Yellow fever vaccine-associated neurologic and viscerotropic disease: a 10-year case series of the French National Reference Center for Arboviruses with clinical and immunological insights.

Autor:	Le Hir A; Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France., Durand GA; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille 13005, France.; National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm) and French Armed Forces Biomedical Research Institute (IRBA), Marseille 13005, France., Boucraut J; Laboratoire d'Immunologie, Assistance-Publique des Hôpitaux de Marseille, Marseille 13005, France.; Institut de Neurosciences des Systèmes (INS, UMR1106), Marseille 13005, France., Garnier A; French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge 91220, France., Mura M; French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge 91220, France.; Institut Pasteur, Laboratoire d'innovation: vaccins, Paris 75015, France., Diamantis S; Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France, Melun 77000, France.; DYNAMIC Research Unit, Université Paris-Est-Creteil, Thiais 94320, France., Carles M; Service de Maladies Infectieuses et Tropicales, CHU de Nice 06200, France., Durand C; Service de Maladies Infectieuses et Tropicales, CHU de Nice 06200, France., Schweitzer C; Service de Médecine Infantile, Hôpital d'enfants, CHRU de Nancy, Vandœuvre-lès-Nancy 54500, France.; DeVAH EA 3450, Université de Lorraine, Faculté de Médecine de Nancy, Vandoeuvre lès Nancy 54500, France., Audouard C; Service de Médecine Infantile, Hôpital d'enfants, CHRU de Nancy, Vandœuvre-lès-Nancy 54500, France., Decroix V; Laboratoire de biologie médicale, CH de Saint-Quentin, Saint-Quentin 02100, France., Boyez R; Service de neurologie, CH de Lunéville, Lunéville 54300, France., Van Dendriessche A; Service de médecine interne et maladies infectieuses, Groupe Hospitalier du Havre, Montivilliers 76290, France., Leclancher A; Service de Neurologie, Groupe Hospitalier du Havre, Montivilliers 76290, France., Kaphan E; Pôle de Médecine Oncologie, Service de médecine interne, CHU Conception, Assistance Publique Hôpitaux de Marseille, Marseille 13005, France., Barbat du Closel L; Service de Neurologie, CHU Timone, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France., Verdon R; Service de maladies infectieuses et tropicales, CHU Côte-de-Nacre, Caen 14000, France., du Cheyron D; Service de médecine intensive et de réanimation, CHU de Caen, Caen 14000, France., Vabret A; INSERM, DYNAMICURE UMR1311, CHU Caen, Department of Virology, Univ de Caen Normandie, Univ Rouen Normandie, Caen 14000, France., Vergnon D; Equipe mobile d'infectiologie, CH Roanne, Roanne 42300, France., Grard G; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille 13005, France.; National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm) and French Armed Forces Biomedical Research Institute (IRBA), Marseille 13005, France., Charrel R; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille 13005, France.; Comité de Lutte contre les Infections Nosocomiales (CLIN), Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France.; Laboratoire des Infections Virales Aigues et Tropicales, Pôle des Maladies Infectieuses, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France., de Lamballerie X; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), Marseille 13005, France.; National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm) and French Armed Forces Biomedical Research Institute (IRBA), Marseille 13005, France., Eldin C; Comité de Lutte contre les Infections Nosocomiales (CLIN), Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Marseille 13005, France.
Jazyk:	angličtina
Zdroj:	Journal of travel medicine [J Travel Med] 2024 Mar 01; Vol. 31 (2).
DOI:	10.1093/jtm/taad160
Abstrakt:	Background: Immunization against the Yellow fever virus (YFV) with the 17D live-attenuated vaccine is the most effective way to prevent the disease. However, unexpected severe adverse events can occur. They consist in a neurological impairment - neurological disease (YEL-AND), a YF-like illness - viscerotropic disease (YEL-AVD) or anaphylaxis. In this article, we describe the epidemiology, clinical and biological features of YEL-AND and YEL-AVD cases reported to the French National Reference Center for Arboviruses (NRCA) in the past 10 years. Methods: We conducted a national, retrospective study using the database of the NRCA from June 2012 to June 2022. All patients whose biological samples were sent to the NRCA for detection of YFV by serology and/or RT-qPCR for a suspected vaccine-associated adverse event were included. We collected data by reading medical records and conducted complementary neuro-immunological analysis, followed by a search for autoimmunity against type-1-interferon when samples were available at the NRCA. Results: There were 10 cases of YEL-AND and 2 cases of YEL-AVD reported to the NRCA in the past 10 years, which represented an overall incidence of 0.6 for 100 000 doses. A total of 6/12 cases were previously healthy patients (50%, mean age 31 years), and 4/12 cases had cardiovascular co-morbidities (42%, mean age 56 years). The majority of YEL-AND had a favourable outcome at 6 months of follow up. One YEL-AVD patient passed. In secondary analyses, we evidenced a significant blood cerebrospinal fluid (CSF) barrier dysfunction, without intrathecal synthesis of immunoglobulin and without argument for a neuron damage. We further detected a significant rate of anti-type-1alpha interferon antibodies in 3/10 tested patients (2 YEL-AND and 1 YEL-AVD). Conclusion: YEL-AND and YEL-AVD are rare events that can underlie defect in the innate immunity of apparently healthy or mild co-morbid subjects. Outcome was generally favourable in the YEL-AND cases of our series, but still life-threatening or even fatal in the YEL-AVD cases. (© International Society of Travel Medicine 2023. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu