Unusual Responses to Smallpox Vaccinations in Two Children
Since it appears that no case of lymphatic transfer of smallpox vaccine to new areas with resultant primary takes or of excessive hair growth around the periphery of a recently healed smallpox scar has been described in the medical literature, it seems important to report one infant with the former, and another with the latter, condition. Case 1 F.S., a 3-week-old white male infant, received a smallpox vaccination on the right deltoid area, June 3, 1956 at Kern County Health Department, Bakersfield, California. On June 15, an enlarged lymph node (about 1.5 cm in diameter) appeared in the right axilla. Although somewhat tender on June 15 and 16, the swollen node was barely palpable on June 17. On June 16, an elevated erythematous "ridge" extended from the right deltoid vaccination site to the elbow. On June 17, the erythematous area had extended to the dorsum of the hand, about 1 cm below the wrist. Immediately below the termination of the "ridge" a small yellow vesicle had formed, after which the entire erythematous area disappeared. Subsequently, an elevated erythematous area extended from the vesicle to the end of the distal phalanx of the third right finger. On June 19, a yellow vesicle formed on the indicated finger immediately below the termination of the erythematous area. Shortly after the formation of the second vesicle, the erythematous "ridge" spontaneously disappeared. The vesicles underwent desiccation, umbilication, and scab formation. The scabs thereafter separated, leaving the typical pitted smallpox scar. (Except for the tiny needle pricks related to the original inoculation, there was no change in the deltoid vaccination site.)