Dataset Information

Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar.

ABSTRACT: This study was conducted to find the burden of dengue virus (DENV) and Japanese encephalitis virus (JEV) among children under the age of 13, who presented with acute encephalitis syndrome at Mandalay Children Hospital in Myanmar in 2013. Molecular and serological investigations were performed on 123 cerebrospinal fluid (CSF) samples collected from these patients. By neutralization tests and/or virus isolation, four (3.3%) JEV- and one DENV-associated encephalitis cases (0.8%) were confirmed. Antibody titer against JEV Genotype 3 was the highest among the laboratory-confirmed JEV cases. One strain of DENV-1 with Genotype 1 was isolated from the CSF sample of the dengue encephalitis patient; this was similar to the virus circulating in the study area and neighboring countries. This study shows that flaviviruses are important pathogens causing encephalitis in Myanmar. Active disease surveillance, vector control, and vaccination programs should be enforced to reduce the morbidity and mortality caused by flavivirus encephalitis.

SUBMITTER: Kyaw AK

PROVIDER: S-EPMC6402905 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar.

Kyaw Aung Kyaw AK Ngwe Tun Mya Myat MM Nabeshima Takeshi T Buerano Corazon C CC Ando Tsuyoshi T Inoue Shingo S Hayasaka Daisuke D Lim Chang-Kweng CK Saijo Masayuki M Thu Hlaing Myat HM Thant Kyaw Zin KZ Morita Kouichi K

The American journal of tropical medicine and hygiene 20190301 3

This study was conducted to find the burden of dengue virus (DENV) and Japanese encephalitis virus (JEV) among children under the age of 13, who presented with acute encephalitis syndrome at Mandalay Children Hospital in Myanmar in 2013. Molecular and serological investigations were performed on 123 cerebrospinal fluid (CSF) samples collected from these patients. By neutralization tests and/or virus isolation, four (3.3%) JEV- and one DENV-associated encephalitis cases (0.8%) were confirmed. Ant ...[more]

PMID: 30628568

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Project description:BACKGROUND: In recent decades, Echovirus 30 (E30) and Japanese encephalitis virus (JEV) have been reported to be the common causative agents of acute meningitis among patients in South East Asia. An E30 outbreak in Vietnam in 2001-2002 gained our interest because the initial clinical diagnosis of infected patients was due to JEV infection. There are few clinical insights regarding E30 cases, and there are no reports comparing E30 and JEV acute meningitis/encephalitis cases based on clinical symptoms and case histories. We therefore aimed to identify reliable clinical methods to differentiate E30 and JEV acute meningitis/encephalitis. METHODS: A retrospective, cross-sectional study was conducted to compare E30 and JEV acute meningitis/encephalitis cases. We collected and analyzed the clinical records of 43 E30 confirmed cases (E30 group) and 60 JEV confirmed cases (JEV group). Clinical data were compared between the E30 and the JEV groups. Differences of clinical parameters were analyzed by certain statistical tests. RESULTS: Fever, headache, and vomiting were the most common symptoms in both the E30 and the JEV groups. Combined symptoms of headache and vomiting and the triad of symptoms of fever, headache, and vomiting were observed in more patients in the E30 group (E30 vs. JEV: 19% vs. 0%, p?<?0.001; 74% vs. 27%, p?<?0.001, respectively). On the other hand, strong neurological symptoms such as seizure (5% vs. 73%, p?<?0.001) and altered consciousness (12% vs. 97%, p?<?0.001) were manifested primarily in the JEV group. CSF leukocytosis was observed predominantly in the E30 group (80 vs. 18 cells/?L, p?=?0.003), whereas decreasing CSF sugar level was observed predominantly in the JEV group (58.7 vs. 46.9 mg/dL, p?<?0.001). CONCLUSION: Fever, headache, vomiting, absence of neurological symptoms (seizure, altered consciousness), and presence of CSF leukocytosis are important parameters to consider in differentiating E30 from JEV cases during early infection. Then, proper measures can be adopted immediately to prevent the spread of the disease in the affected areas.

Dataset Information

Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar.

Publications

Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar.

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