Myelopathy After Duck Embryo Vaccine

To the Editor.—  The clinical picture did indeed suggest the Guillain-Barré syndrome, and this diagnosis would probably have been more appropriate. However, involvement of the anterior horn cells exclusively was not ruled out, and there is little certainity of the origin of the Guillain-Barré syndrome as a distinct nosologic entity.We had been unable to find published reports describing Guillain-Barré neuropathy as a reaction to duck embryo rabies vaccine. However, five cases of cranial or peripheral neuropathy are included in the rabies surveillance summary issued in January 1973 by the PHS Center for Disease Control. This summary covers reactions reported in the 15 years (1957-1971) since duck embryo rabies vaccine was first licensed and made available commercially. An estimated 424,000 persons were given nearly 6,000,000 doses of the vaccine during this period. The 15-year summary also mentions 37 cases of minor and transient neurologic symptoms, 4 cases of transverse myelitis,