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Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016.
J Vector Borne Dis. 2017 Oct-Dec; 54(4):311-316.JV

Abstract

Background & objectives

It is imperative to know the aetiology of acute encephalitis syndrome (AES) for patient management and policy making. The present study was carried out to determine the prevalence of common aetiological agents of AES in Uttar Pradesh (UP) state of India.

Methods

Serum and/or CSF samples were collected from AES patients admitted at Gandhi Memorial and Associated Hospital, King George's Medical University, Lucknow, a tertiary care centre, UP during 2014-16. Cerebrospinal fluid (CSF) and serum samples from cases were tested for IgM antibodies against Japanese encephalitis virus (anti-JEV), and dengue virus (anti-DENV) by ELISA; and for enterovirus, herpes simplex virus (HSV) and varicella zoster virus (VZV) by real-time PCR. Serum samples of cases having sufficient CSF volume, were also tested for anti-scrub typhus IgM antibodies and for Neisseria meningitides, Streptococcus pneumoniae and Haemophilus influenzae.

Results

JEV and DENV (8% each) were the most common identified aetiology from the 4092 enrolled patients. Enterovirus, HSV and VZV, each were detected in <1% AES cases. Co-positivity occurred in 48 cases. Scrub typhus (31.8%) was the most common aetiology detected. Haemophilus influenzae and S. pneumoniae were detected in 0.97 and 0.94% cases, respectively, however, N. meningitides was not detected in any of the cases. About 40% of the JEV/DENV positive AES cases were adults. The gap between the total number of AES cases and those with JEV/ DENV infection increased during monsoon and post-monsoon seasons.

Interpretation & conclusion

Scrub typhus, JEV and DENV are the main aetiological agents of AES in UP. DENV and JEV can no longer be considered paediatric diseases. The prevalence of non-JEV/DENV aetiology of AES increases in the monsoon and post-monsoon seasons.

Authors+Show Affiliations

Department of Microbiology, King George's Medical University, Lucknow, India.Department of Microbiology, King George's Medical University, Lucknow, India.Department of Microbiology, King George's Medical University, Lucknow, India.Department of Neurology, King George's Medical University, Lucknow, India.Department of Paediatrics, King George's Medical University, Lucknow, India.Department of Microbiology, King George's Medical University, Lucknow, India.Department of Microbiology, King George's Medical University, Lucknow, India.Department of Microbiology, King George's Medical University, Lucknow, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29460860

Citation

Jain, Parul, et al. "Aetiology of Acute Encephalitis Syndrome in Uttar Pradesh, India From 2014 to 2016." Journal of Vector Borne Diseases, vol. 54, no. 4, 2017, pp. 311-316.
Jain P, Prakash S, Khan DN, et al. Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016. J Vector Borne Dis. 2017;54(4):311-316.
Jain, P., Prakash, S., Khan, D. N., Garg, R. K., Kumar, R., Bhagat, A., Ramakrishna, V., & Jain, A. (2017). Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016. Journal of Vector Borne Diseases, 54(4), 311-316. https://doi.org/10.4103/0972-9062.225835
Jain P, et al. Aetiology of Acute Encephalitis Syndrome in Uttar Pradesh, India From 2014 to 2016. J Vector Borne Dis. 2017 Oct-Dec;54(4):311-316. PubMed PMID: 29460860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aetiology of acute encephalitis syndrome in Uttar Pradesh, India from 2014 to 2016. AU - Jain,Parul, AU - Prakash,Shantanu, AU - Khan,Danish N, AU - Garg,Ravindra Kumar, AU - Kumar,Rashmi, AU - Bhagat,Amit, AU - Ramakrishna,V, AU - Jain,Amita, PY - 2018/2/21/entrez PY - 2018/2/21/pubmed PY - 2018/11/22/medline KW - Acute encephalitis syndrome KW - Japanese encephalitis virus KW - aetiology KW - dengue virus KW - scrub typhus SP - 311 EP - 316 JF - Journal of vector borne diseases JO - J Vector Borne Dis VL - 54 IS - 4 N2 - Background & objectives: It is imperative to know the aetiology of acute encephalitis syndrome (AES) for patient management and policy making. The present study was carried out to determine the prevalence of common aetiological agents of AES in Uttar Pradesh (UP) state of India. Methods: Serum and/or CSF samples were collected from AES patients admitted at Gandhi Memorial and Associated Hospital, King George's Medical University, Lucknow, a tertiary care centre, UP during 2014-16. Cerebrospinal fluid (CSF) and serum samples from cases were tested for IgM antibodies against Japanese encephalitis virus (anti-JEV), and dengue virus (anti-DENV) by ELISA; and for enterovirus, herpes simplex virus (HSV) and varicella zoster virus (VZV) by real-time PCR. Serum samples of cases having sufficient CSF volume, were also tested for anti-scrub typhus IgM antibodies and for Neisseria meningitides, Streptococcus pneumoniae and Haemophilus influenzae. Results: JEV and DENV (8% each) were the most common identified aetiology from the 4092 enrolled patients. Enterovirus, HSV and VZV, each were detected in <1% AES cases. Co-positivity occurred in 48 cases. Scrub typhus (31.8%) was the most common aetiology detected. Haemophilus influenzae and S. pneumoniae were detected in 0.97 and 0.94% cases, respectively, however, N. meningitides was not detected in any of the cases. About 40% of the JEV/DENV positive AES cases were adults. The gap between the total number of AES cases and those with JEV/ DENV infection increased during monsoon and post-monsoon seasons. Interpretation & conclusion: Scrub typhus, JEV and DENV are the main aetiological agents of AES in UP. DENV and JEV can no longer be considered paediatric diseases. The prevalence of non-JEV/DENV aetiology of AES increases in the monsoon and post-monsoon seasons. SN - 0972-9062 UR - https://www.unboundmedicine.com/medline/citation/29460860/Aetiology_of_acute_encephalitis_syndrome_in_Uttar_Pradesh_India_from_2014_to_2016_ L2 - http://www.jvbd.org/article.asp?issn=0972-9062;year=2017;volume=54;issue=4;spage=311;epage=316;aulast=Jain;type=2 DB - PRIME DP - Unbound Medicine ER -