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This is VAERS ID 39772

Case Details

VAERS ID: 39772 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Male  
Location: Georgia  
Vaccinated:1992-01-16
Onset:1992-01-26
   Days after vaccination:10
Submitted: 1992-02-25
   Days after onset:30
Entered: 1992-03-03
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. G01031 / UNK UN / SC
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 1F31063 / UNK UN / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 1K31145 / UNK UN / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. 120602A / UNK MO / PO
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 1L21002 / UNK UN / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, CSF test abnormal, Diplopia, Guillain-Barre syndrome, Headache
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Ocular motility disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Began Lariam (Mefloquine) on 26JAN92;
Current Illness: NONE
Preexisting Conditions: hx of endocarditis 1986
Allergies:
Diagnostic Lab Data: inc protein on spinal tap;
CDC Split Type:

Write-up: Following vax pt began to exp h/a; woke am of 27JAN92 w/severe h/a & diplopia; Seen by MD then went to hos for MRI, sp tap & lab work; 28JAN92 sx continued began having weakness; pt adm to hosp & given steroid therapy; cont to have diplopia


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