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Found 469 cases where Vaccine targets Measles (MEA or MER or MM or MMR or MMRV) and Patient Died and Vaccination Date on/before '2018-11-30'

Case Details

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VAERS ID: 269984 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-01-02
Entered: 2007-01-03
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / SC

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0612USA03333

Write-up: Information has been received from a healthcare worker concerning a child who on an unspecified date was vaccinated with a dose of vARIVAX vaccine and concomitantly with a dose of MMR II. Subsequently the patient died. There was no product quality complaint involved. Additional information was sought, and the reporting healthcare worker indicated that she heard of this case through a pediatrician who was since retired. The patient was not a patient in the reporters office. She did not know if the patient had actually ever been a patient of the retired pediatrician. No further information was provided. No further information is available.


VAERS ID: 271683 (history)  
Form: Version 1.0  
Age: 1.21  
Sex: Male  
Location: Indiana  
Vaccinated:2007-01-26
Onset:2007-01-28
   Days after vaccination:2
Submitted: 2007-01-29
   Days after onset:1
Entered: 2007-02-05
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2292AA / 1 RL / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 1203F / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 308682D / 3 RL / IM

Administered by: Public       Purchased by: Other
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-01-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, previously Pedicare
Current Illness: URI
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Seen on 1/26/07 and received ProQuad, Prevnar, and Flu vaccine. According to grandmother died on Sunday. 4/17/2007 Received Autopsy Report which reveals COD as sepsis with bronchopneumonia & tracheobronchitis. Anatomic findings include: small abrasions on central forehead; marked congestion & edema of bilat lungs; enlarged heart; small contusion on right forhead; skin lesions around mouth & nares & dried mucous around nares.


VAERS ID: 272008 (history)  
Form: Version 1.0  
Age: 1.01  
Sex: Female  
Location: Michigan  
Vaccinated:2006-08-28
Onset:2006-09-11
   Days after vaccination:14
Submitted: 2007-02-08
   Days after onset:150
Entered: 2007-02-09
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0812F / 1 UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B086S2K / 4 UN / -

Administered by: Private       Purchased by: Private
Symptoms: Cyanosis, Peripheral coldness, Pyrexia, Rash, Viral myocarditis, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2006-09-16
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Gastroenteritis & febrile illness for several days prior to death.
Allergies:
Diagnostic Lab Data: body temperature 09/11/06 Fever - for 5 days
CDC Split Type: WAES0702USA00409

Write-up: Information has been received from a physician concerning a 12-month-old female with no pre-existing allergies, birth defects, or medical conditions who on 28-AUG-2006 was vaccinated in the right leg with her first dose of ProQuad vaccine (upgrade process) (lot#654471/0821F). Concomitant therapy that day included Prevnar vaccine (lot# B086S2K). There was no illness at the time of vaccination. There were no adverse reports following prior vaccinations for the patient or siblings. On 11-SEP-2006, the patient developed a fever which lasted for five days and vomited three times. It was reported that the patient developed a three elevated molluscum rashes on the left deltoid and shoulder. The patient turned blue with cold mouth, feet, and hands, and was rushed to the emergency room. On 16-SEP-2006, the patient was pronounced dead. An autopsy was performed and the cause of death was viral myocarditis (life threatening). Additional information has been requested. 2/20/07 Received medical records & autopsy report from provider which reveal patient experienced few molluscum lesions & viral macules on day of vax but was otherwise well. Seen on 9/16 for fever, rash, vomiting & ear pain for approx 5 days. Dx w/gastroenteritis & tx symptomatically. Autopsy Report reveals COD as myocarditis, most likely viral; however, micro studies did not detect virus. It was felt that the molluscum contagiosum rash was not related to the myocarditis. 3/20/07 Received cardiac path report which reveals lymphocytic myocarditis. No congenital anomalies or structural damage noted.


