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Marsland MJ, Thomson TN, O'Brien HM, Peach E, Bellette J, Humphreys N, McKeon CA, Cross W, Moso MA, Batty M, Nicholson S, Karapanagiotidis T, Lim CK, Williamson DA, Winkler N, Koirala A, Macartney K, Glynn-Robinson A, Stewart T, Minko C, Snow KJ, Black J, Friedman ND. Serosurvey for Japanese encephalitis virus antibodies following an outbreak in an immunologically naïve population, Victoria, 2022: a cross-sectional study. Med J Aust 2024; 220:566-572. [PMID: 38803004 DOI: 10.5694/mja2.52344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/04/2023] [Indexed: 05/29/2024]
Abstract
OBJECTIVES To investigate the distribution and prevalence of Japanese encephalitis virus (JEV) antibody (as evidence of past infection) in northern Victoria following the 2022 Japanese encephalitis outbreak, seeking to identify groups of people at particular risk of infection; to investigate the distribution and prevalence of antibodies to two related flaviviruses, Murray Valley encephalitis virus (MVEV) and West Nile virus Kunjin subtype (KUNV). STUDY DESIGN Cross-sectional serosurvey (part of a national JEV serosurveillance program). SETTING Three northern Victorian local public health units (Ovens Murray, Goulburn Valley, Loddon Mallee), 8 August - 1 December 2022. PARTICIPANTS People opportunistically recruited at pathology collection centres and by targeted recruitment through community outreach and advertisements. People vaccinated against or who had been diagnosed with Japanese encephalitis were ineligible for participation, as were those born in countries where JEV is endemic. MAIN OUTCOME MEASURES Seroprevalence of JEV IgG antibody, overall and by selected factors of interest (occupations, water body exposure, recreational activities and locations, exposure to animals, protective measures). RESULTS 813 participants were recruited (median age, 59 years [interquartile range, 42-69 years]; 496 female [61%]); 27 were JEV IgG-seropositive (3.3%; 95% confidence interval [CI], 2.2-4.8%) (median age, 73 years [interquartile range, 63-78 years]; 13 female [48%]); none were IgM-seropositive. JEV IgG-seropositive participants were identified at all recruitment locations, including those without identified cases of Japanese encephalitis. The only risk factors associated with JEV IgG-seropositivity were age (per year: prevalence odds ratio [POR], 1.07; 95% CI, 1.03-1.10) and exposure to feral pigs (POR, 21; 95% CI, 1.7-190). The seroprevalence of antibody to MVEV was 3.0% (95% CI, 1.9-4.5%; 23 of 760 participants), and of KUNV antibody 3.3% (95% CI, 2.1-4.8%; 25 of 761). CONCLUSIONS People living in northern Victoria are vulnerable to future JEV infection, but few risk factors are consistently associated with infection. Additional prevention strategies, including expanding vaccine eligibility, may be required to protect people in this region from Japanese encephalitis.
