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Volume 17, Number 4—April 2011


Vaccinia Virus Infections in Martial Arts Gym, Maryland, USA, 2008

Christine M. HughesComments to Author , David Blythe, Yu Li, Ramani Reddy, Carol Jordan, Cindy Edwards, Celia Adams, Holly Conners, Catherine Rasa, Sue Wilby, Jamaal Russell, Kelly S. Russo, Patricia Somsel, Danny L. Wiedbrauk, Cindy Dougherty, Christopher Allen, Mike Frace, Ginny L. Emerson, Victoria A. Olson, Scott K. Smith, Zachary Braden, Jason Abel, Whitni Davidson, Mary G. Reynolds, and Inger K. Damon
Author affiliations: Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.M. Hughes, Y. Li, C. Dougherty, C. Allen, M. Frace, G. Emerson, V.A. Olson, S.K. Smith, Z. Braden, J. Abel, W. Davidson, M. Reynolds, I.K. Damon) ; Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, USA (D. Blythe); Maximed Associates, Silver Spring, Maryland, USA (R. Reddy); Montgomery County Department of Health and Human Services, Silver Spring (C. Jordan, C. Edwards, C. Adams, H. Conners, C. Rasa, S. Wilby, J. Russell, K.S. Russo); Michigan Department of Community Health, Lansing, Michigan, USA (P. Somsel); Warde Medical Laboratory, Ann Arbor, Michigan, USA (D. Wiedbrauk)

Main Article


Characteristics of 4 cases of vaccinia infection at a martial arts gym, Maryland, USA, 2008*

Case-patient no.†
Age, y/sex
Date of onset
Rash features
Initial diagnosis
Serologic results
1 26/M Jun 16 Pustules on face, arm, back of knee Unknown viral exanthem + NA
2 28/M Mid–late Jun Vesicles on right forearm None Weak + IgM+ (0.243), IgG+ (0.116)
3 31/M Jun 25 Unknown presentation MRSA‡ NA IgM+ (0.389), IgG+ (0.227)
4 31/M Late Jun/early Jul Unknown presentation MRSA‡ NA IgM+ (0.137), IgG+ (0.2195)

*Ig, immunoglobulin; NA, not applicable; MRSA, methicillin-resistant Staphylococcus aureus.
†For purposes of this investigation, a case-patient is defined as a person whose clinical samples are positive for vaccinia virus DNA by PCR, or a person with lesions or a rash (macular, papular, vesicular, or pustular) and whose serum sample was positive for anti-orthopoxvirus IgM antibodies (indicative of a recent orthopoxvirus exposure). No case-patients had received a previous smallpox vaccination.
‡Clinically diagnosed, no laboratory confirmation.

Main Article

1These authors contributed equally to this article.