VAERS ID: 273384 (history)  
Form: Version 1.0  
Age: 1.24  
Sex: Male  
Location: California  
Vaccinated:2007-01-24
Onset:2007-02-11
   Days after vaccination:18
Submitted: 2007-03-02
   Days after onset:19
Entered: 2007-03-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR C2552AA / UNK UN / -
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0257F / UNK UN / -
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 1396F / UNK UN / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08639A / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Autopsy, Death, Mental status changes
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2007-02-12
   Days after onset: 1
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Jaundice neonatal PMH: NSVD, phototherapy for hyperbilirubinemia. URI s/s for 2-3 wks prior to admit.
Allergies:
Diagnostic Lab Data: computed axial 02/11?/07 - Non-conclusive LABS: from outlying ER, WBC 10.3, neutros 48, bands 4, lymphs 39. CT of brain, abdomen & pelvis were WNL. Blood c/s, urine c/s & RSV were all pending. Urine tox neg. LFTs were WNL. CSF showed 0 WBC & RBC, protein 155, glucose 70. EEG was severely abnormal w/evidence of slowing but no seizure activity. Rapid influenza was neg. Repeat CT scan showed no edema but extensive deep white matter abnormalities, probably congenital in origin, mitocondrial antibody type disorder was suspected as not typical of neoplastic or inflammatory process. MRI was recommended but due to continued deterioration was not able to be performed. Cerebral perfusion scan showed no blood flow.
CDC Split Type: WAES0702USA03955

Write-up: Information has been received from a physician concerning a 15-month-old male with a history of jaundice at birth, who on 24-JAN-2007 was vaccinated with a 0.5ml dose of ProQuad (lot #656160/1396F, expiration date 16-MAY-2008). Concomitant vaccinations included: Prevnar (lot #B08639A), Tripedia (lot # C2552AA) and Comvax (lot reported as 653660/0257F). Subsequently, on 11-FEB-2007 the patient experienced a mental state change and was hospitalized. The patient underwent a CT scan that was non conclusive at the time of this report. It was reported that the patient experienced unexpected rapid deterioration and died on 12-FBE-2007. An autopsy was performed, however, results were not yet available. The cause of death was unknown at the time of this report. The patients adverse experiences were considered to be life threatening and disabling. Additional information has been requested. 4/24/07 Received medical records from PCP which reveal patient experienced good health on day of vax. Later on day of vax developed swollen left leg & patient had difficulty walking that day. Next day was resolved when seen by PCP. Dx suspected Prevnar reaction. On 1/26 seen in ER for abdominal distention, vomiting & diarrhea. ER dx w/ileus. Seen by PCP 1/27 & dx w/resolving ileus secondary to acute gastroenteritis. Next note is of t/c from parent that patient deceased on 2/12/07. PCP requested autopsy report on 2/28/07. Vax record included w/med records from PCP. 4/24/07 PCP also forwarded med records from 2/12/07 hospitalization which reveal patient experienced altered mental status, fussiness, congestion, swollen face, increased sleepiness & pallor. Patient had been seen at outying Urgent Care center then transported to outlying ER via ambulance for fever, wheezes & respiratory difficulty w/a single apneic period reported. Child then transported to another hospital for PICU higher level of care. On admit there, very lethargic, pale, crying & opening eyes intermittently. There was crusty nares, inspiratory wheezing & crackles & coarse breath sounds, no neck rigidity, hypotonia. Started on antibiotics & LP obtained. Seizures were noted in PICU & loaded w/dilantin. Emergently intubated following AM for dilated pupils, responsiveness to deep pain w/decerebrate posturing & respiratory difficulty. Treated w/high dose steroids for possible ADEM. Condition deteriorated over the day, patient declared brain dead & deceased. ER DX: meningitis vs encephalitis. PICU Dx: brain stem dysfunction. 10/2/07 Reviewed Autopsy Report which revals COD as undetermined & manner of death as undetermined.


VAERS ID: 281033 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: North Carolina  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-06-07
   Days after onset:167
Entered: 2007-06-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / UNK UN / UN
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Abnormal behaviour, Convulsion, Death, Dyskinesia, Irritability, Lethargy, Muscle tightness
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-12-24
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Influenza like illness; Pyrexia; Tremor; Viral infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Reported Cause of Death unknown
CDC Split Type: HQWYE488805JUN07

Write-up: Information regarding Prevnar vaccine was received from a consumer, the mother of a 16-month-old female patient who on 21-Dec-2006, received a dose of Prevnar along with a dose of Hib (manufacturer unknown), a dose of Varivax (manufacturer unknown), and a dose of M-M-R II (Merck Sharp & Dome). On the same day, the patient experienced lethargy, possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, the child would not respond and on 24-Dec-2006, the child died. On 21-Dec-2006, the patient with a history of influenza like illness, pyrexia, virus (unspecified) and tremor of hands, was evaluated at the physician''s office for those symptoms and was also administered Prevnar along with Hib, Varivax, and M-M-R II. Later that day, the child was lethargic and experienced a possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, child would not respond and was taken to the hospital and placed on life-support for two days. On 24-Dec-2006, the child died. The cause of death was not reported. The reporter stated she "feels that her daughter had an adverse reaction to Prevnar." No additional information was available at the time of this report.


