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December 23, 1950

TULAREMIA PROPHYLAXIS

JAMA. 1950;144(17):1468. doi:10.1001/jama.1950.02920170048015
Abstract

Reports of tularemia among laboratory workers have indicated a high incidence of infection due to Pasteurella tularensis approaching 100 per cent.1 To avoid this danger prophylactic vaccination has been suggested.2 The efficiency of such vaccination has been tested by Foshay3 and associates of Camp Detrick, Maryland.

Two vaccines were tested: (a) a phenolized broth culture of P. tularensis and (b) an acetone-extracted vaccine of the same organism. In a preliminary test 0.5 cc. of one vaccine was given subcutaneously to 15 unselected subjects. Three suffered severe systemic reactions necessitating hospitalization. Subsequent study of serums drawn from them before vaccination showed that all three had circulating agglutinins for P. tularensis. All had been exposed to possible tularemia infection in the past.

In order to prevent additional severe reactions, prevaccination skin reactions and agglutinin titers were determined for each prospective subject. Those with positive skin reactions and high agglutinin

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