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This is VAERS ID 66001

Case Details

VAERS ID: 66001 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: Louisiana  
Vaccinated:1993-03-09
Onset:1993-03-22
   Days after vaccination:13
Submitted: 1994-08-13
   Days after onset:508
Entered: 1994-08-19
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 2E41060 / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1186V / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0658L12 / UNK - / -

Administered by: Public       Purchased by: Other
Symptoms: Asthenia, Dehydration, Hepatocellular damage, Infection, Jaundice, Lymphocytosis, Pyrexia, Spleen disorder
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1993-06-11
   Days after onset: 80
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 60 days
   Extended hospital stay? Yes
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to sulfa other than that healthy
Allergies:
Diagnostic Lab Data: MD felt pt had hepatitis, but test came back neg, it was determined pt had mono from EBV
CDC Split Type:

Write-up: fever, vomiting, dehydration, jaundice, tired, blood problems, liver & spleen problems went on for over 2 months;


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