Smallpox vaccination and myopericarditis: a clinical review.

摘要: Smallpox is a devastating viral illness that was eradicated after an aggressive, widespread vaccination campaign. Routine U.S. childhood vaccinations ended in 1972, and routine military 1990. Recently, the threat of bioterrorist use smallpox has revived need for vaccination. Over 450,000 personnel received between December 2002 June 2003, with rates non-cardiac complications at or below historical levels. The rate cardiac complications, however, been higher than expected, two confirmed cases over 50 probable myopericarditis reported to Department Defense Vaccination Program. practicing physician should history physical, electrocardiogram, biomarkers initial evaluation post-vaccination patient chest pain. Echocardiogram, catheterization, magnetic resonance imaging, nuclear biopsy may be further workup. Treatment non-steroidal anti-inflammatory agents, four six weeks limited exertion, conventional heart failure treatment as necessary. Immune suppressant therapy steroids uniquely beneficial related vaccination, compared other types myopericarditis. If program undertaken future, many more post-vaccinial could seen. Practicing physicians aware vaccine-associated real entity, symptoms appropriately evaluated, treated if necessary, Vaccine Adverse Events Reporting System.