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UNITED STATES PUBLIC HEALTH SERVICE
CONTAINING INFORMATION OF THE CURRENT
OF EPIDEMICS, AND RELATED SUBJECTS
VOLUME 38-PART 1
By II. E. HASSELTINE, Surgeon, United States Public Health Service; Director, Leprosy Investigation
Station, Honolulu, IIawaii.
It has been reported that vaccination of lepers is followed by a more or less acute outbreak of leprous manifestations. The following account of the vaccination of a number of lepers in the Kalihi Hospital apparently confirms this report.
At the time when these vaccinations were begun there were 219 patients, including suspects, in the hospital. Examination of these patients showed that 163 had vaccination scars, 49 had no vaccination scars, and 7 6 Filipinos, 1 Portuguese) had had smallpox. The number showing evidence of previous vaccination was much greater than was anticipated.
Before the virus for the vaccinations arrived, 20 patients had been paroled, 4 of these having no scars, thereby reducing the number having no evidence of previous vaccination to 45. Twenty-seven of these were vaccinated on August 23. The remaining 18 served as controls; though one case should not be considered, as she was showing an acute leprous outbreak at the time.
The type of the 27 cases vaccinated is recorded as follows: Nodular, 16; anesthetic, 4; mixed, 7. Vaccination was successful in 19 cases (9 nodular, 4 anesthetic, 6 mixed) and unsuccessful in 8 cases (7 nodular, 1 mixed). In the cases unsuccessfully vaccinated no evidence of any change of the leprous lesions was noted. Of the 19 successfully vaccinated cases, 11 (6 nodular, 5 mixed) developed acute leprous eruptions in the two weeks following date of vaccination. Eight (3 nodular, 4 anesthetic, 1 mixed) showed no evidence of any increased activity of their leprosy.
In character the eruption seen in these cases was like that seen at variable intervals in the course of leprosy under treatment. It consisted of a red, infiltrated rash, frequently beginning as small areas and then growing larger, sometimes coalescing to involve large areas. When it first appeared, the lesions were very painful under pressure. As the eruption progressed, the color, a bright red at first, changed
1 Denney, Oswald E., and Hopkins, Ralph: Specific Leprous Reactions and Abnormal Vaccinia Induced in Lepers by Smallpox Vaccination. Public Health Reports, Vol. 37, No. 51, Dec. 22, 1922, pp, 3141-3149. Reprint No. 805. 243969--23—1