A Case of Yellow Fever Vaccine–Associated Viscerotropic Disease in Ecuador

Richard W. Douce Hospital Vozandes, Quito, Ecuador

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Diana Freire Hospital Vozandes, Quito, Ecuador

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Betzabe Tello Hospital Vozandes, Quito, Ecuador

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Gavino A. Vásquez Hospital Vozandes, Quito, Ecuador

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We report the first case of viscerotropic syndrome in Ecuador. Because of similarities between yellow fever and viscerotropic syndrome, the incidence of this recently described complication of vaccination with the 17D yellow fever vaccine is not known. There is a large population in South America that is considered at risk for possible reemergence of urban yellow fever. Knowledge of potentially fatal complications of yellow fever vaccine should temper decisions to vaccinate populations where the disease is not endemic.

Author Notes

*Address correspondence to Richard W. Douce, Hospital Vozandes, Casilla 0691, Quito, Ecuador. E-mail: rdouce@hcjb.org.ec

Authors' address: Richard W. Douce, Diana Freire, Betzabe Tello, and Gavino A. Vásquez, Hospital Vozandes, Quito, Ecuador.

  • 1.

    Pan American Health Organization, 2005. Control of Yellow Fever: Field Guide. Washington, DC: Pan American Health Organization.

  • 2.

    Pan American Health Organization, 2008. Outbreak of yellow fever in Paraguay. PAHO Epidemiol Bull 27: 17.

  • 3.

    Pan American Health Organization, 2008. Final Statement by the Pan American Health Organization/World Health Organization (PAHO/WHO) on Investigation of Serious Adverse Events in Peru following Receipt of Yellow Fever Vaccine Produced by Bio-Manguinhos, Brazil. Posted March 21, 2008 [cited 2009 Apr 23]. Available at: http://www.paho.org/English/AD/DPC/CD/eid-eer-2008-03-27htm.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Barnett ED, 2007. Yellow fever: epidemiology and prevention. Clin Infect Dis 44: 850856.

  • 5.

    Martin M, Tsai TF, Cropp B, Chang GJ, Holmes DA, Tseng J, Shieh W, Zaki SR, Al-Sanouri I, Cutrona AF, Ray G, Weld LH, Cetron MS, 2001. Fever and multisystem organ failure associated with 17D-204 yellow fever vaccination: a report of four cases. Lancet 358: 98104.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    2002. Adverse events associated with 17D-derived yellow fever vaccination–United States, 2001–2002. MMWR Morb Mortal Wkly Rep 51: 989993.

  • 7.

    Engel AR, Vasconcelos PF, McArthur MA, Barrett AD, 2006. Characterization of a viscerotropic yellow fever vaccine variant from a patient in Brazil. Vaccine 24: 28032809.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Centers for Disease Control and Prevention, 2002. Adverse events associated with 17D-derived yellow fever vaccination–United States, 2001–2002. MMWR Morb Mortal Wkly Rep 51: 989993.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Bae HG, Domingo C, Tenorio A, de Ory F, Munoz J, Weber P, Teuwen DE, Niedrig M, 2008. Immune response during adverse events after 17D-derived yellow fever vaccination in Europe. J Infect Dis 197: 15771584.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Munoz J, Vilella A, Domingo C, Nicolas JM, de Ory F, Corachan M, Tenorio J, Gascon J, 2008. Yellow fever-associated viscerotropic disease in Barcelona, Spain. J Travel Med 15: 202205.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Engel AR, Vasconcelos PF, McArthur MA, Barrett AD, 2006. Characterization of a viscerotropic yellow fever vaccine variant from a patient in Brazil. Vaccine 24: 28032809.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Martin M, Weld LH, Tsai TF, Mootrey GT, Chen RT, Niu M, Cetron MSGeoSentinel Yellow Fever Working Group, 2001. Advanced age a risk factor for illness temporally associated with yellow fever vaccination. Emerg Infect Dis 7: 945951.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Lindsey NP, Schroeder BA, Miller ER, Braun MM, Hinckley AF, Marano N, Slade BA, Barnett ED, Brunette GW, Horan K, Staples JE, Kozarsky PE, Hayes EB, 2008. Adverse event reports following yellow fever vaccination. Vaccine 26: 60776082.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Whittembury A, Ramirez G, Hernandez H, Ropero AM, Waterman S, Ticona M, Brinton M, Uchuya J, Gershman M, Toledo W, Staples E, Campos C, Martinez M, Chang GJ, Cabezas C, Lanciotti R, Zaki S, Montgomery JM, Monath T, Hayes EMinisterio de Salud, Lima, Peru, 2009. Viscerotropic disease following yellow fever vaccination in Peru. Vaccine 27: 59745981.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Monath TP, Cetron MS, 2002. Prevention of yellow fever in persons traveling to the tropics. Clin Infect Dis 34: 13691378.

  • 16.

    Wilder-Smith A, Hill DR, Freedman DO, 2008. The revised International Health Regulations (2005): impact on yellow fever vaccination in clinical practice. Am J Trop Med Hyg 78: 359360.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Monath TP, 2007. Dengue and yellow fever–challenges for the development and use of vaccines. N Engl J Med 357: 22222225.

  • 18.

    Kramer LD, Li J, Shi PY, 2007. West Nile virus. Lancet Neurol 6: 171181.

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