Postexposure prevention of progressive vaccinia in SCID mice treated with vaccinia immune globulin.

A recently reported case of progressive vaccinia (PV) in an immunocompromised patient has refocused attention on this condition. Uniformly fatal prior to the licensure of vaccinia immune globulin (VIG) in 1978, PV was still fatal in about half of VIG-treated patients overall, with a greater mortality rate in infants and children. Additional therapies would be needed in the setting of a smallpox bioterror event, since mass vaccination following any variola virus release would inevitably result in exposure of immunocompromised people through vaccination or contact with vaccinees. Well-characterized animal models of disease can support the licensure of new products when human studies are not ethical or feasible, as in the case of PV. We chose vaccinia virus-scarified SCID mice to model PV. As in immunocompromised humans, vaccinia virus-scarified SCID animals develop enlarging primary lesions with minimal or no inflammation, eventual distal virus spread, and lethal outcomes if left untreated. Postexposure treatment with VIG slowed disease progression, caused local lesion regression, and resulted in the healthy survival of most of the mice for more than 120 days. Combination treatment with VIG and topical cidofovir also resulted in long-term disease-free survival of most of the animals, even when initiated 7 days postinfection. These results support the possibility that combination treatments may be effective in humans and support using this SCID model of PV to test new antibody therapies and combination therapies and to provide further insights into the pathogenesis and treatment of PV.

Clinical disease in kittens inoculated with a pathogenic strain of Bartonella henselae.

OBJECTIVE: To evaluate disease in kittens inoculated with Bartonella henselae strain LSU16. ANIMALS: Eighteen 12-week-old specific-pathogen-free kittens. PROCEDURE: Kittens were inoculated with B henselae strain LSU16 or saline (0.9% NaCl) solution. Blood samples were collected from kittens on alternate weeks, and bacteremia, clinical signs, and antibody concentrations were monitored for 6 months after inoculation. RESULTS: Kittens developed raised, erythematous areas at the site of inoculation within 72 hours. Swelling peaked at 14 days and resolved by 28 days after inoculation. Fever had a biphasic pattern, with an episode of 1- to 3-days' duration beginning 6 to 7 days after inoculation followed by an episode of 3- to 8-days' duration beginning 11 to 13 days after inoculation. Kittens were bacteremic by day 14 with peak bacteremia at days 14 to 28. Strong antibody responses to B henselae were detected. Clinical disease resolved before bacteremia became undetectable, but signs of disease correlated with the highest degree of bacteremia. Regional lymphadenopathy also was evident. CONCLUSION AND CLINICAL RELEVANCE: Clinical disease in kittens was similar to that in adult cats infected with B henselae strain LSU16, except that lethargy and anorexia were less severe in kittens, and a biphasic pattern of fever was detected in kittens. Clinical disease after inoculation with B henselae may be strain-dependent. To limit transmission of Bartonella organisms, appropriate flea prevention should be instituted. IMPACT FOR HUMAN MEDICINE: Kittens that are febrile, anorectic, lethargic, and that have lymphadenopathy should be tested for Bartonella organisms, and contact with immunocompromised owners should be discouraged.