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Show Your Doctor Says... The tollomng is one of a irrrr of j articles written by members ot the Utah State Medical Association and Published in cooperation with local newspaper. These arl'dcs are scheduled to appear every oilier neck throughout the year in an effort to bcll-T acoitant you with Problems o hc-!ih, and designed to improve the ucll-betng o the people of Utah SMALLPOX VACCINATION This simple procedure, smallpox vaccination. h:is hud as profound en influence on the lives of people as any other single medical advance. ad-vance. Kefore the days of artificial im-rrv.initv im-rrv.initv to smallpox, whole communities com-munities were wipeu out by this dreaded disease. Commerce, industry, indus-try, religion, and social life were all interrupted at the outbreak of an epidemic. There was no known prevention or cure. Smallpox is caused by a tiny virus which has been isolated and can be seen with an electron microscope. mi-croscope. It is similar to cowpox virus in that each disease causes immunity to the other. Thus, if a person is Riven the disease "cow-pox", "cow-pox", which is a mild disease, the body produces a substance which protects it against smallpox. This :s exactly what occurred in the first smallpox vaccination. In 1774 a Dorsetshire farmer by the name of Benjamin Jesty used the method of vaccination to protect pro-tect his own family. He took material from a cowpox lesion and put it on the skin of the members of his family and, by injuring the skin in that area, allowed the cow-pox cow-pox virus to invade the skin and produce the mild lesion which caused the body to produce its protective substance which also protected njrainst smallpox. The credit for smallpox vaccination vaccina-tion poes to Dr, Edward Jenner. In 1TJ8 he proved conclusively to the medical profession that in- oculation of humans with the cow-pox cow-pox material produced immunity against smallpox. Since Dr. Jenner's time the Tnaterial used has been changed. We now use another virus called vaccinia virus which is closely related re-lated to cowpox and smallpox and also produces not only a mild disease, but also an immunity ajrninst the smallpox virus. The vaccination procedure is a painless one. The skin is first cleansed with acetone or ether. A drop of the vaccinia suspension is placed on the clean area and the operator then either makes a small scratch in the superficial layer of skin without drawing blood, or repeatedly presses the side of a needle point ajjainst the skin through the drop of fluid. Even thoujrh neither of the methods is painful, the top layer of skin cells is injured and thus allows the virus to enter the cells and produce the lesioa The time for the virus to penetnote the skin may be as lonR as twenty-four hours or more. Therefore, the skin should not be wet or washed for at least forty-eisrht forty-eisrht hours after the vaccination process. Following the procedure, there Is a dormant period of five to ten days during which no sign of reaction is evident. Then a small "pimple" appears which jrrows and lias an increasing area of redness ,'iround it. This rea halo may attain the size of a silver tldlaf ot ever, larger. The size of the "scab" i usually less than the size of a dime During the time the red area is present, the oatient mav (eel nc reaction. However., he usuallv run? a fever which mav tie as hich as lor to 104. He mav also have generalized symptoms similar tc those of the "flu" such as listless-ness. listless-ness. irritability, and general izea ache and pains and headache. These jymntoms may continue for three to four days. The redness ther disappears and the "scab" becomes hiird. dark, and dry. and usuallv drops off leaving a small faint wear about one-i,uarter inch in diameter. The "multiple pressure" technique described before, usually leaves a smaller scar than the "scratch" technique. The above reaction is the usual one und is called a "primary take." One may also have an accelerated or "vaceinoid" reaction. The dormant dor-mant stage is only about two days and the peak of the reaction is over in seven days. There are few. if any, symptoms and the immunity is as lasting as a "primary" take. This type reaction usually implies at least u partial immunity. It is found most often in patients who have had a previous vaccination. In some persons the vaccination produces no reaction. This does not necessar'ly mean the person is immune to smallpox. The vaccine vac-cine may have lost its potency, the skin may not havt been thoroughly cleaned, soillp may have been used on the area after vaccination, vac-cination, or the person may have a "resistance" to the virus prottin. These people should be revaccinated until a "take" is obtained. The length of immunity is variable vari-able and may be for life following a vaccination with a primary take. However, cases have occurred after five years following vaccination. Therefore, it is recommended that vaccinations be repeated at five-year five-year intervals. The best time for vaccination is usually during the first year of life, for several reasons: (1) the reaction symptoma are usually usual-ly less at this age, (2) encephalitis, one of the rare complications to smallpox vaccination, is almost unheard un-heard of at this age, and (3) the patient develops early immunity to the disease. Sometimes vaccinations should be delayed. This is true when the person has eczema or a similar disease, or where a member of the family has such a disease and is in close contact with the person being vaccinated. In these cases there is a chance for the vaccinia vac-cinia virus to get into the eczema lesions and produce multiple vaccinations vac-cinations at many sites. This is a serious condition and may be fatal. We cannot stress too strongly the importance of vaccination for most people. It is only through vaccination that the disease has been controlled to the point where, in our country, smallpox is a rarity. However, because it is so rare many of us are getting careless care-less and feel that, since the likelihood likeli-hood of exposure is small, we can forego the vaccination procedure. Such an attitude is a threat, not only to the unvaccinated person himself, but allows him to aid the continuance of the smallpox virus. For without a :usceptible host, the virus cannot survive. We cannot afford not to be vaccinated. Many states require by law that a person be vaccinated before he can attend school. If an epidemic were imminent, immi-nent, we would all be clamoring for a vaccination. What if it were not available T |
