Kleiner Perkins Caufield and Byers, 2750 Sand Hill Road, Menlo Park, CA 94025, USA.
Am J Trop Med Hyg. 2010 May;82(5):919-21. doi: 10.4269/ajtmh.2010.10-0001.
Two cases of yellow fever vaccine-associated viscerotropic adverse events (YEL-AVD) were identified by review of correspondence received at the Centers for Disease Control and Prevention (CDC; Ft. Collins, CO). The cases occurred in Indiana and Maryland in 1973 and 1978, respectively. One patient, a 75-year-old man with multi-organ failure died, and the other, a 31-year-old woman, was hospitalized for 14 days. Onset was 3-6 days after vaccination. The illness was characterized by fever, headache, myalgia, gastrointestinal symptoms, hepatic and renal dysfunction, and (in the fatal case), shock and coagulopathy, compatible with YEL-AVD. Liver pathology showed diffuse, spotty necrosis, acidophilic degeneration, Kupffer cell hyperplasia, and microvesicular fat. No virological confirmation was obtained, so that both cases remain classified as "suspect." The 1973 case is the earliest record of YEL-AVD; until now, the earliest known case of YEL-AVD had been in 1975 in Brazil, and most subsequent cases have been reported after 1995.
通过审查疾病预防控制中心（CDC；科罗拉多州柯林斯堡）收到的信件，发现了两例与黄热病疫苗相关的内脏不良事件（YEL-AVD）。这两例病例分别发生于 1973 年和 1978 年的印第安纳州和马里兰州。一名 75 岁的多器官衰竭男性患者死亡，另一名 31 岁的女性患者住院治疗了 14 天。发病时间为接种疫苗后 3-6 天。该疾病的特征是发热、头痛、肌痛、胃肠道症状、肝肾功能障碍，以及（在致命病例中）休克和凝血功能障碍，符合 YEL-AVD。肝脏病理学表现为弥漫性、斑点状坏死、嗜酸性变性、枯否细胞增生和微泡脂肪变性。未获得病毒学确认，因此两例病例均被归类为“疑似”。1973 年的病例是 YEL-AVD 的最早记录；到目前为止，已知最早的 YEL-AVD 病例发生于 1975 年的巴西，此后大多数病例发生在 1995 年之后。
