{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:23:44Z","timestamp":1792513424240,"version":"4.5.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T00:00:00Z","timestamp":1703030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Immunization against the Yellow fever virus (YFV) with the 17D live-attenuated vaccine is the most effective way to prevent the disease. However, unexpected severe adverse events can occur. They consist in a neurological impairment - neurological disease (YEL-AND), a YF-like illness - viscerotropic disease (YEL-AVD) or anaphylaxis. In this article, we describe the epidemiology, clinical and biological features of YEL-AND and YEL-AVD cases reported to the French National Reference Center for Arboviruses (NRCA) in the past 10\u00a0years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a national, retrospective study using the database of the NRCA from June 2012 to June 2022. All patients whose biological samples were sent to the NRCA for detection of YFV by serology and\/or RT-qPCR for a suspected vaccine-associated adverse event were included. We collected data by reading medical records and conducted complementary neuro-immunological analysis, followed by a search for autoimmunity against type-1-interferon when samples were available at the NRCA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 10 cases of YEL-AND and 2 cases of YEL-AVD reported to the NRCA in the past 10\u00a0years, which represented an overall incidence of 0.6 for 100\u2009000 doses. A total of 6\/12 cases were previously healthy patients (50%, mean age 31\u00a0years), and 4\/12 cases had cardiovascular co-morbidities (42%, mean age 56\u00a0years). The majority of YEL-AND had a favourable outcome at 6\u00a0months of follow up. One YEL-AVD patient passed. In secondary analyses, we evidenced a significant blood cerebrospinal fluid (CSF) barrier dysfunction, without intrathecal synthesis of immunoglobulin and without argument for a neuron damage. We further detected a significant rate of anti-type-1alpha interferon antibodies in 3\/10 tested patients (2 YEL-AND and 1 YEL-AVD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>YEL-AND and YEL-AVD are rare events that can underlie defect in the innate immunity of apparently healthy or mild co-morbid subjects. Outcome was generally favourable in the YEL-AND cases of our series, but still life-threatening or even fatal in the YEL-AVD cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taad160","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T03:44:06Z","timestamp":1703130246000},"source":"Crossref","is-referenced-by-count":20,"title":["Yellow fever vaccine-associated neurologic and viscerotropic disease: a 10-year case series of the French National Reference Center for Arboviruses with clinical and immunological insights"],"prefix":"10.1093","volume":"31","author":[{"given":"Anne","family":"Le Hir","sequence":"first","affiliation":[{"name":"Assistance Publique des H\u00f4pitaux de Marseille , Marseille 13005 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume A","family":"Durand","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Virus \u00c9mergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207) , Marseille 13005 , France"},{"name":"National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm) and French Armed Forces Biomedical Research Institute (IRBA) , Marseille 13005 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Boucraut","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019Immunologie, Assistance-Publique des H\u00f4pitaux de Marseille , Marseille 13005 , France"},{"name":"Institut de Neurosciences des Syst\u00e8mes (INS, UMR1106) , Marseille 13005 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Garnier","sequence":"additional","affiliation":[{"name":"French Armed Forces Biomedical Research Institute , Br\u00e9tigny-sur-Orge 91220 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Mura","sequence":"additional","affiliation":[{"name":"French Armed Forces Biomedical Research Institute , Br\u00e9tigny-sur-Orge 91220 , France"},{"name":"Institut Pasteur, Laboratoire d\u2019innovation: vaccins , Paris 75015 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Diamantis","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Groupe Hospitalier Sud Ile de France , Melun 77000 , France"},{"name":"DYNAMIC Research Unit, Universit\u00e9 Paris-Est-Creteil , Thiais 94320 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Carles","sequence":"additional","affiliation":[{"name":"Service de Maladies Infectieuses et Tropicales, CHU de Nice 06200 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Durand","sequence":"additional","affiliation":[{"name":"Service de Maladies Infectieuses et Tropicales, CHU de Nice 06200 , 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H\u00f4pitaux de Marseille , Service de m\u00e9decine interne, CHU Conception, , Marseille 13005 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luce","family":"Barbat du Closel","sequence":"additional","affiliation":[{"name":"Service de Neurologie, CHU Timone, Assistance Publique des H\u00f4pitaux de Marseille , Marseille 13005 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Verdon","sequence":"additional","affiliation":[{"name":"Service de maladies infectieuses et tropicales, CHU C\u00f4te-de-Nacre , Caen 14000 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"du Cheyron","sequence":"additional","affiliation":[{"name":"Service de m\u00e9decine intensive et de r\u00e9animation, CHU de Caen , Caen 14000 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Vabret","sequence":"additional","affiliation":[{"name":"INSERM , DYNAMICURE UMR1311, CHU Caen, Department of Virology, , Caen 14000 , France"},{"name":"Univ de Caen Normandie, Univ Rouen Normandie , DYNAMICURE UMR1311, CHU Caen, Department of Virology, , Caen 14000 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Vergnon","sequence":"additional","affiliation":[{"name":"Equipe mobile d\u2019infectiologie, CH Roanne , Roanne 42300 , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Grard","sequence":"additional","affiliation":[{"name":"Unit\u00e9 des Virus \u00c9mergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207) , Marseille 13005 , France"},{"name":"National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm) and French Armed Forces Biomedical Research Institute (IRBA) , Marseille 13005 , 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