Mitigating yellow fever vaccine associated viscerotropic disease in older travellers

Patel, Dipti, Simons, Hilary and Fletcher, Rachael (2020) 'Mitigating yellow fever vaccine associated viscerotropic disease in older travellers'. Journal of Travel Medicine, Vol 27, Issue 4, taaa052.

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Abstract

In the 1930s, the development of a vaccine for humans toprevent or interrupt outbreaks of yellow fever,an acute viral haemorrhagic illness that is endemic in tropicaland sub-tropical areas of Africa, and Central and South America and in Trinidad, was hailed as a breakthrough. Early yellow fever vaccines were,because of theirtendency to cause neurotropic side effects,eventually replaced by the live attenuated vaccines used globally today. Using the17D-204 or 17DDstrainsof attenuated yellow fever virus as a backbone, these modern dayvaccines are acknowledged to be amongst the most effective and immunogenic vaccines ever produced ;1one dose is now considered enough, in most healthy individuals, to confer lifelong immunity.2Nevertheless, this remarkablevaccine,which is generally considered safe,hasover the past two decades,been dogged with a rare and worrisome side effect profile; seven cases of multiple organ system failure following yellow fever vaccination were identified in a review of adverse events (AE) occurring between 1996-2001.3Two separate serious AEprofiles occurring(almost exclusively)in first time vaccinerecipients, are recognised; Yellow Fever Vaccine Associated Neurologic disease [YEL-AND], which can occur two to 56 days after vaccination[RR 0.8 per 100 000 doses distributed]and Yellow Fever Vaccine Associated Viscerotropic Disease [YEL-AVD] which can occur one to eighteen days post-vaccination [RR 0.3 per 100 000 doses distributed], manifesting with fever and multi-organ failure, essentially mimicking the naturally acquired infection. Such serious AEare reported in all age groups but the reporting rate for both YEL-AND and YEL-AVD increases in persons aged 60 years and above.

Item Type:	Article
Additional Information:	Editorial
Subjects:	WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine. WA Public Health > Preventive Medicine > WA 115 Immunization WC Communicable Diseases > Virus Diseases > Infectious Mononucleosis. Arbovirus Infections > WC 530 Yellow fever WT Geriatrics. Chronic Disease > Geriatrics > WT 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1093/jtm/taaa052
Depositing User:	Stacy Murtagh
Date Deposited:	15 Jun 2020 08:15
Last Modified:	10 Aug 2020 11:00
URI:	https://archive.lstmed.ac.uk/id/eprint/14752

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