title: Viscerotropic disease following yellow fever vaccination in Peru.
abstract: Five suspected cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) clustered in space and time following a vaccination campaign in Ica, Peru in 2007. All five people received the same lot of 17DD live attenuated yellow fever vaccine before their illness; four of the five died of confirmed YEL-AVD. The surviving case was classified as probable YEL-AVD. Intensive investigation yielded no abnormalities of the implicated vaccine lot and no common risk factors. This is the first described space-time cluster of yellow fever viscerotropic disease involving more than two cases. Mass yellow fever vaccination should be avoided in areas that present extremely low risk of yellow fever.
authors.affiliation: Ministerio de Salud, Lima, Peru.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Whittembury
authors.forename: Gladys
authors.initials: G
authors.lastname: Ramirez
authors.forename: Herminio
authors.initials: H
authors.lastname: Hernández
authors.forename: Alba Maria
authors.initials: AM
authors.lastname: Ropero
authors.forename: Steve
authors.initials: S
authors.lastname: Waterman
authors.forename: María
authors.initials: M
authors.lastname: Ticona
authors.forename: Margo
authors.initials: M
authors.lastname: Brinton
authors.forename: Jorge
authors.initials: J
authors.lastname: Uchuya
authors.forename: Mark
authors.initials: M
authors.lastname: Gershman
authors.forename: Washington
authors.initials: W
authors.lastname: Toledo
authors.forename: Erin
authors.initials: E
authors.lastname: Staples
authors.forename: Clarense
authors.initials: C
authors.lastname: Campos
authors.forename: Mario
authors.initials: M
authors.lastname: Martínez
authors.forename: Gwong-Jen J
authors.initials: GJ
authors.lastname: Chang
authors.forename: Cesar
authors.initials: C
authors.lastname: Cabezas
authors.forename: Robert
authors.initials: R
authors.lastname: Lanciotti
authors.forename: Sherif
authors.initials: S
authors.lastname: Zaki
authors.forename: Joel M
authors.initials: JM
authors.lastname: Montgomery
authors.forename: Thomas
authors.initials: T
authors.lastname: Monath
authors.forename: Edward
authors.initials: E
authors.lastname: Hayes
mesh_terms: D000328:Adult; D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru; D012307:Risk Factors; D014611:Vaccination / Q000009:adverse effects*; D014613:Vaccines, Attenuated / Q000009:adverse effects; D015004:Yellow Fever / Q000517:prevention & control*; D022341:Yellow Fever Vaccine / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014613:Vaccines, Attenuated; D022341:Yellow Fever Vaccine