Vaccinia 7-globulins

Vaccinia Globulin IV Vaccinia Glogulin (Cangene) Vaccinia infections... 

Vaccines Yes. Wyeth Vaccine, called VIG or vaccinia immune globulin, one dose by scarification. (Pre- and post-exposure vaccination recommended if greater than three years passed since last vaccine.) Persons who are pregnant, have clinical immunosuppression (such as persons who have undergone heart and other transplant operations and take medicines to control rejection of their new, transplanted organ), eczema, and/or leukemia/ lymphoma would be contraindicated for such vaccine. As one example, the fatality rate for immunosuppressed persons taking such vaccine could be as high as 75 percent or more. 

Drugs Available Vaccinia Immune Globulin (VIG). The U.S. Army maintains a supply of VIG, and as of November of 2001 the U.S. government is attempting to buy VIG in large amounts. Cidofovir, another prescription drug, is effective in vitro. 

Treatment — Vaccinia immune globulin must be used in conjunction with a vaccinia vaccine if exposure to a smallpox case occurred more than 4 days earlier. However, only the vaccinia vaccine is required less than 4 days after such contact. The vaccine starts to be protective in approximately 7 days. This vaccine does not provide life-long immunity. Revaccination is recommended at 5- to 10-year intervals. Certain antiviral drugs such as Cidofovir have demonstrated that they confer some protection against infection. Unfortunately, because smallpox has been eradicated, limited research on such drugs has been conducted.3... 

Inhalation, contact with skin lesions or Incubation period 10-14 days Vaccinia immune globulin, vaccinia vaccine... 

Vaccinia Vaccinia immune globulin Consult the CDC.3 Treatment of severe reactions to vaccinia vaccination, including eczema vaccinatum, vaccinia necrosum, and ocular vaccinia. Available from the CDC.3... 

Administer smallpox vaccine and vaccinia immune globulin (Hardin, 2002). 

Available but currently restricted in use to military and laboratory personnel. Plans to vaccinate U.S. health care workers are pending. Vaccinia Immune Globulin (VIG) 0.6 ml /kg IM may be given for complications of vaccine. 

Smallpox Wyeth calt lymph No current Rx other than Vaccinia immune globulin Pre- and... 

Specific immunoglobulins, termed hyperimmune globulins, are derived from human donors known to have high titers of the desired antibody. Specific immunoglobulin preparations for use in infectious disease prevention include hepatitis B, rabies, tetanus. Varicella zoster, vaccinia, and cytomegalovirus immunoglobulin. 

The risk of postvaccinial encephalomyelitis is reduced by simultaneous administration of hyperimmune Vaccinia gamma globulin (32) or by pre-immunization with an antigen from formol-inactivated Vaccinia virus (34,35). However, cases of postvaccinial encephalomyelitis have been described even after these procedures (32,36). 

Post-exposure antibiotic therapies for plague and anthrax are generally effective if administered within a day or so after exposure. There is no approved therapy for smallpox, but cidofavir and possibly vaccinia-immune globulin (VIG) are showing some promise. 

VIG VX vaccinia-immune globulin O-ethyl S-diisopropylaminoethyl methylphosphonothiolate... 

Inadvertent inoculation, the most frequent complication of smallpox vaccination, refers to the transmission of the vaccinia virus from the inoculation site to another part of the recipient s body (autoinoculation) or to the bodies of close contacts (Fig. 2.8 see color plate 2.8). It can occur because live vaccinia virus is present at the inoculation site from about 4 days after inoculation until the crust separates from the skin. Maximum viral shedding occurs 4-14 days after inoculation. Inadvertent inoculation is responsible for approximately half of all complications for primary vaccination and revaccination. Because inadvertent inoculation frequently results from touching the vaccination site and transmitting the virus manually, the most common affected sites are the face, eyelid, nose, mouth, genitalia, and rectum. Most cases heal without any specific treatment. Inadvertent inoculation of the eye can lead to comeal scarring and subsequent vision loss. Occasionally, vaccinia immune globulin (VIG) is necessary to treat periocular lesions (26). 

