scholarly journals Fatal Acute Hemorrhagic Leukoencephalitis Following Immunization Against Human Papillomavirus in a 14-Year-Old Boy

2021 ◽  
Vol 8 ◽  
pp. 2329048X2110161
Author(s):  
Kari Wellnitz ◽  
Yutaka Sato ◽  
Daniel J. Bonthius
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Acute Disseminated Encephalomyelitis ◽  
High Dose ◽  
Papilloma Virus ◽  
Acute Hemorrhagic Leukoencephalitis ◽  
Hemorrhagic Necrosis ◽  
Cerebral Herniation ◽  
The Central Nervous System ◽  
Prevalent Pathogen

Human papilloma virus (HPV) is a prevalent pathogen whose persistent infection can lead to a variety of cancers. To protect against this threat, an HPV vaccine has been developed and is routinely administered to adolescents. The HPV vaccine has a reassuring safety profile, but reports have emerged of acute disseminated encephalomyelitis following its administration. Acute hemorrhagic leukoencephalitis (AHLE) is a severe inflammatory disease of the central nervous system and the most fulminant form of ADEM. We report a previously healthy 14-year-old boy who developed headache, fatigue, focal weakness, and confusion 3 weeks after receiving the HPV vaccine. Neuroimaging demonstrated multifocal demyelination. Despite treatment with high-dose steroids, his encephalopathy worsened. He developed severe cerebral edema and died of cerebral herniation. Postmortem histology revealed perivenular sleeves of tissue damage, myelin loss surrounding small parenchymal vessels, and diffuse hemorrhagic necrosis, consistent with AHLE. This is the first report of AHLE following HPV vaccination.

HPV VACCINE AND CERVICAL CANCER

2011 ◽  
pp. 108-115
Author(s):  
Vu Quoc Huy Nguyen
Keyword(s):  
Cervical Cancer ◽  
Relative Risk ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Preventive Strategy ◽  
Protective Effects ◽  
Papilloma Virus ◽  
Vaccine Trials ◽  
Close Relationship ◽  
The Relationship

Persistent infection with high-risk Human Papilloma Virus (HPV) has been identified as the causal factor of cervical cancer, with relative risk up to 300-400 folds. This very close relationship leads to the preventive strategy of vaccination against HPV infections and HPV-related lesions. The article describes molecular and immunologic characteristics of HPV, currently available HPV vaccines and its protective effects; the relationship between HPV vaccination and cervical cancer screening, and an introduction to therapeutic HPV vaccine trials.

scholarly journals Human Papilloma Virus Vaccination Compliance in a Military Aviation Training Community

2020 ◽  
Vol 185 (7-8) ◽  
pp. e1155-e1160
Author(s):  
Ian M Porter ◽  
Georgia Stoker ◽  
Samantha R Seals ◽  
Sabrina Drollinger ◽  
Heidi M Schutte ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Intervention Group ◽  
Prospective Analysis ◽  
Control Groups ◽  
Papilloma Virus ◽  
Military Aviation ◽  
Aviation Training ◽  
Rate Ratios ◽  
And Control

Abstract Introduction Human Papilloma Virus (HPV) vaccination compliance as reported by the CDC in 2011 falls short of a national goal to have 80% of adolescents vaccine-complete by 2020. The Naval Aviation Schools Command, Pensacola, Florida offers a single point of contact for military aviation trainees offering near-complete capture of an HPV vaccine target population. The purpose of this study is to identify baseline HPV vaccination rates among military aviation trainees and whether or not the provision of educational materials at the start of aviation training would increase future HPV vaccination compliance. Materials and methods Approval to conduct this study was obtained from the Institutional Review Board of Naval Medical Center Portsmouth, Virginia. Our population of interest consisted of US Navy and Marine Corps student naval aviators, student naval flight officers (officers), and student enlisted air crew (enlisted) reporting for aviation related duty. A convenience sampling of officer and enlisted student classes checking in for training was performed over a period of 6 months. The first 3 months of students were assigned as the intervention group and the remaining 3 months of students were assigned to the control group. This study was conducted in two parts: (1) an anonymous survey captured cross-sectional data of self-reported HPV vaccine use, and (2) prospective analysis of service members’ HPV vaccine rates before and after educational intervention as documented within the military’s electronic health record system, Armed Forces Health Longitudinal Technology Application (AHLTA). Results AHLTA immunization status was evaluated for 1,164 personnel; 114 (9.8%) were excluded for missing basic vaccination information. Of the remaining 1,050, another 199 (19%) members were excluded as already vaccine complete (evidenced by three shots documented) prior to entry into the study. Within the 199 service members with documented baseline HPV vaccination completion, 197/199 (99%) were officers and 2/199 (0.1%) were enlisted. A total of 851 personnel were included for prospective analysis. Person-time of 100 person years was used and the vaccination rate translates to 16.62/100 person years (95% CI 11.29, 23.59) within intervention vs. 2.96/100 person years (95% CI 0.80, 7.58) within control groups and are significantly different (P = 0.0001). Comparing intervention and control groups, rate ratios = 5.61 (95% CI 2.14, 18.64) and rate differences = 13.66 (95% CI 7.13, 20.19). Among intervention group survey responders who previously reported nonvaccine use, 50.5% reported a change in opinion about obtaining the vaccination, with a higher proportion of enlisted members reporting a change in opinion (62.8% vs. 39.7%, P = 0.0053). Conclusions Electronic health records immunizations review noted a baseline vaccine completion rate of 19%. Our study showed a health inequity between enlisted and officers, with officers having 99% of the documented baseline completion rates per AHLTA data. Our prospective analysis noted statistically significant rate differences of 13.66% and rate ratios of 5.61 between intervention and control groups. This analysis of AHLTA data combined with survey response of 50.5% indicating a change in opinion about HPV vaccine use among those who had not yet started vaccine series suggests targeted education would be a low-cost intervention to improve HPV vaccine use rates.