VAERS ID: 284994 (history)  
Form: Version 1.0  
Age: 1.1  
Sex: Female  
Location: Colorado  
Vaccinated:2007-07-12
Onset:2007-07-16
   Days after vaccination:4
Submitted: 2007-07-18
   Days after onset:2
Entered: 2007-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0757F / 3 LL / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 LL / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0431U / 1 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 808681E / 4 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-07-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Infant death. Infant discovered in crib by parents on 7/16/07 expired. No conclusive findings on post. 8/24/07 Received autopsy report which reveals COD as undetermined & manner of death as undetermined.


VAERS ID: 288632 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-08-21
Entered: 2007-08-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK UN / UN
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Apraxia, Autopsy, Blood creatinine normal, Blood immunoglobulin G normal, Blood iron increased, Blood pressure, Body temperature, Body temperature decreased, CSF cell count increased, CSF cell count normal, CSF glucose normal, CSF immunoglobulin increased, CSF lymphocyte count, CSF protein increased, CSF test abnormal, CSF white blood cell count increased, Cerebellar syndrome, Ceruloplasmin increased, Chlamydia serology positive, Computerised tomogram abnormal, Computerised tomogram normal, Confusional state, Coordination abnormal, Crying, Cytomegalovirus antibody negative, Death, Dizziness, Electroencephalogram abnormal, Enterovirus serology test negative, Epstein-Barr virus antibody negative, Fall, Feeding disorder, Fungus serology test negative, Gait disturbance, Gliosis, Globulins increased, Headache, Hemiparesis, Herpes simplex serology positive, Hyperreflexia, Hypertonia, Immunoglobulins increased, Incontinence, Iron binding capacity total increased, Lipase increased, Lymphocyte count decreased, Measles, Memory impairment, Meningitis aseptic, Moaning, Monocyte count increased, Movement disorder, Nausea, Neutrophil count increased, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging abnormal, Oxygen saturation, Pleocytosis, Polymerase chain reaction, Pregnancy, Pregnancy test positive, Protein albumin ratio, Rubella antibody positive, Serum ferritin decreased, Streptococcus identification test positive, Subacute sclerosing panencephalitis, Transferrin increased, Urine analysis abnormal, Varicella zoster virus serology positive, Venogram normal, Virus serology test, Vomiting
SMQs:, Acute pancreatitis (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Normal pregnancy conditions and outcomes (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy NOS (LMP = Unknown) Pregnancy
Preexisting Conditions: Pregnancy; Termination of pregnancy - elective; Measles; Fall; Head injury, Varicella
Allergies:
Diagnostic Lab Data: head computed axial - slight, diffuse prominence of ventricular system, no intracranial mass or other focal brain lesion, blood pressure - 107/81, magnetic resonance - hyperintense signal in left hippocampus and parhippocampal gyrus, electroencephalography - diffuse theta slowing and frontal intermittent rhythmic delta activity R $gL, venography - head-normal, magnetic resonance - new hyperintense signal in pons and middle cerebellar peduncles with assoc. restricted diffuse, electroencephalography - increase attenuation of background activity and less abundant frontal intermittent delta activity, neutrophil count 72% 40-62, lymphocyte count 21% 27-40, serum creatinine 0.5 mg/d 0.5 - 1.5, serum globulin test 4.2 g/dL 2.6 - 4.1, serum lipase test 7.5U/dL 1.3 - 6.0, total iron-binding 464 ug/d 228 - 428, urine ceruloplasmin 84 mg/d 27- 50, serum ferritin assay 9 ng/d 10-200, serum transferrin test 361 mg/d 188 - 341, serum antistreptolysin 208 IU/m <200, serum protein 1490 mg/d 614 - 1295 IgG, serum herpes simplex - positive, CSF red blood cell 2250/mm3, CSF red blood cell 2438/mm3, CSF white cell count 100/mm3, CSF white cell count 46/mm3, CSF neutrophil count 6%, body temp 36.3 C, CSF lymphocyte count 80%, CSF lymphocyte count 82%, CSF monocyte count 7%, CSF monocyte count 4%, cerebrospinal fluid 100 mg/d 5 - 55, CSF gamma-globulin 38.9 mg/d, cerebrospinal fluid - no organisms, pulse oximetry 100%, CSF VZV IgG Ab - non detected, enterovirus PCR - CSR-non detected, Cytomegalovirus culture - CSR-non detected, Epstein-Barr virus - CSR-non detected, CSR HSV Ab - non detected, serum West Nile virus - CSR-non detected, cerebrospinal fluid - no growth, fungal culture - CSR- no growth, adenovirus PCR - CSR-no growth, enterovirus PCR - CSR- no growth
CDC Split Type: WAES0708USA02565

