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Volume 25, Number 6—June 2019
Dispatch

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

Table

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
 2
 2
 2
 2
 2
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
 N
 N
 N
 N
 N
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
 N
 N
 N
 N
 N
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
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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