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Volume 17, Number 10—October 2011
Dispatch

Yellow Fever Virus Vaccine–associated Deaths in Young Women1

Stephen J. SeligmanComments to Author 
Author affiliation: New York Medical College, Valhalla, New York, USA

Main Article

Table

Characteristics of fatal yellow fever vaccine–associated viscerotropic disease in women of childbearing age who had no known immunologic defects*

Age, y Country Year Vaccine Days after vaccination
Possible predisposing factors Virus detection Neutralizing antibody test results Reference
Onset Death
19 Brazil 2001 17DD† 2 10 None known + RT-PCR liver and spleen (12)
22 United States 2002 17D-204 YF-Vax‡ 2 10 None known YF viral antigen in multiple organs, i.e., liver, lungs, brain, heart, spleen, kidney, lymph nodes (7)
22 United States 2005 17D-204 YF-Vax‡ 2 11 See text for postmortem description of thymus Plasma virus 1.1 × 105 PFU/mL 2,560, day 10 (9)
22 Brazil 2000 17DD† 4 11 Hepatitis A and nephritis as a child + Culture IgM + (2)
23 Peru 2007 17DD† 1 9 Acne rosacea Viral RNA lung 7.6 × 106 and serum 3.9 × 106 PFU equivalents/mL 160 (by PRNT), day 9 (10)
Young adult § Brazil 1975 17DD† 5 9 None known + Culture Table 36-30 in (11), (13)
24 Peru 2007 17DD† <1 14 Egg allergy Viral RNA liver 1.1 × 104 and brain 4.2 × 103 PFU equivalents/mL 10,240 (by PRNT), day 11 (10)
26 Spain 2004 17D-204¶ 4 10 None known + Culture liver, kidney, plasma; real-time PCR liver 6.2 × 109 genome equivalents/g 512 (by microneutralization assay), day 8 (8)
34 Brazil 2009 17DD† 1 11 None known RT-PCR + d 10 #

*+, positive test result; RT-PCR, reverse transcription PCR; YF, yellow fever; Ig, immunoglobulin; PRNT, plaque-reduction neutralization test. Blank cells indicate information is not in the reference cited.
†Bio-Manguinhos, Rio de Janeiro, Brazil.
‡Sanofi Pasteur, Swiftwater, PA, USA.
§The age of this patient is not known, but she was a young woman (P. Vasconcelos, pers. comm.).
¶Stamaril, Sanofi Pasteur, Lyon, France.
#R. Menezes-Martins, pers. comm.

*+, positive test result; RT-PCR, reverse transcription PCR; YF, yellow fever; Ig, immunoglobulin; PRNT, plaque-reduction neutralization test. Blank cells indicate information is not in the reference cited.
†Bio-Manguinhos, Rio de Janeiro, Brazil.
‡Sanofi Pasteur, Swiftwater, PA, USA.
§The age of this patient is not known, but she was a young woman (P. Vasconcelos, pers. comm.).
¶Stamaril, Sanofi Pasteur, Lyon, France.
#R. Menezes-Martins, pers. comm.

Main Article

References
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  2. Vasconcelos  PF, Luna  EJ, Galler  R, Silva  LJ, Coimbra  TL, Barros  VL, Serious adverse events associated with yellow fever 17DD vaccine in Brazil: a report of two cases. Lancet. 2001;358:917. DOIPubMed
  3. Chan  RC, Penney  DJ, Little  D, Carter  IW, Roberts  JA, Rawlinson  WD. Hepatitis and death following vaccination with 17D–204 yellow fever vaccine. Lancet. 2001;358:1212. DOIPubMed
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Main Article

1Data previously presented at a National Institutes of Health–supported Northeast Biodefense Center conference, New Paltz, New York, USA, November 2, 2010.

Page created: September 23, 2011
Page updated: September 23, 2011
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