scholarly journals Knowledge of Cervical Cancer, Human Papilloma Virus (HPV) and HPV Vaccination Among Women in Northeast China

2019 ◽  
Vol 35 (6) ◽  
pp. 1197-1205 ◽  
Author(s):  
Yu-e Ning ◽  
Yao Liu ◽  
Xiao-yu Xu ◽  
Xin-yu Zhang ◽  
Ning Wang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papilloma Virus ◽  
Hpv Vaccine ◽  
Family Income ◽  
Hpv Vaccination ◽  
Northeastern China ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Obvious Effect ◽  
Papilloma Virus

AbstractThis study aimed to research the understanding and knowledge of cervical cancer, human papilloma virus (HPV), and HPV vaccination, and the acceptance of HPV vaccination, among a population of women in northeastern China. A cross-sectional survey was carried out by questionnaire to investigate knowledge of cervical cancer, HPV, and HPV vaccination. The 230 female participants were native residents of northeastern China, and their ages ranged between 18 and 65 years. Questionnaires were randomly acquired by the respondents from online and paper questionnaire distribution. The questionnaire included questions on three major aspects to record people’s perceptions of cervical cancer, HPV, and vaccines. Of the sample of 230 women surveyed, 80.9% had heard of cervical cancer, but understanding was only 15.7%; 38.3% knew about HPV; 20% knew about HPV vaccine; 39.6% agreed to receive HPV vaccination, and the remainder were mainly concerned about its safety and effectiveness. Data analysis showed that age, family income, and whether there was experience of screening all influenced knowledge of cervical cancer, but this was not statistically significant. The level of education had no obvious effect on the degree of knowledge about cervical cancer; however, with an improvement in education, women’s awareness of HPV vaccine improved significantly (p < 0.05). Women who have received cervical cancer screening had significantly greater knowledge about cervical cancer and HPV than those with no screening (p < 0.05). Women in northeastern China have little knowledge of cervical cancer, HPV, and HPV vaccine, lack disease knowledge, and hold a skeptical attitude about HPV vaccination. Medical institutions are the main channel providing information to these women.

scholarly journals Knowledge, Attitude and Practice of Main Stakeholders towards Human Papilloma Virus Infection and Vaccination in Mombasa and Tana-River Counties in Kenya: A Qualitative Study

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1099
Author(s):  
Diana Wangeshi Njuguna ◽  
Nour Mahrouseh ◽  
Osarugue Victory Isowamwen ◽  
Orsolya Varga
Keyword(s):  
Human Papilloma Virus ◽  
Hpv Vaccine ◽  
Health Workers ◽  
Hpv Vaccination ◽  
Significant Proportion ◽  
Human Papilloma Virus Infection ◽  
Hpv Infection ◽  
Structured Interviews ◽  
Papilloma Virus ◽  
Tana River

