Talbot Thomas R, Ziel Ellis, Doersam Jennifer K, LaFleur Bonnie, Tollefson Sharon, Edwards Kathryn M
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Clin Infect Dis. 2004 Feb 15;38(4):536-41. doi: 10.1086/381205. Epub 2004 Jan 28.
Transmission of vaccinia virus after smallpox vaccination is a concern. We conducted a prospective examination of the protection afforded by vaccination-site bandages in recently vaccinated individuals. After smallpox vaccination, inoculation sites were covered with 2 occlusive dressings. Site assessment and bandage changes occurred every 3-5 days until the site was healed. At each visit, specimens from the vaccination site, outer dressing surface, and contralateral hand were obtained for vaccinia culture. For 148 vaccinated subjects, vaccinia was detected from vaccination lesions of every subject on several occasions. Only 6 (0.65%) of 918 dressing (95% CI, 0.24%-1.4%) and 2 (0.22%) of 926 hand (95% CI, 0.03%-0.78%) specimens tested positive for vaccinia. The mean number of bandage changes was 9.6 (95% CI, 9.17-10.0). Vaccinia autoinoculation did not occur. The rate of vaccinia recovery outside occlusive bandages covering smallpox vaccination sites was remarkably low, suggesting excellent protection against inadvertent transmission.
天花疫苗接种后牛痘病毒的传播是一个令人担忧的问题。我们对近期接种疫苗个体中接种部位绷带提供的保护作用进行了前瞻性研究。天花疫苗接种后，接种部位覆盖2层封闭敷料。每3 - 5天进行一次接种部位评估和更换绷带，直至接种部位愈合。每次访视时，采集接种部位、外层敷料表面和对侧手部的标本进行牛痘培养。在148名接种疫苗的受试者中，多次在每个受试者的接种损伤处检测到牛痘病毒。918份敷料标本中只有6份（0.65%，95%可信区间，0.24% - 1.4%）以及926份手部标本中只有2份（0.22%，95%可信区间，0.03% - 0.78%）的牛痘检测呈阳性。绷带更换的平均次数为9.6次（95%可信区间，9.17 - 10.0）。未发生牛痘自体接种。覆盖天花疫苗接种部位的封闭绷带外牛痘病毒检出率极低，提示对意外传播具有良好的防护作用。
