NEUROLOGICAL COMPLICATIONS IN ADULTS GIVE N POSTEXPOSURE SEMPLE-TYPE RABIES VACCINE

Objectives: Despite well-known neurological complications, post-exposu re semple-type rabies vaccine is still used in Tunisia. We retrospecti vely studied neurological manifestations following post-exposure rabie s vaccine. Methods: Over a 3-year period, semple-type phenol inactivat ed lamb nerve tissue vaccine (Pasteur Institute, Tunis) was given to 1 392 adults after exposure to rabies. Results: The frequency of neurolo gical complications was 1/200, Seven patients presented complications 4 to 14 days after the first vaccine injection (median 11 days), Centr al nervous system manifestations occurred in all 7 patients with perip heral neuropathy in 5. Manifestations were meningoradiculitis (n=3), m eningomyeloradiculitis (n=2), meningomyelitis (n=1) and myelitis (n=1) . No vaccine-associated death occurred, but one patient suffered persi stant paraplegia. Conclusion: Semple-type adult animal nerve tissue va ccine produces an unacceptable rate of severe post-vaccinal neurologic al complications in adults. Human diploid cell rabies vaccine should b e used for post-exposure rabies vaccination.