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Case Report of Laboratory- Acquired Vaccinia Virus Infection in India Cas D'infection En Laboratoire Par Le Virus De La Vaccin

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Case Report of Laboratory- Acquired Vaccinia Virus Infection in India Cas D'infection En Laboratoire Par Le Virus De La Vaccin Case report of laboratory- Cas d’infection en laboratoire acquired vaccinia virus par le virus de la vaccine infection in India en Inde Renuka Nawadkar,a Ameet Dravid,b Umesh Paprunia,c Renuka Nawadkar,a Ameet Dravid,b Umesh Paprunia,c Rosamund Lewis,d Kazunobu Kojima,e Priya Abrahamf Rosamund Lewis,d Kazunobu Kojima,e Priya Abrahamf et and Arvind Sahua Arvind Sahua Introduction Introduction Various strains of vaccinia virus (VACV), Les vaccins qui ont été utilisés dans le monde a prototype of the genus Orthopoxvirus, entier pour éradiquer la variole contenaient were used around the world in vaccines to diverses souches du virus de la vaccine eradicate smallpox.1 The World Health (VACV), un prototype du genre Orthopoxvi- Assembly recommended termination of rus.1 Après l’éradication de la maladie en 1980, vaccination against smallpox after eradi- l’Assemblée mondiale de la Santé a recom- cation of the disease in 1980.2 mandé de mettre un terme à la vaccination antivariolique.2 During vaccination campaigns with Lors des campagnes de vaccination utilisant des vaccinia-based smallpox vaccines, the vaccins antivarioliques à base de virus de la virus was shown to infect domestic vaccine, il a été constaté que le virus infectait les animals, particularly dairy cattle.3 Over animaux domestiques, en particulier le bétail time, VACV evolved into buffalopox, laitier.3 Au fil du temps, le VACV a évolué pour which caused infections in both cattle aboutir au buffalopox (virus de la variole du and people.4 Brazil and India have buffle), lequel peut infecter aussi bien le bétail reported repeated outbreaks in dairy que l’homme.4 Le Brésil et l’Inde ont signalé des cattle that led to zoonotic infections in flambées répétées chez le bétail laitier, qui ont humans. VACV subspecies are known as conduit à des infections zoonotiques chez buffalopox in India5 and bovine vaccinia l’homme. Les sous-espèces concernées du VACV in Brazil.6 Other Orthopoxvirus infec- sont le buffalopox en Inde5 et la vaccine bovine tions reported in humans include au Brésil.6 Parmi les autres infections à Ortho- cowpox in Europe,7 a new strain of poxvirus notifiées chez l’homme figurent l’infec- Orthopoxvirus in Alaska (United States) tion à cowpox (variole de la vache) en Europe7, and monkeypox, an emerging zoonosis une nouvelle souche de virus en Alaska (Etats- 1 Fenner F, et al. Smallpox and its eradication, World Health 1 Fenner F, et al. Smallpox and its eradication, World Health Organiza- Organization, 1988, chapter 7, pp. 277–296 (https://apps.who. tion, 1988, chapter 7, pp. 277-296 (https://apps.who.int/iris/ int/iris/handle/10665/39485, accessed January 2021). handle/10665/39485, consulté en janvier 2021). 2 Resolution of the World Health Assembly. Global Smallpox 2 Résolution de l’Assemblée mondiale de la Santé. Éradication mon- Eradication. WHA resolution 33.4, 1980: https://www.who.int/ diale de la variole. Résolution WHA33.4, 1980: https://apps.who.int/ publications/i/item/WHA33-4. iris/handle/10665/191252 3 Marennikova S.S. et al. Vaccinia Virus. In: Orthopoxviruses 3 Marennikova S.S. et al. Vaccinia Virus. In: Orthopoxviruses Pathogenic Pathogenic for Humans, Springer, 2005. for Humans, Springer, 2005. 4 Eltom KH, et al. Buffalopox Virus: An Emerging Virus in Lives- 4 Eltom KH, et al. Buffalopox Virus: An Emerging Virus in Livestock and tock and Humans. Pathogens. 2020; 9(9):676. Humans. Pathogens. 2020; 9(9):676. 5 Gurav YK, et al. Buffalopox outbreak in humans and animals in 5 Gurav YK, et al. Buffalopox outbreak in humans and animals in Western Maharashtra, India. Preventive veterinary medicine Western Maharashtra, India. Preventive veterinary medicine 2011. 2011. 100(3–4):242–247. 100(3–4):242–247. 6 Lima MT et al. An Update on the Known Host Range of the 6 Lima MT et al. An Update on the Known Host Range of the Brazilian Brazilian Vaccinia Virus: An Outbreak in Buffalo Calves. Front Vaccinia Virus: An Outbreak in Buffalo Calves. Front Microbiol. 2019; Microbiol. 2019; 9:3327 9:3327 7 Andreani J, et al. Atypical Cowpox Virus Infection in Smallpox- 7 Andreani J, et al. Atypical Cowpox Virus Infection in Smallpox-Vacci- Vaccinated Patient, France. Emerging. Infectious Disease. nated Patient, France. Emerging. Infectious Disease. 2019. 2019. 25(2):212–219. 25(2):212–219. 