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Affiliation(s)
- Madeleine J Marsland
- Victorian Department of Health, Melbourne, VIC, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tilda N Thomson
- Victorian Department of Health, Melbourne, VIC, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | | | | | | | | | | | | | - Michael A Moso
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Mitchell Batty
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Suellen Nicholson
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Theo Karapanagiotidis
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Chuan Kok Lim
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Deborah A Williamson
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, Melbourne, VIC
| | - Noni Winkler
- National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals Network, Sydney, NSW
| | - Archana Koirala
- National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals Network, Sydney, NSW
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Sydney Children's Hospitals Network, Sydney, NSW
| | - Anna Glynn-Robinson
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Tony Stewart
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
| | - Corinna Minko
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Kathryn J Snow
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Jim Black
- Victorian Department of Health, Melbourne, VIC, Australia
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Lau CL, Mills DJ, Mayfield H, Gyawali N, Johnson BJ, Lu H, Allel K, Britton PN, Ling W, Moghaddam T, Furuya-Kanamori L. A decision support tool for risk-benefit analysis of Japanese encephalitis vaccine in travellers. J Travel Med 2023; 30:taad113. [PMID: 37602668 DOI: 10.1093/jtm/taad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND During pre-travel consultations, clinicians and travellers face the challenge of weighing the risks verus benefits of Japanese encephalitis (JE) vaccination due to the high cost of the vaccine, low incidence in travellers (~1 in 1 million), but potentially severe consequences (~30% case-fatality rate). Personalised JE risk assessment based on the travellers' demographics and travel itinerary is challenging using standard risk matrices. We developed an interactive digital tool to estimate risks of JE infection and severe health outcomes under different scenarios to facilitate shared decision-making between clinicians and travellers. METHODS A Bayesian network (conditional probability) model risk-benefit analysis of JE vaccine in travellers was developed. The model considers travellers' characteristics (age, sex, co-morbidities), itinerary (destination, departure date, duration, setting of planned activities) and vaccination status to estimate the risks of JE infection, the development of symptomatic disease (meningitis, encephalitis), clinical outcomes (hospital admission, chronic neurological complications, death) and adverse events following immunization. RESULTS In low-risk travellers (e.g. to urban areas for <1 month), the risk of developing JE and dying is low (<1 per million) irrespective of the destination; thus, the potential impact of JE vaccination in reducing the risk of clinical outcomes is limited. In high-risk travellers (e.g. to rural areas in high JE incidence destinations for >2 months), the risk of developing symptomatic disease and mortality is estimated at 9.5 and 1.4 per million, respectively. JE vaccination in this group would significantly reduce the risk of symptomatic disease and mortality (by ~80%) to 1.9 and 0.3 per million, respectively. CONCLUSION The JE tool may assist decision-making by travellers and clinicians and could increase JE vaccine uptake. The tool will be updated as additional evidence becomes available. Future work needs to evaluate the usability of the tool. The interactive, scenario-based, personalised JE vaccine risk-benefit tool is freely available on www.VaxiCal.com.
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Affiliation(s)
- Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Helen Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Brian J Johnson
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Hongen Lu
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Kasim Allel
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Philip N Britton
- Department of Infectious Diseases and Microbiology, Children's Hospital Westmead, Westmead, NSW, Australia
- Child and Adolescent Health and Sydney ID, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Weiping Ling
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Tina Moghaddam
- School of Information Technology and Electrical Engineering, Faculty of Science, The University of Queensland, St Lucia, QLD, Australia
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Wang X, He A, Zhang C, Wang Y, An J, Zhang Y, Hu W. Japanese encephalitis transmission trends in Gansu, China: A time series predictive model based on spatial dispersion. One Health 2023; 16:100554. [PMID: 37363262 PMCID: PMC10288096 DOI: 10.1016/j.onehlt.2023.100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 06/28/2023] Open
Abstract
Objective This study serves to ascertain trends of space and time for Japanese encephalitis (JE) transmission at the township-level and develop an innovative time series predictive model to predict the geographical spread of JE in Gansu Province, China. Methods We collected weekly data on JE from 2005 to 2019 at the township-level. Kriging interpolation maps were used to visualize the trend of the epidemic spread of JE, and linear regression models were used to calculate the monthly changes in minimum longitude and maximum latitude of emerging towns with JE to assess the speed of the epidemic's spread to the northwest. Additionally, we utilized a time series Seasonal Autoregressive Integrated Moving Average (SARIMA) model to dynamically predict the ongoing weekly number of JE emerging townships. Results The Kriging difference map revealed a significant trend of JE spread towards the northwest. Our regression model indicated that the rate of decrease in minimum longitude was approximately 0.64 km per month, while the rate of increase in maximum latitude was approximately 1.00 km per month. Furthermore, the SARIMA pattern (2,0,0)(2,0,1)52 exhibited a better goodness-of-fit for predicting JE transmission, with an overall agreement of 93.27% to 94.23%. Conclusion Our study highlights the expansion of JE cases towards the northwest of Gansu, indicating the need for ongoing surveillance and control efforts. The use of the SARIMA model provides a valuable tool for predicting the trend of JE spatial dispersion, thereby improving early warning systems. Our findings suggest that the number of emerging townships can be used to predict the trend of JE spatial dispersion, providing crucial insights for future research on JE incidence.
