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Correspondence
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Volume 339:2027-2028 December 31, 1998 Number 27
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Poxvirus Dilemmas

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 by Breman, J. G.
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To the Editor: In their Sounding Board article, Breman and Henderson (Aug. 20 issue)1 promote a traditional, decades-old "contain and vaccinate" strategy of controlling smallpox that requires refinement to remain viable. The human immunodeficiency virus (HIV) emerged after the eradication of smallpox and poses new ethical and operational challenges to the control of poxviruses. Although vaccination against smallpox will preserve public health during an outbreak, it may cause fatal side effects in the HIV-infected population. A high rate of severe vaccine-related complications (generalized and progressive vaccinia and eczema vaccinatum) will make emergency control of poxviruses in regions with a high . . . [Full Text of this Article]

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