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[Neurological complications in adults following rabies vaccine prepared from animal brains]
1Service de Médecine interne et Maladies infectieuses, CHU Sahloul, Sousse, Tunisie.
Objectives:
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.
Conclusion:
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.