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Affiliation(s)
- Xuxia Wang
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Aiwei He
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Chunfang Zhang
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Yongsheng Wang
- Evidence-Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jing An
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Yu Zhang
- Gansu Center for Disease Control and Prevention, Lanzhou, Gansu, China
- Chinese Center for Disease Control and Prevention, Changping, Beijing, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Thomson TN, Marsland MJ, Minko C, Snow KJ, Friedman ND. Japanese encephalitis: A rapid review of reported prevalence of infection, clinical disease and sequelae in immunologically naive populations to inform Australia’s response. Aust N Z J Public Health 2023; 47:100041. [PMID: 37024425 DOI: 10.1016/j.anzjph.2023.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 04/05/2023] Open
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Dutta SK, Langenburg T. A Perspective on Current Flavivirus Vaccine Development: A Brief Review. Viruses 2023; 15:v15040860. [PMID: 37112840 PMCID: PMC10142581 DOI: 10.3390/v15040860] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/09/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
The flavivirus genus contains several clinically important pathogens that account for tremendous global suffering. Primarily transmitted by mosquitos or ticks, these viruses can cause severe and potentially fatal diseases ranging from hemorrhagic fevers to encephalitis. The extensive global burden is predominantly caused by six flaviviruses: dengue, Zika, West Nile, yellow fever, Japanese encephalitis and tick-borne encephalitis. Several vaccines have been developed, and many more are currently being tested in clinical trials. However, flavivirus vaccine development is still confronted with many shortcomings and challenges. With the use of the existing literature, we have studied these hurdles as well as the signs of progress made in flavivirus vaccinology in the context of future development strategies. Moreover, all current licensed and phase-trial flavivirus vaccines have been gathered and discussed based on their vaccine type. Furthermore, potentially relevant vaccine types without any candidates in clinical testing are explored in this review as well. Over the past decades, several modern vaccine types have expanded the field of vaccinology, potentially providing alternative solutions for flavivirus vaccines. These vaccine types offer different development strategies as opposed to traditional vaccines. The included vaccine types were live-attenuated, inactivated, subunit, VLPs, viral vector-based, epitope-based, DNA and mRNA vaccines. Each vaccine type offers different advantages, some more suitable for flaviviruses than others. Additional studies are needed to overcome the barriers currently faced by flavivirus vaccine development, but many potential solutions are currently being explored.
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Shi T, Meng L, Li D, Jin N, Zhao X, Zhang X, Liu Y, Zheng H, Zhao X, Li J, Shen X, Ren X. Impact of the Expanded Program on Immunization on the incidence of Japanese encephalitis in different regions of Mainland China: An interrupt time series analysis. Acta Trop 2022; 233:106575. [DOI: 10.1016/j.actatropica.2022.106575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/01/2022]
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Suresh S, Pannu AK, Arora N, Chabra M. 'Double doughnut' sign in Japanese encephalitis. QJM 2022; 115:241-242. [PMID: 35188207 DOI: 10.1093/qjmed/hcac054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/13/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Suresh
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh, India
| | - A K Pannu
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh, India
| | - N Arora
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh, India
| | - M Chabra
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh, 160012 India
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Mishra B, Aduri R. The RNA Secondary Structure Analysis Reveals Potential for Emergence of Pathogenic Flaviviruses. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:10-29. [PMID: 34694573 DOI: 10.1007/s12560-021-09502-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
The Flavivirus genus is divided into four groups: Mosquito-borne flaviviruses, Tick-borne flaviviruses, no-known vector flaviviruses, and Insect specific flaviviruses. Millions of people are affected worldwide every year due to the flaviviral infections. The 5' UTR of the RNA genome plays a critical role in the biology of flaviviruses. To explore any correlation between the topology of the 5' UTR and pathogenesis, a global scale study of the RNA secondary structure of different groups of flaviviruses has been conducted. We found that most of the pathogenic flaviviruses, irrespective of their mode of transmission, tend to form a Y shaped topology in the Stem loop A of the 5' UTR. Some of the current non-pathogenic flaviviruses were also observed to form Y shaped structure. Based on this study, it has been proposed that the flaviviruses having the Y shaped topology in their 5' UTR regions may have the potential to become pathogenic.
