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Breast-fed infants living in close contact with smallpox vaccinees are at risk for contact vaccinia, even if the vaccinee is not the breast-feeding mother, according to a case report.
Physicians at the Madigan Army Medical Center in Tacoma, Wash., have reported the first documented case of inadvertent contact vaccinia transmission from mother to infant through direct skin-to-skin and skin-to-mucous membrane contact while breast-feeding. In this case, the infant's mother had not been vaccinated for smallpox but her husband received the vaccine before the baby developed symptoms (JAMA 291[6]:725-27, 2004).
Approximately 10 days after the father was inoculated, …