Rare Case of Fatal Yellow Fever Vaccine-associated Viscerotropic Disease

This report describes a case of yellow fever vaccine associated viscerotropic disease (YEL-AVD) that occurred after vaccination in a 22-year-old female. Our patient presented with a clinical syndrome of fever, headache, nausea, and vomiting, which quickly progressed to multiorgan failure and ultimat...

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Bibliographic Details
Main Authors: Gerasimon, Gregg, Lowry, Kristie
Format: Report
Language:English
Subjects:
Anatomy and Physiology
ANTIBIOTICS
BLOOD COAGULATION
DEATH
DIARRHEA
DIC(DISSEMINATED INTRAVASCULAR COAGULATION)
EMESIS
FAILURE
FLAVIVIRIDAE
HEADACHES
HEMOLYTIC
INFLAMMATION
Medicine and Medical Research
Microbiology
MULTIORGAN SYSTEM FAILURE
MYALGIAS
NAUSEA
PATIENTS
REPRINTS
RIBONUCLEIC ACIDS
T LYMPHOCYTES
TOXIC DISEASES
VACCINES
YELLOW FEVER
YELLOW FEVER VACCINE ASSOCIATED VISCEROTROPIC DISEASES
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Summary:This report describes a case of yellow fever vaccine associated viscerotropic disease (YEL-AVD) that occurred after vaccination in a 22-year-old female. Our patient presented with a clinical syndrome of fever, headache, nausea, and vomiting, which quickly progressed to multiorgan failure and ultimately death on hospital day 4. YEL-AVD is an extremely rare condition reported only a few times in the literature. The yellow fever vaccine is a known stimulus of systemic inflammation in the body. A mild subclinical viremia develops, which results in a persistent and robust T-helper-cell-dependent antibody response with long-lasting immune protection. The very rare patient may have an aberrant response to the I7D vaccine strain, causing the multiple organ system failure seen in YEL-AVD. Predisposing host factors that contribute to YEL-AVD are not yet known. Treatment for YEL-AVD is supportive. To the authors' knowledge, this patient was the first to have YEL-AVD as a result of standard US military vaccination protocols. Pub. in Southern Medical Journal, v98 n6, p653-656, Jun 2005.