This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (9)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Pediatrics  • Neonatology and Infant Care  • Women's Health  • Pregnancy and Breast Feeding  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Vinaya Garde, MD; David Harper, MD; Mary P. Fairchok, MD

JAMA. 2004;291:725-727.

On May 4, 2003, a US Army soldier received primary smallpox vaccination and experienced a primary uptake reaction at the inoculation site on days 6 through 8. The vaccinee reported observing all of the standard precautions to avoid household spread. In mid May, his breastfeeding wife developed vesicles on both areolas. On May 29, their infant daughter developed a papule on her philtrum. Contact vaccinia was confirmed by positive polymerase chain reaction and culture for vaccinia of both the maternal and infant lesions. This is the first documented case of inadvertent contact vaccinia transmission from a mother to her infant through direct skin-to-skin and skin–to–mucous membrane contact while breastfeeding. The mechanism of transfer from the vaccinee to the spouse is uncertain. This report demonstrates that breastfeeding infants living in close contact with smallpox vaccinees are at potential risk for contact vaccinia, even if the vaccinee is not the breastfeeding mother, and highlights the need for special precautions to prevent secondary transfer to breastfeeding mothers.

Author Affiliations: Department of Pediatrics, Madigan Army Medical Center, Tacoma, Wash.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Risk of Contact Vaccinia From Immunization Sites
David Lesser
JAMA. 2004;291(19):2313-2314.
EXTRACT | FULL TEXT  

Risk of Contact Vaccinia From Immunization Sites
Harrison G. Weed
JAMA. 2004;291(19):2314.
EXTRACT | FULL TEXT  

Risk of Contact Vaccinia From Immunization Sites—Reply
Vinaya Garde, David Harper, and Mary P. Fairchok
JAMA. 2004;291(19):2314-2315.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk of Contact Vaccinia From Immunization Sites
Weed
JAMA 2004;291:2314-2314.
FULL TEXT  

Risk of Contact Vaccinia From Immunization Sites
Lesser
JAMA 2004;291:2313-2314.
FULL TEXT  

Secondary and Tertiary Transfer of Vaccinia Virus Among U.S. Military Personnel--United States and Worldwide, 2002-2004
Arch Dermatol 2004;140:629-630.
FULL TEXT