The only positive findings have been severe serum IgG deficiency and subnormal levels of antibodies to tetanus toxoid and diphtheria toxoid following adequate challenge. Serum and salivary IgA and the response to oral poliomyelitis vaccine (presumably mainly in the IgA class) have usually been normal, as have serum IgM and isohemagglutinins. Neutro-phile function, lymphocyte transformation, and the responses to vaccinia and childhood virus infections were all normal. This seems a milder disease than Bruton s and does well on y-globulin prophylaxis or even only with prompt treatment of infections. 

Hobbs and Citron showed that normal serum immunoglobulin levels in a man 38 years old could be associated with a severe antibody deficiency syndrome corrected by y-globulin treatment (H19). Previous workers had shown that deficiencies of antibodies to measles virus (M19), to vaccinia virus (K3), and to other viruses (LIO) in the presence of apparently normal y-globulin, could result in overwhelming infections. However, at those times cellular defects of immunity had not been excluded these now seem a more probable explanation in many cases (H4, Nl). 

Some immunoglobulins cannot be obtained from normal, healthy blood donors and are obtained instead by inoculation of volunteers, so that they develop the required antibody. Such procedures are used for immunoglobulins against vaccinia, tetanus, measles, hepatitis A, Rhesus incompatibility and rabies. The biological factory for the immune globulin, in such cases, is the body of the volunteer. 

D. Vaccine/Prophylaxis. Smallpox vaccine (vaccinia virus) is a licensed live poxvirus vaccine that induces strong cross-protection against smallpox. Reliable data are sparse as to efficacy and durability of protection. The duration vaccinia induced immunity is at least 3 years. Vaccine immunity may prevent or modify illness. Fully immune individuals exposed to the virus by the respiratory route may develop fever, sore throat, and conjunctivitis ("contact fever") lasting several days. The vaccine is administered by dermal scarification or intradermal jet injection. The appearance of a vesicle or pustule within several days indicates that the vaccine will be effective. Other available countermeasures include the postexposure use of Vaccinia immune globulin or primary vaccination within 3-4 days of exposure yields some protection. 

VACCINIA IMMUNE GLOBULIN IV (HUMAN) (Vaccinia immune globulin intravenous (Human) solution for injection 50 mg/mL (immunoglobulin 2500 mg/vial))... 

Vaccinia immune globulin IV is a vaccinia-specific immunoglobulin G (IgG), which directly neutralizes vaccinia virus. It is indicated in treatment and/or modification of aberrant infections induced by vaccinia virus (including accidental implantation in eyes, mouth, or other areas where vaccinia infection would constitute a special hazard), eczema vaccinatum, progressive vaccinia, severe generalized vaccinia, and vaccinia infections in individuals who have skin conditions such as bums, impetigo, varicella-zoster, or poison ivy, or in individuals with eczematous skin lesions. Treat complications that include vaccinia keratitis with caution. 

Vaccinia Vaccinia immune globulin Treatment generalized, ocular, skin infections... 

It possesses prophylactic value against smallpox and alastrim. In conjunction with gamma globulin it shows its usefulness against eczema vaccinatum and vaccinia gangrenosa. 

Vaccinia-immune globulin (VIG) is of value in the treatment of progressive vaccinia, eczema vaccinatum,97 and perhaps ocular vaccinia (VIG is discussed below in the section titled Passive Immunoprophylaxis). Topical idoxuridine may benefit vaccinia keratitis.98 99... 

Evidence indicates that vaccinia-immune globulin is of value in postexposure prophylaxis of smallpox when given (a) within the first week following exposure and (b) concurrently with vaccination.121 However, the prophylactic use of VIG should be carefully weighed vis-a-vis the risk of attenuating the immune response to booster vaccination. 

Vaccinia vaccine remains the preeminent countermeasure for preexposure prophylaxis against smallpox. Vaccinia vaccination, vaccinia immune globulin, and methisazone each possess some efficacy in postexposure prophylaxis. 

Kempe CH, Bowles C, Meiklejohn G, et al. The use of vaccinia hyperimmune gamma-globulin in the prophylaxis of smallpox. Bull WHO. 1961 25 41-48. 

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