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Affiliation(s)
- Bibhudutta Mishra
- Department of Biological Sciences, Birla Institute of Technology and Science Pilani, K K Birla Goa campus, Zuarinagar, South Goa, 403726, India
- Department of Zoology, Centurion University of Technology and Management, Bhubaneswar Campus, Khurda, Jatni, 752050, Odisha, India
| | - Raviprasad Aduri
- Department of Biological Sciences, Birla Institute of Technology and Science Pilani, K K Birla Goa campus, Zuarinagar, South Goa, 403726, India.
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Hattasingh W, Chanthavanich P, Sirivichayakul C, Arunsodsai W, Surangsrirat S, Srisuwannaporn T, Kaewma B, Yoksan S, Limkittikul K, Yang J, Mao Y. Antibody persistence upto 5 years after primary immunization and booster with an inactivated chromatographically purified Vero cell-derived Japanese encephalitis vaccine in Thai children. Hum Vaccin Immunother 2022; 18:2028513. [PMID: 35103548 PMCID: PMC8993053 DOI: 10.1080/21645515.2022.2028513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Japanese encephalitis is the main cause of viral encephalitis in Asia. In a previous single-arm vaccine trial, an inactivated chromatographically purified Japanese encephalitis Vero cell vaccine (CVI-JE; JEVACTM) was safe and immunogenic in 152 Thai children aged 1–3 years receiving a 2-dose primary immunization and booster dose 1 year later. We conducted a 5-year follow-up assessment of the persistence of the immune response the 144 children remaining in this cohort after first booster dose. Immunity was assessed by 50% plaque reduction neutralization test annually for up to 5 years post-booster. Seroprotection rates (95%CI) decreased from 100% (97.1–100) at 1 year post-booster to 93% (85.0–98.3) at 5 years post-booster. No serious vaccine-related adverse events or Japanese encephalitis infections were reported. A 2-dose primary immunization and booster 1 year later with CVI-JE provided long-lasting immunity in the majority of children.
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Affiliation(s)
- Weerawan Hattasingh
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pornthep Chanthavanich
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chukiat Sirivichayakul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Watcharee Arunsodsai
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | | | - Benjawan Kaewma
- Nopparat Rajathanee Hospital, Ministry of Public Health, Bangkok, Thailand
| | - Sutee Yoksan
- Japanese Encephalitis/Dengue Virology Laboratory, Center for Vaccine Development, Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, Thailand
| | - Kriengsak Limkittikul
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Junwei Yang
- Liaoning Cheng Da Biotechnology Co., Ltd., Shenyang, China
| | - Yu Mao
- Liaoning Cheng Da Biotechnology Co., Ltd., Shenyang, China
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Damiano RF, Guedes BF, de Rocca CC, de Pádua Serafim A, Castro LHM, Munhoz CD, Nitrini R, Filho GB, Miguel EC, Lucchetti G, Forlenza O. Cognitive decline following acute viral infections: literature review and projections for post-COVID-19. Eur Arch Psychiatry Clin Neurosci 2022; 272:139-154. [PMID: 34173049 PMCID: PMC8231753 DOI: 10.1007/s00406-021-01286-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/21/2021] [Indexed: 12/15/2022]
Abstract
Recently, much attention has been drawn to the importance of the impact of infectious disease on human cognition. Several theories have been proposed, to explain the cognitive decline following an infection as well as to understand better the pathogenesis of human dementia, especially Alzheimer's disease. This article aims to review the state of the art regarding the knowledge about the impact of acute viral infections on human cognition, laying a foundation to explore the possible cognitive decline followed coronavirus disease 2019 (COVID-19). To reach this goal, we conducted a narrative review systematizing six acute viral infections as well as the current knowledge about COVID-19 and its impact on human cognition. Recent findings suggest probable short- and long-term COVID-19 impacts in cognition, even in asymptomatic individuals, which could be accounted for by direct and indirect pathways to brain dysfunction. Understanding this scenario might help clinicians and health leaders to deal better with a wave of neuropsychiatric issues that may arise following COVID-19 pandemic as well as with other acute viral infections, to alleviate the cognitive sequelae of these infections around the world.
