[Neurological complications in adults following rabies vaccine prepared from animal brains].
OBJECTIVE
Despite well-known neurological complications, post-exposure semple-type rabies vaccine is still used in Tunisia. We retrospectively studied neurological manifestations following post-exposure rabies vaccine.


METHODS
Over a 3-year period, semple-type phenol inactivated lamb nerve tissue vaccine (Pasteur Institute, Tunis) was given to 1392 adults after exposure to rabies.


RESULTS
The frequency of neurological complications was 1/200. Seven patients presented complications 4 to 14 days after the first vaccine injection (median 11 days). Central nervous system manifestations occurred in all 7 patients with peripheral neuropathy in 5. Manifestations were meningoradiculitis (n = 3), meningomyeloradiculitis (n = 2), meningomyelitis (n = 1) and myelitis (n = 1). No vaccine-associated death occurred, but one patient suffered persistant paraplegia.


CONCLUSIONS
Semple-type adult animal nerve tissue vaccine produces an unacceptable rate of severe post-vaccinal neurological complications in adults. Human diploid cell rabies vaccine should be used for post-exposure rabies vaccination.
Bahri
F
F
Service de Médecine interne et Maladies infectieuses, CHU Sahloul, Sousse, Tunisie.
Letaief
A
A
Ernez
M
M
Elouni
J
J
Chekir
T
T
Ben Ammou
S
S
Jemni
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D009422:Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D011819:Rabies Vaccines / Q000009:adverse effects*; D011843:Radiculopathy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012756:Sheep; D013997:Time Factors; D014416:Tunisia
D011819:Rabies Vaccines
Les complications neurologiques observées chez l'adulte, secondaires au vaccin antirabique préparé sur cerveaux d'animaux.