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- Title
Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017-2018.
- Authors
Freitas Ribeiro, Ana; Fukelmann Guedes, Bruno; Sulleiman, Jamal M. A. H.; Meneses de Oliveira, Francisco Tomaz; Marcilio de Souza, Izabel Oliva; Silva Nogueira, Juliana; Nascimento Marcusso, Rosa Maria; Fernandes, Eder Gatti; Sciascia do Olival, Guilherme; Fonseca Moreira de Figueiredo, Pedro Henrique; Rocha Veiga, Ana Paula; Esper Dahy, Flávia; Nasser Ximenes, Natália; Figueira Pinto, Lecio; Ernesto Vidal, José; Penalva de Oliveira, Augusto Cesar; Ribeiro, Ana Freitas; Guedes, Bruno Fukelmann; de Oliveira, Francisco Tomaz Meneses; de Souza, Izabel Oliva Marcilio
- Abstract
Yellow fever (YF) vaccine can cause neurologic complications. We examined YF vaccine–associated neurologic disease reported from 3 tertiary referral centers in São Paulo, Brazil, during 2017–2018 and compared the performance of criteria established by the Yellow Fever Vaccine Working Group/Centers for Disease Control and Prevention and the Brighton Collaboration. Among 50 patients who met inclusion criteria, 32 had meningoencephalitis (14 with reactive YF IgM in cerebrospinal fluid), 2 died, and 1 may have transmitted infection to an infant through breast milk. Of 7 cases of autoimmune neurologic disease after YF vaccination, 2 were acute disseminated encephalomyelitis, 2 myelitis, and 3 Guillain-Barré syndrome. Neurologic disease can follow fractional vaccine doses, and novel potential vaccine-associated syndromes include autoimmune encephalitis, opsoclonus-myoclonus-ataxia syndrome, optic neuritis, and ataxia. Although the Brighton Collaboration criteria lack direct vaccine causal assessment, they are more inclusive than the Centers for Disease Control and Prevention criteria.
- Subjects
SAO Paulo (Brazil); CENTERS for Disease Control &; Prevention (U.S.); NEUROLOGICAL disorders; YELLOW fever; NEUROMYELITIS optica; POSTVACCINAL encephalitis; OPTIC neuritis; GUILLAIN-Barre syndrome; VACCINATION
- Publication
Emerging Infectious Diseases, 2021, Vol 27, Issue 6, p1577
- ISSN
1080-6040
- Publication type
journal article
- DOI
10.3201/eid2706.204170