{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:00:35Z","timestamp":1783472435212,"version":"3.55.0"},"reference-count":18,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,5,1]]},"published-print":{"date-parts":[[2019,5,11]]},"abstract":"<jats:p>A 35-year-old man presented to his optician with sudden onset diplopia and a 1-week history of headaches. He was noted to have sixth nerve palsy. The following day he was admitted to hospital with confusion and expressive dysphasia. He had been due to travel to Ghana on business and had received yellow fever (YF) vaccination 18 days prior to onset of headaches. His initial cerebrospinal fluid (CSF) revealed elevated protein, increased white cell count but was PCR negative for standard viral pathogens. Herpes simplex virus (HSV)-1 was detected by PCR in CSF at a very low level from a second lumbar puncture performed 6 days later, and the patient was treated for HSV meningoencephalitis. However, retrospective investigation for yellow fever vaccine-associated neurological disease revealed increasing titres of YF IgG in three serial CSF samples, and no evidence of HSV antibodies in CSF or plasma, ruling out HSV encephalitis.<\/jats:p>","DOI":"10.1136\/bcr-2019-229558","type":"journal-article","created":{"date-parts":[[2019,5,14]],"date-time":"2019-05-14T07:57:02Z","timestamp":1557820622000},"page":"e229558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Yellow fever vaccine-associated neurological disease: it is not just the silver generation at risk"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4212-6819","authenticated-orcid":false,"given":"Emily J","family":"Goldstein","sequence":"first","affiliation":[{"name":"West of Scotland Specialist Virology Centre, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Bell","sequence":"additional","affiliation":[{"name":"Infectious Diseases, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory N","family":"Gunson","sequence":"additional","affiliation":[{"name":"West of Scotland Specialist Virology Centre, NHS Greater Glasgow and Clyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,13]]},"reference":[{"key":"2025082722335710000_12.5.e229558.1","first-page":"1","article-title":"Centres for Disease Control and Prevention. Yellow fever vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"59","author":"Staples","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2025082722335710000_12.5.e229558.2","unstructured":"World Health Organisation. International Health Regulations (2005). 3rd edn. Geneva, 2016."},{"key":"2025082722335710000_12.5.e229558.3","unstructured":"National Travel Health Network and Centre. Yellow fever vaccine usage by yellow fever vaccination centres in England, Wales and Northern Ireland 2017. London 2018."},{"key":"2025082722335710000_12.5.e229558.4","unstructured":"Scotland HP . Summary of yellow fever vaccination centres 2015-2017. Glasgow, 2018."},{"key":"2025082722335710000_12.5.e229558.5","unstructured":"Department of Health. Immunisation against infectious disease (Green Book). Public Health England 2013."},{"key":"2025082722335710000_12.5.e229558.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.11.027"},{"key":"2025082722335710000_12.5.e229558.7","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2009.09-0295"},{"key":"2025082722335710000_12.5.e229558.8","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1002\/jmv.22236","article-title":"Intrathecal antibody production in two cases of yellow fever vaccine associated neurotropic disease in Argentina","volume":"83","author":"Pires-Marczeski","year":"2011","journal-title":"J Med Virol"},{"key":"2025082722335710000_12.5.e229558.9","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taw045"},{"key":"2025082722335710000_12.5.e229558.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(00)00501-3"},{"key":"2025082722335710000_12.5.e229558.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0928-0197(97)00015-9"},{"key":"2025082722335710000_12.5.e229558.12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.pjnns.2016.09.002","article-title":"Yellow fever vaccine-associated neurotropic disease (YEL-AND) - A case report","volume":"51","author":"Florczak-Wyspia\u0144ska","year":"2017","journal-title":"Neurol Neurochir Pol"},{"key":"2025082722335710000_12.5.e229558.13","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit546"},{"key":"2025082722335710000_12.5.e229558.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2005.01.089"},{"key":"2025082722335710000_12.5.e229558.15","first-page":"989","article-title":"Centres for Disease Control and Prevention. Adverse events associated with 17D-derived yellow fever vaccination-United States, 2001-2002","volume":"51","year":"2002","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025082722335710000_12.5.e229558.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2004.01.026"},{"key":"2025082722335710000_12.5.e229558.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2014.01.015"},{"key":"2025082722335710000_12.5.e229558.18","doi-asserted-by":"publisher","DOI":"10.1126\/science.aau8225"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:34:11Z","timestamp":1756359251000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,11]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,13]]},"published-print":{"date-parts":[[2019,5,11]]}},"alternative-id":["10.1136\/bcr-2019-229558"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229558","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,11]]}}}