Vaccination complications
Introduction
Introduction to vaccinia complications The abnormal reaction on the skin mucosa after inoculation of the attenuated pox virus vaccine is called vaccinia complication. The vaccination is the method of obtaining immunity against smallpox by inoculation of vaccinia vaccine. The vaccinia virus is a long-term and complicated vaccinia virus. An artificially attenuated strain obtained by subculture is only caused by local pox rash and does not cause the occurrence of smallpox. Vaccination is a fundamental measure to prevent smallpox. In the countries of the world, the vaccination system of vaccinia has been implemented. Infants are given primary seeds at 6 to 8 months of age, and once every 5 to 6 years. In addition, for entry and exit airports, seaports, border customs staff, cross-border transportation personnel, overseas personnel, infectious diseases and epidemic prevention staff should also arrange for multiple cropping, and once every 2 to 3 years, the global vaccinia The system enabled human society to finally declare the eradication of smallpox in 1980. Since then, according to the recommendations of the WHO, countries have successively stopped the implementation of vaccinia. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: myelitis peripheral neuritis arthritis splenomegaly thrombocytopenic purpura sepsis
Cause
Etiology of vaccinia complications
(1) Causes of the disease
Generally, it can be classified into the following four types: rash caused by vaccinia virus; allergic rash caused by protein in vaccinia; acne combined with bacterial infection; acne causes or exacerbates other skin diseases.
(two) pathogenesis
Secondary acne rash caused by inadvertent or misplaced acne vaccine on normal skin or mucous membranes, vaccination caused by vaccination of vaccinia on the original skin disease due to scratching, etc., such as genetic allergies occurring in infancy Vaccinia-like eczema on eczema, which occurs several days after vaccination, is characterized by skin necrosis at the inoculation site.
Generalized vaccinia, vaccination within a few days to 2 weeks after vaccination, the body spreads rash, from papules to blisters and pustules, into a wholesale, from several to dozens, oral mucosa can also be involved, With fever, it healed in about 3 weeks. The pathogenesis is that the time to form specific antibodies in patients after vaccination is relatively slow (about 1 week for normal people), and the vaccinated virus is spread by blood.
Prevention
Vaccination prevention
Sterile operation is required for vaccination, the inoculation site should be kept clean, avoid scratching, vaccination should not splash into the eyes, mouth or contaminate the skin of other places, pay attention to the lot number of the vaccinia, and the batch number with more reaction should be stopped, and avoid the vaccination when the following conditions occur. :
1. Those with eczema or allergic constitution, or other skin diseases such as neurodermatitis, pyoderma, chickenpox, rash disease, herpes simplex, etc.
2. Immunodeficiency such as physiological hypogammaglobulinemia, abnormal gamma globulinemia, malignant tumors, temporary or permanent immune damage caused by any disease, and hormone and immunosuppressive therapy.
3. Neurological diseases such as convulsions, stroke, family history of encephalitis after vaccination, and any chronic, resting or progressive neurological disease.
4. Acute febrile illness and beta-hemolytic streptococcal infection.
5. The initial breeding of pregnant women, especially within 3 months of pregnancy, can cause fatal generalized vaccinia in the fetus, so it is contraindicated during the first trimester.
Complication
Vaccination complications Complications myelitis peripheral neuritis arthritis splenomegaly thrombocytopenic purpura sepsis
Vaccination with vaccinia can cause encephalitis, myelitis, peripheral neuritis, arthritis, splenomegaly, generalized lymphadenopathy, thrombocytopenic purpura, etc., gangrenous vaccinia, often died of concurrent sepsis.
Symptom
Symptoms of acne complications Common symptoms Spotted acne pimples pustular herpes herpes hyperthermia necrotic skin necrosis
1. Vaccinia virus causes rash
(1) secondary acne rash: acne caused by inadvertent or misplaced acne on normal skin or mucous membranes, such as acne splashing into the cornea, can affect vision after vision, and even cause blindness; also visible in the lips, tongue and Other parts of the skin, sometimes secondary to the initial part of the area, arranged in a satellite shape, from single to dozens, most of them disappear within 2 weeks, rarely more than 1 month.
(2) Vaccination caused by inoculation of vaccinia on the original skin disease due to scratching, etc., such as vaccinia-like eczema on hereditary allergic eczema in infancy, also occurs in other skin diseases such as seborrheic dermatitis, vulva In the case of pruritus, toilet dermatitis and other skin lesions, these patients have low or no immunity to vaccinia virus, usually in infants and young children who have not planted vaccinia, or have been acne, but separated for a long time. Adults whose immunity has disappeared in whole or in part; there are also rashes caused by inhalation or close contact, inoculation on their own or other normal skin.
(3) gangrenous vaccinia: a few days after vaccination, manifested as skin necrosis at the inoculation site, gangrenous lesions gradually progressively expand to the periphery, forming a gray-white necrotic tissue composed of thick-walled vesicles and pustules with umbilical concavities Or ulcers, sometimes in other distant parts of the migration acne, accompanied by high fever, often due to concurrent sepsis and death, this type of vaccinia is due to the determination of gamma globulin in the blood of patients is normal, but because of the quality Defects, can not form enough anti-vaccinia virus specific antibodies, so the ability to resist infection is very poor, clinically, the acne is progressively enlarged, tissue necrosis, or the virus enters the bloodstream to cause migratory lesions, others believe that gangrenous vaccinia In addition to the problem of the formation of humoral antibodies, there are also cellular immune problems, and only if both are completely impeded, can such serious complications be caused.
(4) Generalized vaccinia: morbidity within a few days to 2 weeks after vaccination, the body is scattered with rash, from papules to blisters and pustules, wholesale, from several to dozens, oral mucosa Involved, may be associated with fever, recovered in about 3 weeks, the pathogenesis is due to the slower time to form specific antibodies in patients after vaccination (normal people about 1 week), the vaccinated virus spreads through the blood, and later with the body Gradually produce specific antibodies, which can gradually heal.
2. Protein in vaccinia causes allergic rash:
This group of rash is more common in multiple cases, the most common type is polymorphic erythema, which is characterized by mung bean to soybean rash, papules, blisters and even bullae, with edema, central micro-depression, reddish to dark red, distribution The face and the distal extremities are mainly accompanied by fever, and healed in 2 to 3 weeks. The performance of rose rash often occurs 8 to 9 days after inoculation. From the periphery of the vaccination site, it immediately spreads to the whole body, and the basic damage is spotted. With edema, red rose, scattered or fused into a piece, accompanied by fever, 3 to 5 days subsided, other measles-like, scarlet fever, urticaria, sable and other rash.
3. Vaccination with bacterial infection :
Such as impetigo, sputum, cellulitis, lymphangitis, occasionally lupus erythematosus, bacteria from the inoculation of the skin wound into the body caused.
4. Vaccination causes or exacerbates other skin diseases:
It has been reported that bullous skin diseases such as pemphigus, herpetic dermatitis, eczema or psoriasis occur several weeks after vaccination, and patients with existing eczema, psoriasis or pemphigus may be intensified after vaccination.
Examine
Examination of acne complications
Check the items in accordance with the actual situation of the patient.
Diagnosis
Diagnosis and differentiation of vaccinia complications
Generally not confused with other diseases.
