals exposed to vaccinia.
- Enhanced laboratory safety protocols are essential to prevent accidental vaccinia exposure.
- Antiviral ophthalmic medications and vaccinia-immune globulin are potential treatment options.
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