Age: 34.0
Sex: M
Vaccine: HEP, HEPA, TTOX, YF
Symptoms: CSF neutrophil count, CSF test abnormal, CSF white blood cell count increased, Culture urine negative, Flavivirus test positive
Clinical narrative: Initial case was received on 08 July 2010 from the CDC. The VAERS number is 391918. A 34 year old male patient received on 21 April 2010 injections of YF VAX (lot not reported), TETANUS TOXOID (manufacturer and lot not reported), HEP B (manufacturer and lot not reported), HEP A (manufacturer and lot not reported) and MMRV (manufacturer and lot not reported). Ten days post vaccinations, the patient experienced a fever and a headache and was hospitalized for three days (dates unspecified). On 02 May 2010, cerebrospinal fluid (CSF) results were: WBC = 433; L = 64%. On 02 May 2010 serum results were: YF IgM ELISA+; YF PRNT 2560; YFV RT-PCR negative. Arboviral results were: CSF -YF IgM ELISA+; YF PRNT 8; YFV RT-PCR positive. The patient had no underlying medical conditions and no travel history. Treatment was not reported. He recovered on an unspecified date. Follow-up information was received on 22 July 2010 from the Center for Biologics Evaluation and Research/Office of Vaccines Research and Review/Division of Vaccines and Related Products Applications. The YF VAX lot number was UF71488. The patient became ill "approximately" 01 May 2010 with headache and fever of 38.1C and "more." He also experienced malaise (date unspecified). The patient was observed in the emergency department (ED) for 3 days. He received vancomycin and acyclovir. He was stable and was not transferred to intensive care unit (ICU), not intubated. He denied any bleeding or reduced amount of urine. On 02 June 2010, lab data included YF AG: (+) IGM Capture ELISA; PRNT=2560; Arboviral Nucleic Acid (YF virus) detection; TAQMAN (R)=negative; CSF WBC=433; N5%;L64%; GS=Organisms not seen; CX=negative; Viral =neg; Also blood and urine CX=neg. The patient had no recent history of traveling. No concomitant medications and no chronic or immunosuppressed conditions were reported. The patient had no pre-existing illness. The outcome of the malaise was not reported. The patient and a friend traveled to several cities in a foreign country (not specified) from 14 May 2010 to 28 May 2010. Of note: On an unspecified date, the friend got a similar illness with a light headache and chest, back and spine pain for two days ("mild meningitis"); The friend did not see a physician, had no tests, and was not hospitalized. It was not reported if the friend had received vaccines. Follow-up information was received on 03 August 2010 from sanofi pasteur Regulatory Affairs; additional information was received form the Centers for Disease Control and Prevention (CDC) on 10 August 2010. As per a phone call from the CDC to the clinic, the correct lot number for the YF Vax was confirmed to be UF714AA. Follow-up information was received on 12 August 2010 from the Centers for Disease Control and Prevention (CDC). The patient's illness began on 01 May 2010. He was not hospitalized but he was observed for three days in the emergency department (ED). The patient did not visit the emergency department three consecutive times but he did have CSF testing. The   [Due to memory limitations, the remainder of this text could not be compared.]  . The patient was diagnosed with "asceptic" meningitis. No other information was available at the time of this report. Follow-up information received on 09 November 2010 via a search of the VAERS database (VAERS identification number 391918-1). The dose of YF Vax was the first dose the patient had received. No other relevant medically significant information was received. Documents held by sender: None.