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Sunday, June 22, 2014

Priest died after suffering 'very rare adverse reaction' to yellow fever vaccine

A priest died after suffering a very rare adverse reaction to the yellow fever vaccine, an inquest heard.
Fr Gerard Cusack (71), prior of the Holy Trinity Abbey, Kilnacrott in Ballyjamesduff, Co Cavan, died at Beaumont Hospital on March 18 last year, 11 days after he had been given the vaccine in advance of a trip to central Africa.
Dublin Coroner’s Court heard that there have been only 60 documented cases of death due to the vaccine worldwide since its introduction in the 1930s.
Fr Cusack was due to travel to Tanzania to inspect works on a church roof paid for through fundraising efforts.
His sister Marie Crossan said that he was generally in good health with no medical complaints.
He attended the Tropical Medical Bureau (TMB) clinic on Grafton Street on March 7 where he was initially seen by Dr William Yap and subsequently a member of the nursing staff.
Dr Graham Fry, medical director at the TMB, said that Fr Cusack reported no health issues, previous or at the time, on the medical questionnaire that the clinic requires patients to complete nor did he do so during his consultation with Dr Yap.
He was prescribed medication for his upcoming trip and given a number of vaccinations including yellow fever.
When he left the practice 20 to 30 minutes later, Fr Cusack appeared to be in good health, he said.
The court heard that Fr Cusack subsequently presented at Cavan General Hospital on March 15, complaining of feeling ill for one week.
His GP had prescribed an antibiotic but this had no effect.
His condition deteriorated rapidly over the following 36 hours and he was transferred to Beaumont Hospital where he died from multi-organ failure on March 18.
Professor Peter Conlon, consultant nephrologist at Beaumont, told the court that there is no treatment for yellow fever other than “supportive” measures and the disease is fatal in 20 per cent of cases.
The post-mortem confirmed the presence of yellow fever in the liver and that the strain of the disease was the same as the one administered to Fr Cusack in the vaccine.
The cause of death was acute liver and kidney failure due to an adverse reaction to the yellow fever vaccine.
Dr Fry said yellow fever is a “live vaccine” with a higher instance of side effects in people over 60.
As a result, a risk-benefit analysis must be done considering a number of factors including what parts of the country the person intends to visit, he said.
There are approximately 60 cases of deaths as a result of the vaccine in international travellers since it was introduced, he told the court.
The TMB treats 3,000 people annually with the vaccine and this is the first time they have seen an adverse reaction, he added. 
The inquest was adjourned to August 19 to hear direct evidence from Dr Yap.

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