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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282XOn-line version ISSN 1678-4227

Arq. Neuro-Psiquiatr. vol.60 no.1 São Paulo Mar. 2002

http://dx.doi.org/10.1590/S0004-282X2002000100037 

CLINICAL AND LABORATORIAL ASPECTS OF ASEPTIC MENINGITIS ASSOCIATED WITH MMR (MEASLES-MUMPS-RUBELLA) VACCINE AT A REFERRAL HOSPITAL IN THE STATE OF BAHIA (ABSTRACT)*. THESIS. SALVADOR, 2001.

 

RITA LUCENA**

 

Meningitis associated to vaccination has not been a matter of discussion in Brazil. In 1997, after mass vaccination campaign against measles, mumps and rubella (MMR), an increased number of hospital admission due to aseptic meningitis was verified in some Brazilian States. In the Couto Maia Hospital, reference to parasitic and infectious diseases in the State of Bahia, this fact was also observed and permitted the analysis of an outbreak of aseptic meningitis associated to MMR.

The aim of this issue was to establish a risk analysis of post-vaccinal aseptic meningitis in the city of Salvador and to determine laboratorial, clinic and demographic characteristics of aseptic meningitis associated to MMR and to compare them with cases of aseptic meningitis in children.

Between March and December 1997, we followed all the children admitted in the Couto Maia Hospital, aged between 1 and 12 years, with the diagnosis of aseptic meningitis. At the moment of admission, after cerebral spinal fluid tap and diagnostic of meningitis, a questionnaire was applied in order to obtain clinic, demographic, and laboratorial information. At this moment and every day on neurological examination was performed until discharge. The cases were divided in two groups. In group I, children with history of MMR vaccination between 10 and 35 days before symptoms; in group II, cases of aseptic meningitis not related to MMR vaccination. We performed a coorte and a case series analysis to estimate the incidence and relative risk. Data were analysed with the aid of the SPSS package. Associations with p<0.05 were considered significant.

Our results showed that: (1)The estimated risk of post-vaccinal meningitis was 1 to 14000 doses. (2)There was increased frequency of nuchal rigidity and CSF cellularity in children with meningitis associated to vaccine. (3) Greater number of enkephalic problems was verified in the group of meningitis not-associated to vaccination.

In conclusion, we verified an increased risk of aseptic meningitis in children who received MMR vaccine in some Brazilian cities. Post-vaccinal aseptic meningitis needs a special attention because they can compromise the credibility of vaccine campaigns in Brazil.

KEY WORDS: aseptic meningitis, MMR vaccine, mumps, measles, rubella.

 

 

* Aspectos clínico-laboratoriais de meningite asséptica associada à vacina tríplice viral em um hospital de referência no Estado da Bahia (Resumo). Tese de Doutorado, Universidade Federal da Bahia (Área: Neurologia). Orientador: Ailton Melo

**Address: Alameda Praia do Guarujá 175 / Stela Maris, 41600-100 Salvador BA, Brsil. E-e: rlucena@ufba.br

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