Yellow fever vaccine-associated viscerotropic disease (YEL-AVD) and corticosteroid therapy: Eleven United States cases, 1996-2004

Claudia Vellozzi, Tarissa Mitchell, Elaine Miller, Christine G. Casey, Rachel Barwick Eidex, Edward B. Hayes, T. L. Smith, Robert Chen, Martin Cetron, Michelle Russell, Jennifer Lehman, Katrin Kohl, Nicholas Crass, Neil Halsey, Anna Durbin, Elizabeth Barnett, Dirk Teuwen, Thomas Monath, R. Dana Bradshaw, Mary Elizabeth Wilson

Research output: Contribution to journalArticlepeer-review

Abstract

During 1996 through 2004, 29 cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) have been reported worldwide; 17 were fatal. Stress-dose corticosteroid (SDS) therapy has recently been found to improve survival among patients with septic shock but benefit for the treatment of YEL-AVD patients in septic shock is unknown. We retrospectively reviewed medical records of 11 U.S. YEL-AVD cases reported to the Vaccine Adverse Event Reporting System (VAERS) from 1996 through 2004. Four of 11 case-patients received SDS; 3 of these 4 (75%) survived. Seven patients did not receive SDS and 2 (29%) survived. Altered mental status was documented on admission for 5 of the 11 patients; 4 of these 5 did not receive SDS and died, whereas one received SDS and survived. The use of stress-dose steroids might be a factor that influenced the survival of these YEL-AVD patients and should be further evaluated in the management of both YEL-AVD and wild-type yellow fever septic shock.

Original languageEnglish (US)
Pages (from-to)333-336
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume75
Issue number2
DOIs
StatePublished - 2006

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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