Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T08:00:25.953Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of a Semipermeable Dressing Bonded to an Absorbent Pad and a Semipermeable Dressing Over a Separate Gauze Pad for Containment of Vaccinia Virus at the Vaccination Site

Published online by Cambridge University Press:  02 January 2015

Michael R. Savona ,
Wilfred P. Dela Cruz ,
Jennifer A. Thornton  and
Patrick J. Danaher
Michael R. Savona
Affiliation:
Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor
Wilfred P. Dela Cruz
Affiliation:
Clinical Investigation Facility, David Grant Unites States Air Force (USAF) Medical Center, Travis Air Force Base (AFB), California
Jennifer A. Thornton
Affiliation:
Clinical Investigation Facility, David Grant Unites States Air Force (USAF) Medical Center, Travis Air Force Base (AFB), California
Patrick J. Danaher*
Affiliation:
Department of Infectious Diseases, Eglin USAF Regional Hospital, Eglin AFB, Florida
*
Infectious Diseases, 96 MDG/96 MDOS/SGOMI, 307 Boatner Road, Suite 114, Eglin AFB, FL 32542-1282 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To compare the ability of 2 types of dressings to contain vaccinia virus after smallpox vaccination.

Design.

Prospective, nonrandomized trial.

Setting.

The smallpox vaccination clinic in a medium-sized military hospital.

Participants.

Ninety-seven active-duty military members who received smallpox vaccination in accordance with US Department of Defense and Centers for Disease Control and Prevention guidelines.

Methods.

The first 40 participants enrolled were instructed to cover their vaccination sites with a semipermeable membrane placed over a separate gauze pad, and the subsequent 57 participants were given a semipermeable membrane bonded to an absorbent pad. Swab samples of the external surface of the dressing were collected 7 and 21 days after vaccination. Real-time quantitative polymerase chain reaction was used to detect vaccinia DNA in the samples.

Results.

The rate of vaccinia DNA detection was significantly higher for samples obtained from vaccinees who were using the separate gauze and semipermeable membrane, compared with the vacinees who were using the gauze-impregnated semipermeable membrane (22% vs 2.2%; P = .008; odds ratio, 12.3 [95% confidence interval, 1.4-567.4]).

Conclusion.

A gauze-impregnated semipermeable membrane more effectively reduced viral passage to the external surface of the dressing than did a semipermeable membrane placed over a separate gauze pad. Routine use of such dressings following smallpox vaccination might reduce the incidence of autoinoculation and secondary transmission.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 12 , December 2007 , pp. 1339 - 1343
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lane, JM, Ruben, FL, Abrutyn, E, Millar, JD. Deaths attributable to smallpox vaccination, 1959 to 1966, and 1968. JAMA 1970;212:441–444.Google Scholar
2.Koplan, JP, Marton, KI. Smallpox vaccination revisited: some observations on the biology of vaccinia. Am J Trop Med Hyg 1975;24:656–663.Google Scholar
3.Cooney, EL, Collier, AC, Greenberg, PD, et al. Safety of and immunological response to a recombinant vaccinia virus vaccine expressing HIV envelope glycoprotein. Lancet 1991;337:567–572.CrossRefGoogle ScholarPubMed
4.Sepkowitz, KA. How contagious is vaccinia? N Engl J Med 2003;348 439–446Google Scholar
5.Savona, MR, Dela Cruz, WP, Jones, MS, et al. Detection of Vaccinia DNA in the blood following smallpox vaccination. JAMA 2006;295:1898–1900.Google Scholar
6.Baxby, D, Hessami, RM, Ghaboosi, B. Response of camels to intradermal inoculation with smallpox and camelpox viruses. Infect Immun 1975;11:617–621.CrossRefGoogle ScholarPubMed
7.Bennett, M, Gaskell, RM, Gaskell, CJ, Baxby, D, Kelly, DF. Studies on poxvirus infections in cats. Arch Virol 1989;104:19–33.Google Scholar
8.Military Vaccine Agency. Smallpox vaccination safety summary. Available at: http://www.smallpox.mil/event/SPSafetySum.asp. Accessed July 3, 2007.Google Scholar
9. Smallpox vaccine, eczema vaccinatum—USA. ProMED-Mail March 18, 2007: 20070318.0947. Available at: http://www.promedmail.org. Accessed July 3, 2007.Google Scholar
10.World Health Organization. Fact sheet on smallpox. Available at: http://www.who.int/mediacentre/factsheets/smallpox/en/. Accessed July 3, 2007.Google Scholar
11.Rotz, LD, Dotson, DA, Damon, IK, Becher, JA. Vaccinia (smallpox) vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001. MMWR Recomm Rep 2001;50(RR-10):1–25.Google Scholar
12.Graham, BS, Belshe, RB, Clements, ML, et al. Vaccination of vaccinia-naive adults with human immunodeficiency virus type 1 gpl60 recombinant vaccinia virus in a blinded, controlled, randomized clinical trial. J Infect Dis 1992;166:244–252.CrossRefGoogle Scholar
13.Talbot, TR, Ziel, E, Doersam, JK, LaFleur, B, Tollefson, S, Edwards, KM. Risk of vaccinia transfer to the hands of vaccinated persons after smallpox immunization. Clin Infect Dis 2004;38:536–541.CrossRefGoogle Scholar
14.Waibel, KH, Ager, EP, Topolski, RL, Walsh, DS. Randomized trial comparing vaccinia on the external surfaces of 3 conventional bandages applied to smallpox vaccination sites in primary vaccinees. Clin Infect Dis 2004;39:1004–1007.Google Scholar
15.Panning, M, Asper, M, Kramme, S, Schmitz, H, Drosten, C. Rapid detection and differentiation of human pathogenic orthopox viruses by a fluorescence resonance energy transfer real-time PCR assay. Clin Chem 2004;50:702–708.CrossRefGoogle ScholarPubMed
16.Dryvax (smallpox vaccine dry, calf lymph type) [package insert]. Dried Smallpox vaccine. Philadelphia: Wyeth Pharmaceuticals, 2004.Google Scholar
17.Department of Defense. Clinical policy for the Department of Defense smallpox vaccination program (SVP). Available at: http://www.smallpox.mil/documents/219SPclinicalpolicy.pdf. Accessed July 3, 2007.Google Scholar
18.Centers for Disease Control and Prevention. Guidelines and recommendations: Smallpox vaccination status and procedures—guidelines for grantees using licensed undiluted Wyeth Dryvax vaccine. Available at: http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/statusprocedure.pdf. Accessed July 3, 2007.Google Scholar
19.Xia, D, Gagni, C, Ravizee, A, Dempsy, M, Cooper, L, Hadfield, TL. Rapid detection of orthopoxvirus DNA by Light Cycler PCR with Taqman primer probe set. In: Program and abstracts of the 103rd General Meeting of the American Society for Microbiology (Washington, DC);Washington, DC: American Society for Microbiology, 2003:175–176. Abstract C-312.Google Scholar
20.Centers for Disease Control and Prevention. Secondary and tertiary transfer of vaccinia virus among U.S. military personnel—United States and worldwide, 2002-2004. MMWR Morb Mortal Wkly Rep 2004;53 103–105Google Scholar