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The Expert Group on Serious Adverse Events with History of Human Swine Influenza (HSI) Vaccination has arrived at a consensus view on a suspected case of Acute Disseminated Encephalomyelitis (ADEM) with history of human swine influenza vaccination.
At its meeting today (February 10), the group considered that the clinical features of the patient were compatible with ADEM. Further investigations are under way to better delineate the cause of her illness. However, the expert group considered it unlikely that her illness had been caused by HSI vaccine.
The case was reported to the Centre for Health Protection on February 4.
The patient is a 67-year-old woman who developed generalised weakness on January 12, followed by fever and headache on January 15. She had undiagnosed diabetes mellitus and went into septicaemic shock and renal failure requiring renal replacement therapy. She is currently in the intensive care unit in critical condition.
Further magnetic resonance imaging examination of the brain done on February 1 showed features suggestive of ADEM. Other differential diagnoses include vasculitis, multiple infarcts and infection.
She received a HSI vaccine on December 23 last year in a government outpatient clinic.
Locally, the exact incidence of ADEM is not known. From record reviews, the expert group noted that there had been at least one case in 2008 that was preceded by seasonal influenza infection and another in 2009 preceded by HSI infection.
The expert group also learnt that between December 21, 2009, when the HSI vaccination programme started and February 9 this year, there were 42 severe HSI cases, of which 28 were male and 14 female. The affected people were aged between 30 days and 85 years with a median age of 52 years.
Thirty of these cases, or 71.43%, required admission to Intensive Care Units. Twelve of them died. The majority of them (35 of 42 severe cases and 11 of 12 fatal cases) fell within the target groups for HSI vaccination.
Ends/Wednesday, February 10, 2010
Issued at HKT 17:50
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