Intrathecal antibody production in two cases of yellow fever vaccine associated neurotropic disease in Argentina (pages 2208–2212)

摘要

During the period 2007–2008 several epizooticsnof Yellow fever with dead of monkeys occurrednin southeastern Brasil, Paraguay, and northeasternnArgentina. In 2008 after a Yellow fevernoutbreak an exhaustive prevention campaignntook place in Argentina using 17D live attenuatednYellow fever vaccine. This vaccine is considerednone of the safest live virus vaccines,nalthough serious adverse reactions may occurnafter vaccination, and vaccine-associated neurotropicndisease are reported rarely. The aim ofnthis study was to confirm two serious adversenevents associated to Yellow fever vaccine innArgentina, and to describe the analysis performednto assess the origin of specific IgMnagainst Yellow fever virus (YFV) in cerebrospinalnfluid (CSF). Both cases coincided with thenYellow fever vaccine-associated neurotropicndisease case definition, being clinical diagnosisnlongitudinal myelitis (case 1) and meningoencephalitisn(case 2). Specific YFV antibodiesnwere detected in CSF and serum samples innboth cases by IgM antibody-capture ELISA. Nonother cause of neurological disease wasnidentified. In order to obtain a conclusivendiagnosis of central nervous system (CNS)ninfection the IgM antibody index (AIIgM) wasncalculated. High AIIgM values were found innboth cases indicating intrathecal production ofnantibodies and, therefore, CNS post-vaccinalnYFV infection could be definitively associatednto YFV vaccination. J. Med. Virol. 83:2208–n2212, 2011. u0001 2011 Wiley Periodicals, Inc.