33 in West and Central Africa,8, 9 which has been exported Unis) et l’orthopoxvirose simienne (monkeypox ou variole out of Africa on several occasions.10–16 These infec- du singe), une zoonose émergente en Afrique de l’Ouest et tions are a cause for concern, as there is almost no en Afrique centrale,8, 9 qui a été exportée d’Afrique à plusieurs remaining immunity globally17 and no treatment reprises.10–16 Ces infections sont préoccupantes car l’immu- protocol for such infections. nité de la population est désormais quasiment inexistante dans le monde17 et il n’existe aucun protocole thérapeutique pour ces infections. Human infection with VACV can be caused by zoonotic L’infection humaine par le VACV peut résulter d’une infection infections, as described above, or result from occupa- zoonotique, comme décrit ci-dessus, d’une exposition profes- tional exposure to infected laboratory animals18 or from sionnelle à des animaux de laboratoire infectés18 ou d’accidents laboratory accidents, such as needlestick injuries19 or de laboratoire, tels qu’une blessure par piqûre d’aiguille19 ou self-inoculation of mucous membranes.20 une auto-inoculation des muqueuses.20 We describe accidental exposure of an unvaccinated Le présent document rend compte de l’exposition accidentelle research student to vaccinia virus in a research labora- au virus de la vaccine d’une étudiante chercheuse non vaccinée tory. The student developed a lesion, which was surgi- dans un laboratoire de recherche. L’étudiante a développé une cally debrided and later treated with tecovirimat, a new lésion, qui a fait l’objet d’un débridement chirurgical, puis d’un antiviral agent.21 traitement par le técovirimat, un nouvel agent antiviral.21 Case report Rapport de cas In September 2020, a doctoral student aged in the 30s En septembre 2020, une doctorante âgée d’une trentaine d’an- was exposed occupationally to vaccinia virus in a nées a été exposée au virus de la vaccine sur son lieu de travail, biosafety level 2 (BSL-2) laboratory. The student had not dans un laboratoire de sécurité biologique de niveau 2. Elle been vaccinated against smallpox, as no vaccine is avail- n’avait pas été vaccinée contre la variole, le vaccin n’étant pas able in India. The student had been handling the repli- disponible en Inde. L’étudiante manipulait la souche Western cation-competent Western Reserve strain of VACV Reserve du VACV, apte à la réplication, dans une enceinte de inside a class II, type A2 biosafety cabinet wearing the biosécurité de classe II, type A2, en portant l’équipement de following personal protective equipment: a laboratory protection individuelle suivant: une blouse de laboratoire, coat, 2 pairs of latex gloves, closed-toe shoes and a 2 paires de gants en latex, des chaussures fermées et un respi- powered air-purifying respirator. The incident occurred rateur à adduction d’air filtré. L’incident s’est produit tandis during homogenization of VACV-infected cells in qu’elle procédait à l’homogénéisation de cellules infectées par a Dounce glass homogenizer, which broke and pene- le VACV dans un homogénéisateur en verre de type Dounce, trated the 2 layers of latex, making a small cut on the qui s’est brisé et a perforé les 2 couches de latex, entraînant left thumb. The student immediately cleaned the cut une petite coupure sur son pouce gauche. L’étudiante a immé- 8 Monkeypox – Democratic Republic of the Congo. Disease outbreak news (https:// 8 Orthopoxvirose simienne – République démocratique du Congo. Bulletin d’information sur les www.who.int/csr/don/01-october-2020-monkeypox-drc/en/, accessed January flambées épidémiques (https://www.who.int/csr/don/01-october-2020-monkeypox-drc/fr/, 2020). consulté en janvier 2020). 9 Simpson K, et al. Human monkeypox – After 40 years, an unintended consequence 9 Simpson K, et al. Human monkeypox – After 40 years, an unintended consequence of smallpox of smallpox eradication. Vaccine. 2020. 38(33):5077–5081. eradication. Vaccine. 2020. 38(33):5077–5081. 10 Di Giulio DB, et al. Human monkeypox: an emerging zoonosis. Lancet Infectious 10 Di Giulio DB, et al. Human monkeypox: an emerging zoonosis. Lancet Infectious Diseases. 2004. Diseases. 2004. 4(1):15–25. 4(1):15–25. 11 Reynolds MG, et al. Spectrum of infection and risk factors for human monkeypox, 11 Reynolds MG, et al. Spectrum of infection and risk factors for human monkeypox, United States, United States, 2003. Emerging Infectious Disease. 2007. 13(9):1332–1339. 2003. Emerging Infectious Disease. 2007. 13(9):1332–1339. 12 Vaughan A, et al. Human-to-Human Transmission of Monkeypox Virus, United 12 Vaughan A, et al. Human-to-Human Transmission of Monkeypox Virus, United Kingdom, October Kingdom, October 2018. Emerging Infectious Disease, 2020. 26(4):782–785. 2018. Emerging Infectious Disease, 2020. 26(4):782–785. 13 Erez N, et al. Diagnosis of Imported Monkeypox, Israel, 2018, Emerging Infectious 13 Erez N, et al. Diagnosis of Imported Monkeypox, Israel, 2018, Emerging Infectious Disease Disease 2019. 25(5):980–983. 2019. 25(5):980–983. 14 Yong SEF, et al. Imported Monkeypox, Singapore. Emerging Infectious Disease, 14 Yong SEF, et al. Imported Monkeypox, Singapore. Emerging Infectious Disease, 2020. 26(8): 2020. 26(8): 1826–1830. 1826–1830. 15 Beer EM, et al. A systematic review of the epidemiology of human monkeypox 15 Beer EM, et al.
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