Toddler improving on experimental smallpox drug

By Julie Steenhuysen

CHICAGO (Reuters) - An experimental pill appears to be helping a toddler who had a near-fatal skin reaction to his father's smallpox shot, doctors said on Monday.

The drug, an antiviral made by Siga Technologies called ST-246, worked when more conventional treatment failed, the doctors said.

The 2-year-old, still in critical condition at the University of Chicago's Comer Children's Hospital, developed the rare serious reaction called eczema vaccinatum after being with his father, a soldier vaccinated for deployment in Iraq.

"He's making slow improvement every day. He's still in the pediatric intensive care unit," said Dr. John Marcinak, pediatric infectious disease specialist at the hospital.

Marcinak said the rash now consumes 80 percent of the child's body. "He's lost a lot of the superficial areas of his skin called the epidermis. There is still a lot of healing that needs to be done," he said.

The child, from Indiana, was admitted to the hospital on March 3, and the U.S. Centers for Disease Control and Prevention confirmed he was infected with the virus used in the smallpox vaccine.

Smallpox vaccines do not use the smallpox virus, but instead use a related virus called vaccinia that is weakened but can still infect some people.

The child was given an intravenous form of vaccinia immune globulin -- developed in the 1960s to treat complications of smallpox vaccinations. He also received a treatment of the antiviral drug cidofovir, made by Gilead Sciences Inc.

But he was still failing. His mother also had a rash but was not ill and his father reported no adverse reaction.

By then, Marcinak and his team were having daily conference calls with the CDC, health departments, the Department of Defense and the National Institutes of Health. During one, the CDC suggested the hospital try the experimental drug.

The drug has helped monkeys infected with smallpox, but its effectiveness has not been proven in humans.

Seeing the drug used in an infected patient presents a rare opportunity for Siga. For ethical reasons, the drug can only be tested in healthy volunteers.

"I think we can feel reasonably confident ... that this drug is contributing to the child's recovery," Siga Chief Executive Dr. Eric Rose said in a telephone interview.

The child's case is the first report of eczema vaccinatum since vaccination against smallpox resumed in 2002, CDC pox virus expert Dr. Inger Damon said. She said he may already have had eczema -- which makes patients especially vulnerable to the serious reaction.

The smallpox virus once killed 30 percent of its victims, and disfigured many others. A global vaccination campaign eradicated the disease in 1979.