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Affiliation(s)
- Rodolfo Furlan Damiano
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP, 05403-903, Brazil.
| | - Bruno F. Guedes
- Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Cristiana Castanho de Rocca
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP 05403-903 Brazil
| | - Antonio de Pádua Serafim
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP 05403-903 Brazil
| | | | - Carolina Demarchi Munhoz
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Ricardo Nitrini
- Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Geraldo Busatto Filho
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP 05403-903 Brazil
| | - Eurípedes Constantino Miguel
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP 05403-903 Brazil
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Orestes Forlenza
- Departamento E Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, São Paulo, SP 05403-903 Brazil
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has cast increased attention on emerging infections. Clinicians and public health experts should be aware of emerging infectious causes of encephalitis, mechanisms by which they are transmitted, and clinical manifestations of disease. RECENT FINDINGS A number of arthropod-borne viral infections -- transmitted chiefly by mosquitoes and ticks -- have emerged in recent years to cause outbreaks of encephalitis. Examples include Powassan virus in North America, Chikungunya virus in Central and South America, and tick-borne encephalitis virus in Europe. Many of these viruses exhibit complex life cycles and can infect multiple host animals in addition to humans. Factors thought to influence emergence of these diseases, including changes in climate and land use, are also believed to underlie the emergence of the rickettsial bacterium Orientia tsutsugamushi, now recognized as a major causative agent of acute encephalitis syndrome in South Asia. In addition, the COVID-19 pandemic has highlighted the role of bats as carriers of viruses. Recent studies have begun to uncover mechanisms by which the immune systems of bats are poised to allow for viral tolerance. Several bat-borne infections, including Nipah virus and Ebola virus, have resulted in recent outbreaks of encephalitis. SUMMARY Infectious causes of encephalitis continue to emerge worldwide, in part because of climate change and human impacts on the environment. Expansion of surveillance measures will be critical in rapid diagnosis and limiting of outbreaks in the future.
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Hameed M, Wahaab A, Nawaz M, Khan S, Nazir J, Liu K, Wei J, Ma Z. Potential Role of Birds in Japanese Encephalitis Virus Zoonotic Transmission and Genotype Shift. Viruses 2021; 13:357. [PMID: 33668224 PMCID: PMC7996159 DOI: 10.3390/v13030357] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022] Open
Abstract
Japanese encephalitis (JE) is a vaccine-preventable disease caused by the Japanese encephalitis virus (JEV), which is primarily prevalent in Asia. JEV is a Flavivirus, classified into a single serotype with five genetically distinct genotypes (I, II, III, IV, and V). JEV genotype III (GIII) had been the most dominant strain and caused numerous outbreaks in the JEV endemic countries until 1990. However, recent data shows the emergence of JEV genotype I (GI) as a dominant genotype and it is gradually displacing GIII. The exact mechanism of this genotype displacement is still unclear. The virus can replicate in mosquito vectors and vertebrate hosts to maintain its zoonotic life cycle; pigs and aquatic wading birds act as an amplifying/reservoir hosts, and the humans and equines are dead-end hosts. The important role of pigs as an amplifying host for the JEV is well known. However, the influence of other domestic animals, especially birds, that live in high abundance and close proximity to the human is not well studied. Here, we strive to briefly highlight the role of birds in the JEV zoonotic transmission, discovery of birds as a natural reservoirs and amplifying host for JEV, species of birds susceptible to the JEV infection, and the proposed effect of JEV on the poultry industry in the future, a perspective that has been neglected for a long time. We also discuss the recent in vitro and in vivo studies that show that the newly emerged GI viruses replicated more efficiently in bird-derived cells and ducklings/chicks than GIII, and an important role of birds in the JEV genotype shift from GIII to GI.
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Affiliation(s)
- Muddassar Hameed
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Abdul Wahaab
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Mohsin Nawaz
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Sawar Khan
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Jawad Nazir
- Vaccinologist/Head Virology, Tréidlia Biovet Pty Ltd. Units, Seven Hills, NSW 2147, Australia;
| | - Ke Liu
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Jianchao Wei
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
| | - Zhiyong Ma
- Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Science, Shanghai 200241, China; (A.W.); (M.N.); (S.K.); (K.L.)
