Yellow Fever Vaccine-Associated Neurotropic Disease (YEL-AND, Postvaccinal Encephalitis)

 

Synonym: postvaccinal encephalitis

 

Risk factors:

(1) newborn or infant < 9 months of age

 

Onset: 4 to 23 days after the vaccination

 

Clinical features:

(1) fever

(2) headache

(3) malaise

(4) focal neurologic signs

(5) rarely coma and death

 

Laboratory features:

(1) elevated CSF protein

(2) elevated CSF WBC count (up to 500 per µL)

(3) IgM antibody to yellow fever antigen

 

Other neurologic complications of YF vaccination:

(1) Guillain Barre syndrome

(2) acute disseminated encephalomyelitis

(3) allergic encephalomyelitis (associated with a French neurotropic vaccine)