Ribeiro Ana Freitas, Guedes Bruno Fukelmann, Sulleiman Jamal M A H, de Oliveira Francisco Tomaz Meneses, de Souza Izabel Oliva Marcilio, Nogueira Juliana Silva, Marcusso Rosa Maria Nascimento, Fernandes Eder Gatti, do Olival Guilherme Sciascia, de Figueiredo Pedro Henrique Fonseca Moreira, Veiga Ana Paula Rocha, Dahy Flávia Esper, Ximenes Natália Nasser, Pinto Lecio Figueira, Vidal José Ernesto, de Oliveira Augusto Cesar Penalva
Emerg Infect Dis. 2021 Jun;27(6):1577-87. doi: 10.3201/eid2706.204170.
Yellow fever (YF) vaccine can cause neurologic complications. We examined YF vaccine–associated neurologic disease reported from 3 tertiary referral centers in São Paulo, Brazil, during 2017–2018 and compared the performance of criteria established by the Yellow Fever Vaccine Working Group/Centers for Disease Control and Prevention and the Brighton Collaboration. Among 50 patients who met inclusion criteria, 32 had meningoencephalitis (14 with reactive YF IgM in cerebrospinal fluid), 2 died, and 1 may have transmitted infection to an infant through breast milk. Of 7 cases of autoimmune neurologic disease after YF vaccination, 2 were acute disseminated encephalomyelitis, 2 myelitis, and 3 Guillain-Barré syndrome. Neurologic disease can follow fractional vaccine doses, and novel potential vaccine-associated syndromes include autoimmune encephalitis, opsoclonus-myoclonus-ataxia syndrome, optic neuritis, and ataxia. Although the Brighton Collaboration criteria lack direct vaccine causal assessment, they are more inclusive than the Centers for Disease Control and Prevention criteria.
黄热病（YF）疫苗可引发神经系统并发症。我们对2017年至2018年期间巴西圣保罗3家三级转诊中心报告的与黄热病疫苗相关的神经系统疾病进行了研究，并比较了黄热病疫苗工作组/疾病控制与预防中心以及布莱顿协作组织制定的标准的性能。在符合纳入标准的50例患者中，32例患有脑膜脑炎（14例脑脊液中YF IgM呈反应性），2例死亡，1例可能通过母乳将感染传播给了一名婴儿。在7例黄热病疫苗接种后发生的自身免疫性神经系统疾病中，2例为急性播散性脑脊髓炎，2例为脊髓炎，3例为吉兰-巴雷综合征。神经系统疾病可在接种部分剂量疫苗后发生，新出现的潜在疫苗相关综合征包括自身免疫性脑炎、眼阵挛-肌阵挛-共济失调综合征、视神经炎和共济失调。尽管布莱顿协作组织的标准缺乏对疫苗因果关系的直接评估，但它们比疾病控制与预防中心的标准涵盖范围更广。
