An elderly priest who died after he was given a yellow fever vaccine was aware of the higher risk it posed to his age group before he consented to it, an inquest heard.
Fr Gerard Cusack (71), prior of the Holy Trinity Abbey, Kilnacrott in Ballyjamesduff, Co Cavan, died at Beaumont Hospital on March 18th last year as a result of an adverse reaction to the vaccine.
Worldwide there have been only 60 documented fatalities due to the yellow fever vaccine since its introduction in the 1930s.
Dublin Coroner's Court had previously heard that Fr Cusack, who was due to travel to Tanzania to inspect work on a church roof paid for through fundraising efforts, was given the vaccine following a consultation with Dr William Yap at the Tropical Medical Bureau on Grafton Street, Dublin, on March 7th, 2013.
Age group
On the final day of the inquest Dr Yap gave evidence that he discussed with Fr Cusack the risks associated with the vaccine for people of his age group.
“I am certain I cautioned and warned Fr Cusack of the potential side effects and in the rare instance a serious adverse life-threatening reaction, about one in 100,000. Fr Cusack understood and accepted the risk.”
He said the World Health Organisation listed Tanzania as "low risk" for yellow fever and the vaccine was generally not recommended but it "may be considered for a subset of travellers".
Fr Cusack planned to visit rural parts of the country and stay with members of his community with a higher risk of exposure to mosquitos. “Fr Cusack and I both agreed that his trip was not generally what an average traveller to Tanzania would do.”
Dr Yap said issues around border control were also taken into consideration in the risk-benefit analysis of administering the vaccine. There had been cases where travellers were forced to receive the yellow fever vaccine at entry points to Tanzania, with border officials taking differing approaches to travellers arriving without certification for it.
There was also a risk that Fr Cusack would not be allowed into a neighbouring country if he was in need of emergency medical treatment without the certification, the court heard.
Feeling ill
Eight days after receiving the vaccine Fr Cusack presented at
Cavan General Hospital
complaining of feeling ill for one week. His GP had prescribed an antibiotic but this had no effect. His condition deteriorated rapidly over 36 hours and he was transferred to Beaumont Hospital where he died from multi-organ failure on March 18th.
Prof Peter Conlon, consultant nephrologist at Beaumont, previously told the court there was no treatment for yellow fever other than "supportive" measures and the disease was fatal in 20 per cent of cases.
The postmortem 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.
Coroner Dr Brian Farrell said he was satisfied the death was due to an adverse reaction to the vaccine.