关于现代天花接种的新的问题


  2002年10月17日─美国加州圣地牙哥美国家庭医学协会年会上,一名生物恐怖主义专家提到,尽管美国已经普遍接种天花一段很长的时间,但是考虑何者应当接种天花疫苗,和如何才能将并发症降到最低的问题,于是就产生新的问题和麻烦。
  
  因为天花疫苗为活病毒,因此它可藉由一些方法从疫苗中散布出来。早期美国进行天花接种,需要进行专门研究,而采取新的措施。另外,由于角膜接触镜的广泛使用,可以将病毒从接种部位传染到眼睛,而导致水晶体感染。并且,由于HIV感染升高,这显示在新人群中,有自接种部位接触将病毒扩散的风险。同样地,每日使用固定剂量的强体松是进行免疫接种的禁忌症。而要进行接种的人也不知道是否患有湿疹,因此他们有疫苗湿疹症的风险。
  
  不管这些问题将如何解决,家庭医生应当站在反对生物恐怖主义袭击的前线和领导位置。不仅是在前线,而且还是预防生物恐怖主义的最好防线,要做好预防新一代疾病的准备。家庭医生应当在公共卫生社区内建立联系,以获得相关的参考资料。
  
  
  
  

New Concerns About Modern Smal

By
Medscape Medical News

Oct. 17, 2002 (San Diego) — Although the practice of medicine has come a long way since the smallpox vaccine was given routinely in the U.S., new and troubling concerns have arisen regarding who should receive the smallpox vaccine and what recipients should do to minimize complications, a bioterrorism expert at the Annual Scientific Assembly of the American Academy of Family Physicians in San Diego, California, said Wednesday.

Because the smallpox vaccine uses a live virus, it may disseminate from the vaccination site in a number of ways. Some of these represent new practices since the earlier times of smallpox vaccination in the U.S. and need special consideration, according to. Jonathan L. Temte, MD, associate professor of family medicine, University of Wisconsin at Madison. "My concern is what happens to kids in day care," he told the packed audience at the assembly.

In addition, the widespread use of contact lenses could spread virus from the vaccination site to the eyes, resulting in ocular infection, Dr. Temte noted. And the rise of HIV infection presents a new population at risk of contracting disseminated disease from vaccination sites, he added. Similarly, the use of daily prednisone at certain doses may be a contraindication to vaccination, he pointed out. Furthermore, patients presenting for vaccination could be unsure of whether or not they have been diagnosed with eczema, and therefore would be at risk for eczema vaccinatum, Dr. Temte said.

Regardless of how these issues are solved, family physicians represent the leading edge of responders to a bioterrorism attack, he noted. "Not only are you the front line,...but also the best defense against bioterrorism," he said. "Be prepared for a new generation of diseases and disorders," Dr. Temte had recommended one year ago and reiterated Wednesday. He also suggested that family physicians establish a contact within the public health community and gather relevant reference material to be prepared.

AAFP Annual Scientific Assembly. Presented Oct. 16, 2002.

Reviewed by Gary D. Vogin, MD

    
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