title: [Neurological complications in adults following rabies vaccine prepared from animal brains].
abstract: 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.
authors.affiliation: Service de Médecine interne et Maladies infectieuses, CHU Sahloul, Sousse, Tunisie.
authors.forename: F
authors.initials: F
authors.lastname: Bahri
authors.forename: A
authors.initials: A
authors.lastname: Letaief
authors.forename: M
authors.initials: M
authors.lastname: Ernez
authors.forename: J
authors.initials: J
authors.lastname: Elouni
authors.forename: T
authors.initials: T
authors.lastname: Chekir
authors.forename: S
authors.initials: S
authors.lastname: Ben Ammou
authors.forename: L
authors.initials: L
authors.lastname: Jemni
mesh_terms: 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
chemical_list: D011819:Rabies Vaccines
vernacular_title: Les complications neurologiques observées chez l'adulte, secondaires au vaccin antirabique préparé sur cerveaux d'animaux.