Infectious causes of acute encephalitis syndrome hospitalizations in Central India, 2018-20.
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Tandale Babasaheb V, Tomar Shilpa J, Bondre Vijay P, Sapkal Gajanan N, Damle Rekha G, Narang Rahul, Qazi Mohiuddin S, Goteti Padmaja V, Jain Manish, Jain Dipty, Guduru Vijay Kumar, Jain Jyoti, Gosavi Rajesh V, Sekhar V Chandra, Study-Group Infectious-Encephalitis-Aetiologies, Pavitrakar Daya V, Shankarraman Vasudha, Mahamuni Shubhangi A, Salunkhe Asha, Khude Poornima, Deshmukh Pravin S, Deshmukh Pradeep R, Raut Abhishek V, Niswade Abhimanyu K, Bansod Yogendra V, Narlawar Uday W, Talapalliwar Manoj, Rathod Pragati, Jha Punam Kumari, Rao R Kondal, Jyothi K, B Padmini Soujanya, M Pavan Kumar, K J Kishore Kumar, Taksande Amar, Kumar Sunil, Mudey Gargi, Yelke B S, Kamble Milind, Tankhiwale Supriya
Аннотация
METHODS: From October 2018 to September 2020, we screened neurological patients for AES in all age groups in Maharashtra and Telangana States. AES cases were enrolled at study hospitals along with other referrals and sampled with cerebrospinal fluid, acute and convalescent sera. We tested specimens for non-viral aetiologies viz. leptospirosis, typhoid, scrub typhus, malaria and acute bacterial meningitis, along with viruses - JEV, Dengue virus (DENV), Chikungunya virus (CHIKV), Chandipura virus (CHPV) and Herpes simplex virus (HSV).
RESULTS: Among 4977 neurological hospitalizations at three study site hospitals over two years period, 857 (17.2%) were AES. However, only 287 (33.5%) AES cases were eligible. Among 278 (96.9%) enrolled AES cases, infectious aetiologies were identified in 115 (41.4%) cases, including non-viral in 17 (6.1%) cases - leptospirosis (8), scrub-typhus (3) and typhoid (6); and viral in 98 (35.3%) cases - JEV (58, 20.9%), HSV (22, 7.9%), DENV (15, 5.4%) and CHPV (3, 1.1%). JEV confirmation was significantly higher in enrolled cases than referred cases (10.2%) (p < 0.05). However, the contribution of JEV in AES cases was similar in both children and adults. JE was reported year-round and from adjacent non-endemic districts.
CONCLUSIONS: The Japanese encephalitis virus continues to be the leading cause of acute encephalitis syndrome in central India despite vaccination among children. Surveillance needs to be strengthened along with advanced diagnostic testing for assessing the impact of vaccination.