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Furuya-Kanamori L, Mills DJ, Lau CL. Could intradermal be an economical alternative route of administration for Japanese encephalitis vaccines? J Travel Med 2021; 28:5912909. [PMID: 32990731 DOI: 10.1093/jtm/taaa181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/14/2022]
Abstract
Highlight Uptake of Japanese encephalitis (JE) vaccine remains low among travellers, with cost of vaccines likely being one of the main hurdles. We found that smaller doses of JE vaccine administered via intradermal (ID) had similar effect on seroconversion than standard doses administered via subcutaneous. ID is a cheaper yet effective route of JE vaccine administration, and could potentially increase vaccination uptake among travellers.
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Affiliation(s)
- Luis Furuya-Kanamori
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Deborah J Mills
- Research School of Population Health, Australian National University, Canberra, Australia.,Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australia.,Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
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14
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Singh H, Singh N, Mall RK. Japanese Encephalitis and Associated Environmental Risk Factors in Eastern Uttar Pradesh: A time series analysis from 2001 to 2016. Acta Trop 2020; 212:105701. [PMID: 32956640 DOI: 10.1016/j.actatropica.2020.105701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 01/19/2023]
Abstract
India and other Southeast Asian countries are severely affected by Japanese encephalitis (JE), one of the deadliest vector-borne disease threat to human health. Several epidemiological observations suggest climate variables play a role in providing a favorable environment for mosquito development and virus transmission. In this study, generalized additive models were used to determine the association of JE admissions and mortality with climate variables in Gorakhpur district, India, from 2001-2016. The model predicted that every 1 unit increase in mean (Tmean;°C), and minimum (Tmin;°C) temperature, rainfall (RF; mm) and relative humidity (RH; %) would on average increase the JE admissions by 22.23 %, 17.83 %, 0.66 %, and 5.22 % respectively and JE mortality by 13.27 %, 11.77 %, 0.94 %, and 3.27 % respectively Conversely, every unit decrease in solar radiation (Srad; MJ/m2/day) and wind speed (WS; Kmph) caused an increase in JE admission by 17% and 11.42% and in JE mortality by 9.37% and 4.88% respectively suggesting a protective effect at higher levels. The seasonal analysis shows that temperature was significantly associated with JE in pre-monsoon and post-monsoon while RF, RH, Srad, and WS are associated with the monsoon. Effect modification due to age and gender showed an equal risk for both genders and increased risk for adults above 15 years of age, however, males and age groups under 15 years outnumbered females and adults. Sensitivity analysis results to explore lag effects in climate variables showed that climate variables show the strongest association at lag 1 to 1.5 months with significant lag effect up tp lag 0-60 days. The exposure-response curve for climate variables showed a more or less linear relationship, with an increase in JE admissions and mortality after a certain threshold and decrease were reported at extreme levels of exposure. The study concludes that climate variables could influence the JE vector development and multiplication and parasite maturation and transmission in the Gorakhpur region whose indirect impact was noted for JE admission and mortality. In response to the changing climate, public health interventions, public awareness, and early warning systems would play an unprecedented role to compensate for future risk.
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15
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Ma HY, Lai CC, Chiu NC, Lee PI. Adverse events following immunization with the live-attenuated recombinant Japanese encephalitis vaccine (IMOJEV®) in Taiwan, 2017-18. Vaccine 2020; 38:5219-5222. [PMID: 32546414 DOI: 10.1016/j.vaccine.2020.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Japanese encephalitis (JE) is a significant public health concern in the Asia-Pacific region, with a case-fatality rate of around 20% for those who develop encephalitis. Mouse-brain derived vaccines against JE have been used in the publicly funded national immunization program (NIP) in Taiwan since 1968. They were replaced with a live-attenuated recombinant vaccine (JE-CV, IMOJEV®) in May 2017. We assessed reports of adverse events (AE) following the introduction of JE-CV into the Taiwan NIP to characterize its post-licensure safety profile. METHODS AEs reported between 1 May 2017 and 31 December 2018 post vaccination with JE-CV were extracted from the National Adverse Drug Reactions (ADR) Reporting System, a passive surveillance system run by the Taiwan Food and Drug Administration. The report rates were calculated based on the number of doses distributed by the manufacturer during the assessment period. RESULTS There were 51 AEs reported among 30 subjects (12 girls and 18 boys; mean age 25 months), with a reporting rate of 4.7 AEs per 100,000 doses distributed. The AEs occurred after a median of. 1-day post vaccination. Eight subjects had received concomitant vaccination with another vaccines. There were four serious AEs reported: febrile seizure, acute renal failure, viral respiratory tract infection, and injection site cellulitis. None of these serious AEs were classified as being causally related to JE-CV vaccination. CONCLUSION These post-licensure AE surveillance data confirm the favorable safety profile of JE-CV.
