TY - JOUR AU - Ribeiro, Ana Freitas AU - Guedes, Bruno Fukelmann AU - Sulleiman, Jamal M.A.H. AU - de Oliveira, Francisco Tomaz Meneses AU - de Souza, Izabel Oliva Marcilio AU - Nogueira, Juliana Silva AU - Marcusso, Rosa Maria Nascimento AU - Fernandes, Eder Gatti AU - do Olival, Guilherme Sciascia AU - de Figueiredo, Pedro Henrique Fonseca Moreira AU - Veiga, Ana Paula Rocha AU - Dahy, Flávia Esper AU - Ximenes, Natália Nasser AU - Pinto, Lecio Figueira AU - Vidal, José Ernesto AU - de Oliveira, Augusto Cesar Penalva T1 - Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017–2018 T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 6 SP - 1577 SN - 1080-6059 AB - 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. KW - encephalitis KW - aseptic meningitis KW - Guillain-Barré syndrome KW - myelitis KW - optic neuritis KW - autoimmune encephalitis KW - yellow fever KW - vaccine KW - viruses KW - vaccine-associated adverse events KW - São Paulo KW - Brazil KW - meningitis/encephalitis DO - 10.3201/eid2706.204170 UR - https://wwwnc.cdc.gov/eid/article/27/6/20-4170_article ER - End of Reference