Following a successful Human Papilloma Virus (HPV) vaccination pilot in 2013–2015 in Kitui county, Kenya introduced the HPV vaccine in October 2019 with a goal to immunize approximately 800,000 girls annually against HPV. Our study assessed the knowledge, attitudes, and practice of affected groups towards HPV infection and vaccination in two counties of Kenya. Semi-structured interviews from children aged between nine and thirteen years and key informants comprising of parents, head teachers, community leaders and health workers involved in HPV vaccination in health facilities from Mombasa and Tana-River counties were conducted. Content was analyzed thematically and coded for emerging themes using the QRS Nvivo 12 Plus software package. From our findings, a significant proportion of participants, especially children, have limited knowledge of the subject. Vaccination of boys was opposed by most participants. Parents and the community members are not in favor of HPV vaccination, as compared to the other groups. A similar pattern of inadequate knowledge and strongly opposed attitudes was observed in Tana-River and Mombasa. Active community involvement in primary prevention strategies may promote the uptake of the vaccine which can be achieved by robust awareness, modifying the negative beliefs about HPV vaccine and encouraging the perceptibility of HPV vaccination.

scholarly journals Human papilloma virus vaccination: knowledge, awareness and acceptability among medical and paramedical students

2020 ◽  
Vol 9 (2) ◽  
pp. 474
Author(s):  
Suchith Hoblidar ◽  
Suma S. Moni ◽  
Rathnamala M. Desai ◽  
Asha Neravi
Keyword(s):  
Cervical Cancer ◽  
Nursing Students ◽  
Human Papilloma Virus ◽  
Health Care Professionals ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Target Population ◽  
Hpv Infection ◽  
Papilloma Virus ◽  
Sexually Transmitted

Background: Cervical cancer is the second leading cause of death in india. it is also one of the few malignancies where an infectious etiological agent human papilloma virus (HPV) has been identified. With the advent of HPV vaccination, it is possible to reduce the morbidity and mortality associated with carcinoma cervix. But biggest hurdle to achieve this is the lack of awareness about the availability and use of HPV vaccine. This study was conducted to know knowledge and awareness of HPV infection and vaccination among medical and paramedical students. We also evaluated the acceptability and coverage of HPV vaccine among these students.Methods: This study was conducted among a total of 520 female students of the Sri Dharmasthala Manjunatheshwara University with the help of a questionnaire. The study group included 207 MBBS students, 167 BDS students, 89 nursing students and 57 physiotherapy students.Results: Most of the students were in 18-20 years’ age group. Nearly 40.57% of the students knew that HPV is sexually transmitted and 29.80% were aware that this infection can be prevented. Availability of HPV vaccine was known to 75% of the students and the main source of their information was through their college teachings. Nearly 43.75% of the students knew HPV vaccine protects against cervical cancer and 26.73% of the students were vaccinated. Overall knowledge and awareness were better among medical students.Conclusions: A lot of work needs to be done so as to make the target population accept HPV vaccine. There is a great difference between awareness of availability of the vaccine and its use. This emphasizes the need for health care professionals to take special interest in promoting this vaccine in the general population.

Acute Disseminated Encephalomyelitis Secondary to Mycoplasma pneumoniae Infection Mimicking Extrapyramidal Symptoms: A Case Report

2017 ◽  
Vol 16 (01) ◽  
pp. 015-020 ◽  
Author(s):  
Chih-Chieh Cheng ◽  
Hueng-Chuen Fan ◽  
Ching-Shiang Chi ◽  
Shih-Ting Huang ◽  
Lang-Lung Yeh ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mycoplasma Pneumoniae ◽  
Rare Case ◽  
Acute Disseminated Encephalomyelitis ◽  
Good Prognosis ◽  
Extrapyramidal Symptoms ◽  
High Dose ◽  
The Central Nervous System ◽  
Mycoplasma Pneumoniae Infection

AbstractAcute disseminated encephalomyelitis (ADEM) is a rare disease affecting the central nervous system (CNS), and it is difficult to diagnose clinically because of vague prodromal presentations. The therapeutic aim for ADEM is to inhibit the CNS inflammatory reaction as quickly as possible. Treatments may include high-dose corticosteroids and anti-inflammatory and immunosuppressant therapies such as plasmapheresis and high-dose intravenous immunoglobulin. ADEM usually has a good prognosis. Here, we report a rare case of ADEM secondary to Mycoplasma pneumoniae infection mimicking extrapyramidal symptoms.

scholarly journals Use of Cyclophosphamide in a Child With Fulminant Acute Disseminated Encephalomyelitis

2018 ◽  
Vol 5 ◽  
pp. 2329048X1875463
Author(s):  
Hana Ayed ◽  
Mohammed W. Chaudhary ◽  
Raidah AlBaradie ◽  
Ali Mir
Keyword(s):  
Intravenous Immunoglobulin ◽  
Immunosuppressive Agents ◽  
Acute Disseminated Encephalomyelitis ◽  
High Dose ◽  
Intravenous Methylprednisolone ◽  
First Line ◽  
Demyelinating Disorder ◽  
Immune Mediated ◽  
Minimal Improvement ◽  
The Central Nervous System

