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Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a four year AES surveillance study of Japanese encephalitis in selected states of India.
Int J Infect Dis. 2019 Jul; 84S:S19-S24.IJ

Abstract

BACKGROUND

Acute encephalitis syndrome (AES) surveillance in India has indicated that Japanese encephalitis virus (JEV) accounts for 5-35% of AES cases annually; the etiology remains unknown in the remaining cases. We implemented comprehensive AES surveillance to identify other etiological agents of AES, with emphasis on dengue virus.

METHODS

Serum and cerebrospinal fluid (CSF) specimens were collected from patients enrolled prospectively in AES surveillance from 2014-2017 at selected sites of three high burden states of India. All samples were initially tested for JEV IgM. Specimens negative for JEV by serology were tested for IgM to scrub typhus, dengue virus (DEN), and West Nile virus; all JEV IgM-negative CSF samples were tested by PCR for S. pneumoniae, N. meningitidis, H. influenzae, herpes simplex virus type 1, enteroviruses and DEN.

RESULTS

Of 10,107 AES patients, an etiology could be established in 49.2% of patients including JEV (16%), scrub typhus (16%) and DEN (5.2%) as the top three agents. Amongst the DEN positive cases (359/6892), seven (2%) were positive only for dengue virus RNA: one in serum and six in CSF.

CONCLUSION

Amongst the pathogens identified, dengue accounted for 5% of all AES cases and was one of the three common etiological agents. These results underscore the importance of including dengue virus in routine testing of AES cases.

Authors+Show Affiliations

National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India. Electronic address: virusravi@gmail.com.National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India.National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India.National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India.National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India.CDC India, New Delhi, India.National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, 560029, India.King George's Medical University, Lucknow, India.Assam Medical College, Dibrugarh, Assam, India.Assam Medical College, Dibrugarh, Assam, India.Gauhati Medical College, Guwahati, Assam, India.School of Tropical Medicine and Hygiene, Kolkota, India.School of Tropical Medicine and Hygiene, Kolkota, India.National Vector Borne Diseases Control Program, New Delhi, India.National Vector Borne Diseases Control Program, New Delhi, India.National Centre for Disease Control, New Delhi, India.Director General of Health Services, Ministry of Health and Family Welfare, New Delhi, India.CDC India, New Delhi, India.CDC India, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30641206

Citation

Vasanthapuram, Ravi, et al. "Dengue Virus Is an Under-recognised Causative Agent of Acute Encephalitis Syndrome (AES): Results From a Four Year AES Surveillance Study of Japanese Encephalitis in Selected States of India." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 84S, 2019, pp. S19-S24.
Vasanthapuram R, Shahul Hameed SK, Desai A, et al. Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a four year AES surveillance study of Japanese encephalitis in selected states of India. Int J Infect Dis. 2019;84S:S19-S24.
Vasanthapuram, R., Shahul Hameed, S. K., Desai, A., Mani, R. S., Reddy, V., Velayudhan, A., Yadav, R., Jain, A., Saikia, L., Borthakur, A. K., Mohan, D. G., Bandyopadhyay, B., Bhattacharya, N., Dhariwal, A. C., Sen, P. K., Venkatesh, S., Prasad, J., Laserson, K., & Srikantiah, P. (2019). Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a four year AES surveillance study of Japanese encephalitis in selected states of India. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 84S, S19-S24. https://doi.org/10.1016/j.ijid.2019.01.008
Vasanthapuram R, et al. Dengue Virus Is an Under-recognised Causative Agent of Acute Encephalitis Syndrome (AES): Results From a Four Year AES Surveillance Study of Japanese Encephalitis in Selected States of India. Int J Infect Dis. 2019;84S:S19-S24. PubMed PMID: 30641206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dengue virus is an under-recognised causative agent of acute encephalitis syndrome (AES): Results from a four year AES surveillance study of Japanese encephalitis in selected states of India. AU - Vasanthapuram,Ravi, AU - Shahul Hameed,Shafeeq Keeran, AU - Desai,Anita, AU - Mani,Reeta Subramaniam, AU - Reddy,Vijayalakshmi, AU - Velayudhan,Anoop, AU - Yadav,Ravi, AU - Jain,Amita, AU - Saikia,Lahari, AU - Borthakur,A K, AU - Mohan,Daiji Gogoi, AU - Bandyopadhyay,Bhaswati, AU - Bhattacharya,Nemai, AU - Dhariwal,Akshay Chandra, AU - Sen,Prabir Kumar, AU - Venkatesh,Srinivas, AU - Prasad,Jagdish, AU - Laserson,Kayla, AU - Srikantiah,Padmini, Y1 - 2019/01/11/ PY - 2018/12/12/received PY - 2019/01/02/revised PY - 2019/01/04/accepted PY - 2019/1/15/pubmed PY - 2019/10/29/medline PY - 2019/1/15/entrez KW - Acute encephalitis syndrome KW - Dengue KW - Etiological agents KW - India SP - S19 EP - S24 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int. J. Infect. Dis. VL - 84S N2 - BACKGROUND: Acute encephalitis syndrome (AES) surveillance in India has indicated that Japanese encephalitis virus (JEV) accounts for 5-35% of AES cases annually; the etiology remains unknown in the remaining cases. We implemented comprehensive AES surveillance to identify other etiological agents of AES, with emphasis on dengue virus. METHODS: Serum and cerebrospinal fluid (CSF) specimens were collected from patients enrolled prospectively in AES surveillance from 2014-2017 at selected sites of three high burden states of India. All samples were initially tested for JEV IgM. Specimens negative for JEV by serology were tested for IgM to scrub typhus, dengue virus (DEN), and West Nile virus; all JEV IgM-negative CSF samples were tested by PCR for S. pneumoniae, N. meningitidis, H. influenzae, herpes simplex virus type 1, enteroviruses and DEN. RESULTS: Of 10,107 AES patients, an etiology could be established in 49.2% of patients including JEV (16%), scrub typhus (16%) and DEN (5.2%) as the top three agents. Amongst the DEN positive cases (359/6892), seven (2%) were positive only for dengue virus RNA: one in serum and six in CSF. CONCLUSION: Amongst the pathogens identified, dengue accounted for 5% of all AES cases and was one of the three common etiological agents. These results underscore the importance of including dengue virus in routine testing of AES cases. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/30641206/Dengue_virus_is_an_under_recognised_causative_agent_of_acute_encephalitis_syndrome__AES_:_Results_from_a_four_year_AES_surveillance_study_of_Japanese_encephalitis_in_selected_states_of_India_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(19)30019-0 DB - PRIME DP - Unbound Medicine ER -