Smallpox: Vaccinia exposures linked to vaccinees; new vaccine updates

Somewhat unexpectedly, May has been a very busy month for news about smallpox and the vaccinia vaccine used against it. Here are the headlines:

• MMWR reported a vaccinia infection in the genital region of a woman reporting sexual contact with a U.S. military member who had received been vaccinated against smallpox. Here's the MMWR report, a related story from CIDRAP News, and the Reuters item. The woman's case was minor and resolved with minimal treatment.

• A similar story, albeit a much more severe event, was reported last week, also via MMWR and picked up by CIDRAP News and Reuters. A two-year old child developed a severe case of eczema vaccinatum from his father, a soldier vaccinated against smallpox prior to service in Iraq. After a 48-day hospitalization, the child is expected to suffer no long-term effects from his illness. It is the first case of the rare, potentially fatal condition in the U.S. since 1998.

• A new smallpox vaccine developed by Acambis received a positive vote from a key FDA advisory committee, all but assuring licensure in the near future. Here's the story from Forbes and the Chicago Tribune. The Tribune story acknowledges the very serious side-effects associated with this new vaccine, likely limiting its use to emergency scenarios only.

• The website of Congressional Quarterly reports that HHS is nearing a contract a Danish company called Bavarian Nordic for 20 million doses of a new smallpox vaccine. The vaccine is hoped to have a more favorable side-effect profile than the current vaccine or the Acambis product noted above.
  

• Finally, this MSNBC story notes that the WHO delayed a decision on the fate of the (known) stockpiles of smallpox -- the actual virus, not the vaccine -- held by the U.S. and Russia. The story reports that both countries are reluctant to destroy their stockpiles, citing their potential value if the virus is found elsewhere. Unclear from the story is the WHO or U.N. authority to enforce their decisions, whenever they may be made.