Write-up: It was report in a published article, title as stated above, that "A 20-year-old pregnant woman was admitted to this hospital at 26 weeks of gestation because of dizziness, confusion, and difficulty walking. Ten weeks before admission, the patient had a positive result on a home pregnancy test and presented to a neighborhood health center for prenatal screening. Tests for sickle cell trait, syphilis, and human immunodeficiency virus (HIV) and hepatitis B and C virus antibodies were negative. Serologic tests for varicella-zoster virus and rubella IgG were positive. Two weeks later, an endocerival specimen was positive for Chlamydia trachomatis infection and negative for gonorrhea. The patient missed follow-up appointments and treatment with azithromycin was initiated 4 weeks later. (She) was happy, with a childlike affect, a poor memory, confusion, and odd movements of her head. During the next 2 weeks, nausea and vomiting occurred daily and were controlled with metoclopramide. Four days before admission, dizziness and weakness on the left side developed; she began to fall to her left and vomited several times. The next day, she went to the ED of another hospital. On evaluation, the patient was oriented to location but not to date, day, or month, and she provided inconsistent information about her medical history. The uterus was gravid, and he remainder of the physical examination was normal. An EKG revealed sinus tachycardia and counterclockwise rotation with T waves in the right precordial leads. Urinalysis showed a protein level of 30 mg per deciliter and a glucose level of 100 mg per deciliter (5.6 mmol per liter). Tricyclic metabolites were present on toxicology screening of a urine specimen. CT scanning of the head revealed a slight, diffuse prominence of the ventricular system. There was no intracranial mass or other focal brain lesion. On the second hospital day, the patient was alert, calm, cooperative, and oriented to person, location, and current events but was not aware of details of her life. There were no tremors or extrapyramidal signs. Ultrasonographic examination revealed normal fetal anatomy and growth, corresponding to a gestation of 25 weeks 6 days. On the third day, the weakness, nausea and vomiting had resolved, and the patient was thought to have returned to her baseline mental status. She was discharged to the shelter with a recommendation to schedule a follow-up neurologic evaluation. At the shelter, she was dizzy, had difficulty walking, and fell into a chair. That evening, she was brought to the emergency department of this hospital. In the emergency department, the patient reported feeling "woozy" and nauseated. She noted a mild headache of gradual onset, extending bandlike across the brow. The history as given by the patient was inconsistent; the history was then provided by staff members of the shelter, and many details were lacking. She had had measles at 4 months of age and varicella infection in childhood. at 7 years of age, she injured her head in a fall but was said to have recovered fully. Immunizations included polio vaccine and diphtheria, pertussis, and tetanus vaccine series; measles vaccine felt (at 11 months of age); measles, mumps and rubella vaccine combination; and hepatitis B vaccine (between 2 and 3 years before admission, on enrollment in high school). She had no known allergies and did not use alcohol, illicit drugs, or tobacco. On examination in the ED, the patient was alert but somewhat uncooperative, with involuntary head movements. Her mental status was not formally assessed, but her level of cognitive function was said by a friend to be at baseline. The abdomen was soft, gravid, and not tender; the fetus appeared to be healthy. The 1st cranial nerve was not tested, and the 2nd through 12th nerves were intact. Strength was intact, and the gait was unsteady. The remainder of the examination was normal. After premedication with lorazepam at a dose of 1 mg to control involuntary movements, MRI of the brain was performed without administration of contrast material. On T2-weighted, FLAIR images, hyperintense signal was seen in the left hippocampus and parahippocampal gyrus as well as in the posterior limb of the left internal capsule. There was no evidence of restricted diffusion. Examination by a neurology consultant showed that the patient was oriented to person and place, with a childlike affect. Her speech was fluent, and naming was intact. She could read a short sentence and do simple addition. She was left-handed, could write her name but not a sentence, and followed simple and complex commands. Her attention was variable, and testing of her memory showed recollection of zero of three items at 5 minutes on repeated examination. Smell and taste were not tested. The function of the other cranial never was intact. There were choreiform movements of the head and neck, poor performance of rapid alternating movements, and apraxia. Hypertonia and hyperreflexia with clonus were noted in the right leg. The gait was wide-based, with postural instability and leaning toward the left. She was unable to stand on one foot. She was admitted to the neurology service. On the second hospital day, a lumbar puncture was performed. An enzyme-linked immunosorbent assay for serum antibodies against HIV was negative. An EEG showed diffuse theta slowing and frontal intermittent rhythmic delta activity, which was more prominent in the right hemisphere than in the left. There was no epileptiform activity. Repeated MRI of the brain after the administration of gadolinium showed no changes and no evidence of abnormal enhancement. Acyclovir was administered