Human Infection Due to Recombinant Vaccinia–Rabies Glycoprotein Virus

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Abstract
Rabies is a fatal viral disease transmitted from animals to humans. It causes more than 35,000 human deaths per year.1 Successful application of veterinary vaccines can eliminate canine rabies in an area, but control of rabies in free-ranging carnivores requires other strategies, such as oral vaccination.2 Live viral vaccines containing modified live rabies or recombinant vaccinia–rabies glycoprotein virus, placed in a bait, are used for disease control in Europe and North America.2-5 In the United States, more than 22 million doses of vaccinia–rabies glycoprotein vaccine were distributed from 1990 to 2000, mainly to control rabies in raccoons in the eastern states and in foxes and coyotes in Texas.6-8 Despite contact with bait containing vaccinia–rabies glycoprotein vaccine by nontarget species, including domestic animals and humans, no substantial adverse health effects of the vaccine were reported, and no lesions related to infection with vaccinia–rabies glycoprotein virus were detected in a wide variety of immunocompetent species.9,10 We have now documented an infection with the vaccinia–rabies glycoprotein virus after transdermal exposure in a woman with a chronic skin condition.