The active-duty father came into contact with his infant son, who had eczema, within a month of the father having received a smallpox vaccination prior to deployment overseas. Although the father's vaccine site was covered during the unplanned visit, the child developed a high fever and a generalized papular, vesicular rash that began on the head and neck. Within days, umbilicated lesions covered more than 50% of the child's body and he required mechanical ventilation.
After a course of antiviral and vasopressor medications, intravenous immunoglobulin, and supportive therapy, the child was discharged from the hospital48 days after admission.
His mother, who had rested her head on the child's chest at one point, also developed a mild vesicular rash on her face.
Cell cultures in the home found evidence of the virus on a booster seat, a toy, and a slipper.
"This ain't real smallpox, people!" Dr. Lushniak said to emphasize the high level of transmission there would be in an actual attack, and the importance of then having a "ring" vaccination strategy aimed at everyone in contact with an exposed subject within 3-4 days.
In the meantime, dermatologists and other physicians should be aware of individuals at high risk for vaccine reactions, including pregnant women, patients with skin disorders characterized by epidermal disruption, immunodeficient patients, those with life-threatening allergies or cardiovascular disease, and their household contacts, he said.
How to Learn More or Deploy
▸ Learn more by going to
▸ Join the civilian volunteer Medical Reserve Corps and participate in disaster response in your community (
▸ Train and deploy with a National Disaster Medical Assistance Team (
www.hhs.gov/aspr/opeo/ndms/teams/dmat.html
▸ Join the active reserve corps of the U.S. Public Health Service (
Source: Dr. Lushniak