IV. The next day, a serum Lyme antibody test, a test of a throat swab for Mycoplasma pneumoniae nucleic acid, and cultures of blood and urine were negative. On the fifth day, the patient''s condition appeared to be improved. She was oriented and remembered details of her past; dysmetria and truncal ataxia were reduced. Results on a repeated EEG were unchanged. The next day, a repeated lumbar puncture was performed. Between the 7th and 18th hospital days, the patient''s motor function gradually worsened, right-sided neglect developed, she became unable to feed herself, her responsiveness and ability to follow commands decreased, and she became incontinent. She began lying in a fetal position, moaning and crying out unintelligible sounds. A skin test for tuberculosis, a test of a nasopharyngeal specimen for respiratory viral antigens, and a viral culture of a stool specimen were negative. Nucleic acid testing for HIV RNA and tests for antinuclear antibodies were negative. Levels of free and total thyroxine were normal, and the thyroglobulin level was elevated (54.7 ng per milliliter). On the 12th day, the acyclovir was discontinued, and ceftriaxone, at a dose of 2 g, was administered IV. A repeated EEG study showed increased attenuation of background activity and less abundant frontal intermittent rhythmic delta activity. MRI on the 13th day showed new hyperintense signal in the pons and middle cerebellar peduncles with associated restricted diffusion of water on T2-weighted FLAIR images. Restricted diffusion was also noted in the posterior limb of the left internal capsule. There was atrophy in the left medical temporal lobe, with resolution of the abnormal hyperintense signal on FLAIR images. On the 14th day, a third lumbar puncture was performed. On the 18th hospital day, a test result was received. The patient lived semi-independently until she became pregnant 27 weeks before admission. Her level of function at that time was unknown, and because of the lack of information, it was not possible to determine either her level of function before her illness or the tempo of her disease. This patient''s neurological examination showed abnormal cognitive function indicating dysfunction of the cortical and subcortical gray matter, abnormal motor function indicating dysfunction of the pyramidal motor system, and choreiform movements indicating dysfunction of the extrapyramidal motor systems. This examination also showed a clumsy gait and difficulty performing rapid alternating movements, indicating dysfunction of the cerebellum or its connections. The results of the cerebrospinal fluid analysis in this patient showed a lymphocytic pleocytosis with few red cells, a mildly elevated protein level, and a normal glucose level. These findings are characteristic of aseptic meningitis. Although they were nonspecific, the cerebrospinal fluid findings provide support for the possibility of acute or subacute infection or inflammatory illness. The presence of an inflammatory response made chronic degenerative disease such as Huntington''s disease, Wilson''s disease and systems abiotrophies such as multisystem atrophy unlikely. The initial EEG was markedly abnormal, but the findings were nonspecific. The slow and attenuated posterior dominant rhythm suggests cortical gray-matter disease, whereas the intermittent frontal rhythmic delta activity suggests subcortical gray-matter disease. The monomorphic slow waves also suggest that initially the subcortical white matter was relatively spared. Axial T2-weighted FLAIR images from the MRI studies of the brain on the day of admission, performed without the administration of gadolinium, revealed a region of hyperintense signal in the left medical temporal lobe and subtle increased signal in the posterior limb of the left internal capsule corresponding to the location of the cortispinal tract. These foci did not show restricted diffusion or abnormal enhancement on a gadolinium-enhanced study performed the next day. The appearance of the pons was unremarkable, and no other clinically significant findings were noted. Magnetic resonance venography of the head was normal. By day 13, there had been marked changes. There was a region of abnormal signal in the pons, with areas of restricted diffusion on the diffusion-weighted image and apparent-diffusion-coefficent maps. The hyperintensity of the left medial temporal lobe had resolved, and there was volume loss in the region of the hippocampal formation. There was restricted diffusion in the left corticospinal tract; no abnormal enhancement was detected. These findings were interpreted as resulting from a subacute encephalitis caused by an infection or an autoimmune disorder. In summary, this patient has a disturbance of cognitive function, pyramidal tract and cerebellar dysfunction, and a choreiform-movement disorder, and both laboratory tests and EEG and imaging studies suggest an infectious or autoimmune encephalitis. This patient had only a minimally elevated antistreptolysin-antibody titer, with no other evidence of recent streptococcal infection or cardiac disease. The antiphospholipid-antibody syndrome2 may be primary or secondary to systemic lupus erythematosus, and it may become manifest during pregnancy. This patient had no symptoms or signs of systemic lupus. antiphospholipid-antibody testing and all laboratory studies for lupus were negative. Herpes simplex encephalitis was initially considered as one of the acute infectious encephalitis because of the abnormality detected in the left hippocampus on MRI. The negative results on cerebrospinal fluid testing for herpes simplex virus nucleic acid and the lack of