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Volume 25, Number 6—June 2019

Outbreak of Vaccinia Virus Infection from Occupational Exposure, China, 2017

Bing Lu1, Lun-Biao Cui1, Min-Hua Gu, Chao Shi, Chuan-Wu Sun, Kang-Chen Zhao, Jun Bi, Zhong-Ming Tan, Xi-Ling Guo, Xiang Huo, and Chang-Jun BaoComments to Author 
Author affiliations: Wuxi Municipal Center for Disease Control and Prevention, Wuxi, China (B. Lu, C. Shi); Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China (L.-B. Cui, K.-C. Zhao, Z.-M. Tan, X.-L. Guo, X. Huo, C.-J. Bao); Jiangyin Center for Disease Control and Prevention, Wuxi (M.-H. Gu); Xuzhou Municipal Center for Disease Control and Prevention, Xuzhou, China (C.-W. Sun, J. Bi)

Main Article


Epidemiologic characteristics in 5 case-patients infected with vaccinia virus from occupational exposure, China, 2017*

Characteristics Case-patients
1 (index) 2 3 4 5
General information
   Age, y 37 21 50 52 53
   Sex M M M M M
   Occupation Worker Worker Worker Worker Intermediary
   Underlying conditions N N N N Y†
   Current medications N N N N N
   Immunosuppressant drugs N N N N N
   Smallpox vaccination, y N N Y, 1974 Y, 1976 Y, 1977
   Vaccination scar N N Y Y Y
   Date of exposure, March 2017
Exposure type and duration, min
   Inside enclosed work area 60 60 60 60 30
   Contact with rabbit skins, ungloved hand 0 5 0 20 5
   Contact with pulverized rabbit skins 0 2–3 0 10 10
   Disassembling pulverizer 0 0 30 30 0
   Washing pulverizer 5 0 5 0 0
   Wearing PPE
Clinical manifestations
   Date of symptom onset, March 2017 6 6 7 4 6
   Date of first doctor visit, March 2017 9 7 8 8 9
   Highest temperature, °C; duration, d 42.0; 9 39.2; 7 39.0; 5 42.0; 9 39.2; 8
   No. painful vesicular-pustular lesions 1 7 0 3 0
   Site of painful vesicular-pustular lesions Left hand Both hands NA Right hand, torso, upper leg NA
   Other symptoms or laboratory findings N N Headache, muscular pain Headache, vomiting Elevated leukocyte count
   Complication Pneumonia Pulmonary infection Pulmonary infection Pulmonary infection Pulmonary infection
   Admitted to hospital Y N N N N
   Treatment duration, d 16 9 16 10 13
   Sequelae of scar formation
Laboratory results with real-time PCR
   Vaccinia virus (source) + (BL, SE, NPS, CS) + (BL, SE, NPS, LB) + (BL, SE, NPS) + (BL, SE, NPS)
   Cowpox virus
   Monkeypox virus
   Francisella tularensis
   Bacillus anthracis

*BL, blood; CS, content of scabs; LB, liquid form blisters; NA, not available; NPS, nasopharyngeal swabs; SE, serum; +, positive; –, negative.
†Hypertension and hyperthyroidism.

Main Article

1These authors contributed equally to this article.

Page created: May 20, 2019
Page updated: May 20, 2019
Page reviewed: May 20, 2019
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