Wayne L. Greaves

Streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination.

Abscesses developed in seven children who received diphtheria-tetanus toxoid-pertussis vaccine at a clinic in Indiana. Epidemiologic investigation revealed that all seven children had received vaccine from the same multidose vial and had been vaccinated by the same nurse at the office of one physician. Group A beta-hemolytic Streptococcus was isolated from abscesses in six of the seven children. No source was identified as the cause of this cluster of abscesses. Vaccine of the same lot number used elsewhere was not associated with the development of abscesses. It appears that the vaccine became contaminated during use.

Pneumococcal bacteremia in adults: differences between patients with and without human immunodeficiency virus infection

Abstract Objective: To determine the differences between human immunodeficiency virus (HIV)-infected and non-HIV-infected patients with pneumococcal bacteremia. Methods: The demographics, clinical findings, and hospital course of 194 adult cases of pneumococcal bacteremia were retrospectively reviewed. Results: All but six patients were African-American and 41 had HIV infection. The HIV-infected patients were younger (37 vs. 51 years, P Conclusions: The overall hospital course of HIV-infected patients with pneumococcal bacteremia is similar to that of non-HIV-infected patients, despite some clinical differences.

Fetal Risk Associated with Rubella Vaccine

Ninety-four susceptible women received either Cendehill or HPV-77 rubella vaccine. All gave birth to healthy infants. Seventeen susceptible women received the RA 27/3 vaccine. All their infants were free of abnormalities compatible with congenital rubella, as were 54 born to mothers of unknown immune status at the time of RA 27/3 vaccination and those later found to be immune. An additional susceptible woman received an unknown strain of vaccine; she also had a healthy infant. The risk of severe congenital malformations after rubella vaccination is low. In our 112 cases, the maximum risk was approximately 3%. Concern about the potential adverse effects of rubella vaccine on the fetus should not interfere with vaccination of women of childbearing age. However, since the actual risk may not be zero, women known to be pregnant should not be vaccinated, and conception should be avoided for three months after vaccination.