response to acyclovir made this diagnosis unlikely. This patient''s clinical and cerebrospinal fluid findings were not consistent with paraneoplastic encephalitis. This patient did not have a recent history of immunizations or a viral infection or evidence of optic neuritis, and the imaging findings were not typical of acute disseminated encephalomyelitis. The cerebrospinal fluid findings were an important clue to the diagnosis in the case. Although the protein level in the initial cerebrospinal fluid specimen was modestly elevated, the IgG component was markedly elevated. Cerebrospinal fluid levels of total protein, albumin, and IgG obtained on the second hospital day are shown. Agarose-gel electrophoresis of cerebrospinal fluid revealed oligoclonal bands in the gamma region. The cerebrospinal fluid to serum mass concentration quotients for albumin and IgG concentrations were QA1b=4.7x10-3 and QIgG=26.1x10-3, corresponding to an IgG index of 5.6. On the basis of an analysis developed by Reiber, this patient''s results indicated markedly increased intrathecal IgG synthesis (intrathecal production fraction, 87.7%) without evidence of clinically significant blood-brain barrier dysfunction. The mass concentration ratio of IgG to total protein in the cerebrospinal fluid was 58.9%. This patient did not have syphilis, as shown by negative results on serologic testing and a symptom complex that was inconsistent with the disease. Examination of the cerebrospinal fluid shows pleocytosis and a moderately elevated protein level, with up to 50% of the cerebrospinal fluid protein composed of immunoglobulins. The diagnosis is confirmed by a high antirubella-antibody titer in the cerebrospinal fluid. In summary, this patient presented with a subacute progressive neurologic disease characterized by widespread dysfunction of the central nervous system, inflammatory features in the cerebrospinal fluid, and an extremely high level of cerebrospinal fluid IgG. My colleagues and I favored the diagnosis of subacute sclerosing panencephalitis, a delayed consequence of her infection with measles at 4 months of age. This condition may have been exacerbated by her pregnancy. Specimens of serum and cerebrospinal fluid from the 14th hospital day were sent for testing for levels of antibodies against measles. The measles-specific cerebrospinal fluid to serum IgG antibody index was elevated at 31.8. Measles-specific IgM antibodies were not detected in the serum. This profile indicates a chronic immune response to measles infection in the cerebrospinal fluid compartment. The results confirm the diagnosis of subacute sclerosing panencephalitis in the patient. The disease was a late consequence of persistent infection with measles virus. When we made the diagnosis in this patient, she was 28 weeks of gestation, and her condition was deteriorating rapidly. We believed that an attempt at treatment was in the best interest of the patient and her fetus. We treated her with interferon and inosine pranobex for 8 weeks, without any clear clinical benefit. After the delivery of a healthy baby by elective cesarean section at 34 weeks gestation, a decision was made to discontinue treatment with the consent of the patient''s mother. The patient died 6 weeks later. The autopsy revealed inflammatory infiltrates containing macrophages, plasma cells, and lymphocytes around vessels, with neuronal destruction and reactive gliosis that were most prominent in the brain stem. No viral inclusions of the type usually seen in acute measles encephalitis were seen in the nuclei or cytoplasm of any cell types (neurons, glia, or vascular endothelial cells). In the cerebral cortex, neuronal populations were perserved, but there was marked gliosis with reactive astrocytes. The brain stem was softened by the pathologic process, but the hemispheric white matter was firmer than normal; this was most evident when the brain was cut in the fresh state. This firmness corresponds to the sclerosis in the name, subacute sclerosing panencephalitis. The subcortical white matter also showed reactive gliosis and extensive microglial activation. These findings are nonspecific, but together with the serologic studies, they are consistent with a diagnosis of subacute sclerosing panencephalitis. Immunohistochemical analysis for measles virus nucleoprotein antigen was negative. Molecular diagnostic studies performed to detect portions of the measles genome were negative in repeated attempts at amplification of regions of the measles nucleoprotein gene. Weak signals were detected in a real-time reverse-transcriptase-polymerase-chain-reaction assay, but there were insufficient amounts of amplified DNA product to perform a sequence analysis. As a result, it was not possible to definitively establish the presence of measles virus in this case. Two years before admission, the patient was seen in the emergency department of another hospital because of an episode of loss of consciousness that was associated with rolling of the eyes and arching of the back. On examination, there were intermittent involuntary movements of the head and neck and jerking movements of the arms. Deep-tendon reflexes were brisk and symmetric. CT scanning of the head and an electroencephalogram were normal. Further testing showed an early pregnancy, which was electively terminated. During the next 20 months, the patient was lost to medical follow-up, and it is not known whether the abnormal movements stopped. Anatomical Diagnosis: Subacute sclerosing panencephalitis secondary to measles virus infection. A copy of the published article is attached as further documentation of the patient''s experience.


