WORLD HEALTH ORGANIZATION EXPERT COMMITTEE ON YELLCW FEVER VACCINE Geneva, 8-15 A p r i l 1957
ORGANISATION MONDIALE DE LA SANTÉ / /— 1 /
7 March 1957 ORIGINALJ ENGLISH
THE OCCURRENCE OP ENCEPHALITIS AND OTHER COMPLICATIONS IN CONNEXION WITH VACCINATION AGAINST YELLCW FEVER by TJV A, Gast-Galvis
I can only bring forward c e r t a i n considerations of a general nature and have nothing much to add to the two papers presented by Tr G, Stuart on the subject at
the Kampala Seminar ("Encephalitis i n man following use of yellow fever immunizing vaccines", A f r i c a n Seminar on Yellow Fever (195^!) pp. 125-145). I consider that still
one of the conclusions of t h i s complete review of l i t e r a t u r e up to 1955 Is v a l i d , namely: "As regards the 17D v i r u s vaccine:
since the standardization,
i n 19^2, of the seed v i r u s used i n i t s preparation, no case of e n c e p h a l i t i s has been reported following i t s use". The same author, i n einother paper published i n t h i s book and entitled yellow
"Nervous reactions and antibody response i n i n f a n t s following the use of fever immunizing vaccines", analyses
the p o s i t i o n i n a very complete manner,
I have only been able to consult the following papers i n our l i b r a r y snbsequent to the studies by Dr Stuarts (a) Panthier, R, (1956) "A propos de quelques cas de réactions nerveuses
tardives observées chez des nourrissons après vaccination antiamarile (17D)", P u l l , Soc. (b) Path, exot.,
L a r t i g a u t & Lartigaut, D, (195^) " E n c e p h a l i t i s following the vaccination J. Méd, Bordeaux, 151^ No, 12, 1588
of an i n f a n t against yellow fever", (c)
Stuart, G. ("-95f:) Cited i n '..'ropical Diseases,
B u l l e t i n , 52, 550» eleven
"Between August I952 and recember 1954 there have now been reported
cases of meningo-encephalltis associated with 17D vaccine, seven i n France, three i n Siigland, and one i n N i g e r i a " ,
WHO/YFV/3 page 2
(d)
Eklund, C. M. (1955) " i n f a n t i l e e n c e p h a l i t i s i n Costa R i c a and Honduras
follovd.ng the use of the Dakar vaccine against yellow f e v e r " . B u l l e t i n of the Pan American S a n i t a r y Bureau, 55, 505, 5l6. (In Spanish)
The c o n c l u s i o n reached i n these papers i s t h a t , i n r e a l i t y , i t i s d i f f i c u l t t o a s s o c i a t e e n c e p h a l i t i s w i t h the vaccine, since a t the same time cases occur i n unvaccinated persons, l e a d i n g t o the s u s p i c i o n t h a t the r e l a t i o n s h i p may be a coincidence or that these e n c e p h a l i t i s cases are produced by other unknown v i r u s e s i n o c u l a t e d simultaneously. We f e e l t h a t i t i s d i f f i c u l t to demonstrate w i t h I n a d d i t i o n , the number
c e r t a i n t y t h a t such r e a c t i o n s are produced by v i r u s 17D.
of cases observed bears no r e l a t i o n s h i p to the m i l l i o n s of v a c c i n a t i o n s c a r r i e d out w i t h v i r u s I7D, i n d i c a t i n g the d i f f i c u l t y i n drawing f i n a l conclusions on the r e l a t i o n s h i p between e n c e p h a l i t i s and t h i s vaccine. I n n e a r l y three m i l l i o n
v a c c i n a t i o n s c a r r i e d out i n Colombia we have never encountered cases of p o s t - v a c c i n a l encephalitis. On a n a l y s i n g the v a c c i n a t i o n s c a r r i e d out i n the I n s t i t u t e during
s i x years on a t o t a l of 78 855 persons, we found that 75^ were l e s s than one year of age (0.95^), but t h a t no r e a c t i o n of nervous o r i g i n was observed. I n the v a c c i n a t i o n s c a r r i e d out i n the f i e l d , 500 c h i l d r e n aged l e s s than one year were vaccinated (4,06^) i n a random sample of 12 297 persons without any i n d i c a t i o n of nervous r e a c t i o n s .