Acute disseminated encephalomyelitis is an immune-mediated inflammatory demyelinating disorder of the central nervous system. The first-line treatment is usually high-dose intravenous methylprednisolone. Intravenous immunoglobulin and plasmapheresis have also shown to be beneficial. Immunosuppressive agents like cyclophosphamide have been used in adults with fulminant acute disseminated encephalomyelitis. We report a case of a 3-year-old boy with fulminant acute disseminated encephalomyelitis. Minimal improvement was seen with high-dose intravenous methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Based on the reports of cyclophosphamide being used successfully to treat adult patients with fulminant acute disseminated encephalomyelitis, we used it in our patient who then showed dramatic and quick improvement. We suggest that if conventional treatment fails, cyclophosphamide could be tried in pediatric patients with fulminant acute disseminated encephalomyelitis.

Fulminant Acute Disseminated Encephalomyelitis: A Remarkable Outcome with Cyclophosphamide

2020 ◽  
Author(s):  
Hadas Meirson ◽  
Shelly I. Shiran ◽  
Michal Raz ◽  
Jonathan Roth ◽  
Aviva Fattal-Valevski
Keyword(s):  
Central Nervous System ◽  
Acute Treatment ◽  
Demyelinating Disease ◽  
Pediatric Population ◽  
Acute Disseminated Encephalomyelitis ◽  
High Dose ◽  
Cyclophosphamide Treatment ◽  
The Central Nervous System ◽  
Intravenous Glucocorticoids ◽  
Cyclophosphamide Administration

AbstractAcute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system which occurs predominantly in the pediatric population. Acute treatment is high-dose intravenous glucocorticoids. Alternative treatment is usually intravenous immune globulin and/or plasma exchange. Fulminant ADEM is rare in children. Only a few cases of cyclophosphamide use in refractory ADEM have been reported. Here, we report a case of a 12-year-old girl with fulminant ADEM who was comatose and improved dramatically after cyclophosphamide administration. Cyclophosphamide treatment should be considered as a therapy in children with fulminant ADEM nonresponsive to standard therapies.

scholarly journals Acute Disseminated Encephalomyelitis following Vaccination against Hepatitis B in a Child: A Case Report and Literature Review

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Jun-liang Yuan ◽  
Shuang-kun Wang ◽  
Xiao-juan Guo ◽  
Wen-li Hu
Keyword(s):  
Hepatitis B ◽  
Marked Improvement ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Acute Disseminated Encephalomyelitis ◽  
Hepatitis B Vaccination ◽  
High Dose ◽  
The Central Nervous System ◽  
Alteration Of Consciousness ◽  
Brain And Spinal Cord

Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system, which has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, and the Hog vaccine. Here, we presented a case of 12-year-old child who suffered from ADEM three weeks after hepatitis B vaccination. He was admitted to our hospital with symptoms of weakness of limbs, high fever, and alteration of consciousness. Some abnormalities were also found in CSF. Treatment with high-dose corticosteroids and intravenous immunoglobulin had significant effect, with marked improvement of the clinical symptoms and the results of CSF. The findings of MRI also detected some abnormal lesions located in both brain and spinal cord. The clinical features, the findings of CSF and MRI, and therapeutic effect may contribute to such diagnosis of ADEM.

CNS demyelination and quadrivalent HPV vaccination

2009 ◽  
Vol 15 (1) ◽  
pp. 116-119 ◽  
Author(s):  
I Sutton ◽  
R Lahoria ◽  
IL Tan ◽  
P Clouston ◽  
MH Barnett
Keyword(s):  
Hpv Vaccine ◽  
Case Control Study ◽  
Hpv Vaccination ◽  
Safety Data ◽  
Target Population ◽  
Temporal Association ◽  
Papilloma Virus ◽  
Young Females ◽  
Cns Demyelination ◽  
Control Study

Vaccination is generally considered safe in patients with multiple sclerosis (MS). We report five patients who presented with multifocal or atypical demyelinating syndromes within 21 days of immunization with the quadrivalent human papilloma virus (HPV) vaccine, Gardasil®. Although the target population for vaccination, young females, has an inherently high risk for MS, the temporal association with demyelinating events in these cases may be explained by the potent immuno-stimulatory properties of HPV virus-like particles which comprise the vaccine. A prospective case–control study of patients with MS or clinically isolated demyelinating syndromes receiving the Gardasil® vaccine may provide relevant safety data in this population.

Sign in / Sign up

Export Citation Format

Share Document