VAERS ID: 290970 (history)  
Form: Version 1.0  
Age: 1.17  
Sex: Female  
Location: Indiana  
Vaccinated:2007-07-24
Onset:2007-08-08
   Days after vaccination:15
Submitted: 2007-09-20
   Days after onset:43
Entered: 2007-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U2290BA / 4 LL / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF058AA / 4 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1026F / 1 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B588456 / 4 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0362U / 1 RL / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-08-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no meds
Current Illness: none reported
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Currently autopsy reveals no confirmed cause of death
CDC Split Type:

Write-up: Mother reported that child ran a fever following the immunizations.


VAERS ID: 291678 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Male  
Location: Connecticut  
Vaccinated:2007-09-24
Onset:2007-09-25
   Days after vaccination:1
Submitted: 2007-10-01
   Days after onset:6
Entered: 2007-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B056CA / 4 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT2456BA / 1 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0700F / 1 LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0823U / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: mild febrile rxn~Vaccine not specified (no brand name)~UN~0.00~In Patient
Other Medications: None
Current Illness: None
Preexisting Conditions: Febrile seizure 3/07 - nl EEG 5/07
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Healthy 18 mo male with history of febrile seizure in 3/07 given MMR II, VZV, DTaP & Flu vaccine on 9/24/07. Child discovered by mother deceased in bed approx 9/25/07. 11/30/07 Reviewed autopsy report which states COD as undetermined & manner of death undetermined. Anatomic diagnoses: pulmonary congestion & edema, sudden of unknown etiology. Patient was found unresponsive face down on mattress in crib.


VAERS ID: 297178 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Texas  
Vaccinated:2007-11-07
Onset:2007-11-10
   Days after vaccination:3
Submitted: 2007-11-16
   Days after onset:6
Entered: 2007-11-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U2156AA / 4 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF205AA / 4 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0873 / 4 RL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0706F / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08702H / 4 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 06084 / 1 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Bronchopneumonia, Death, Electrolyte imbalance, Gastroenteritis, Histology, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-11-12
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PRE-MATURE BIRTH....NO COMPLICATIONS
Allergies:
Diagnostic Lab Data: Electrolytes with mild dehydrate. Histology shows acute gastroenteritis and broncho-pneumonia
CDC Split Type:

Write-up: Child started with high fever, 48 C, post vaccination and died on 11/12/2007. 12/11/2007 Reviewed autopsy report which states COD as acute bronchopneumonia complicated by acute gastroenteritis. Blood c/s neg.


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