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Affiliation(s)
- Hsuan-Yin Ma
- Sanofi Pasteur, Taiwan, 7F., No.3, Songren Rd., Xinyi Dist., Taipei City 11010, Taiwan
| | - Chung-Chih Lai
- Medical Affairs, Asia & JPAC, Sanofi Pasteur, 38 Beach Road, #18-11 South Beach Tower, Singapore 189767, Singapore
| | - Nan-Chang Chiu
- Department of Pediatrics, Mackay Children's Hospital, No. 92, Section 2, Zhongshan N Rd, Zhongshan District, Taipei City 10449, Taiwan; Department of Medicine, MacKay Medical College, No. 46, Section 3, Zhongzheng Road, Sanzhi District, New Taipei City 252, Taiwan.
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital, and National Taiwan University College of Medicine, No.8, Chung Shan S. Rd., Taipei 10041, Taiwan.
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16
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Entomological Surveillance for Zika and Dengue Virus in Aedes Mosquitoes: Implications for Vector Control in Thailand. Pathogens 2020; 9:pathogens9060442. [PMID: 32512828 PMCID: PMC7350330 DOI: 10.3390/pathogens9060442] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/17/2022] Open
Abstract
Entomological surveillance for arthropod-borne viruses is vital for monitoring vector-borne diseases and informing vector control programs. In this study, we conducted entomological surveillance in Zika virus endemic areas. In Thailand, it is standard protocol to perform mosquito control within 24 h of a reported dengue case. Aedes females were collected within 72 h of case reports from villages with recent Zika–human cases in Kamphaeng Phet Province, Thailand in 2017 and 2018. Mosquitoes were bisected into head-thorax and abdomen and then screened for Zika (ZIKV) and dengue (DENV) viruses using real-time RT-PCR. ZIKV RNA was detected in three samples from two female Ae. aegypti (1.4%). A partial envelope sequence analysis revealed that the ZIKV sequences were the Asian lineage identical to sequences from ZIKV-infected cases reported in Thailand during 2016 and 2017. Dengue virus-1 (DENV-1) and dengue virus-4 (DENV-4) were found in four Ae. aegypti females (2.8%), and partial capsid sequences were nearly identical with DENV-1 and DENV-4 from Thai human cases reported in 2017. Findings in the current study demonstrate the importance of entomological surveillance programs to public health mosquito-borne disease prevention measures and control.
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17
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Turtle L, Easton A, Defres S, Ellul M, Bovill B, Hoyle J, Jung A, Lewthwaite P, Solomon T. 'More than devastating'-patient experiences and neurological sequelae of Japanese encephalitis§. J Travel Med 2019; 26:5554873. [PMID: 31504712 PMCID: PMC6792067 DOI: 10.1093/jtm/taz064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Japanese encephalitis (JE), caused by the mosquito-borne JE virus, is a vaccine-preventable disease endemic to much of Asia. Travellers from non-endemic areas are susceptible if they travel to a JE endemic area. Although the risk to travellers of JE is low, the consequences may be severe. METHODS Here, we describe three cases of JE in British travellers occurring in 2014-15. In addition, we report, through interviews with survivors and their families, personal experiences of life after JE. RESULTS Three cases of JE were diagnosed in British travellers in 2014/15. One was acquired in Thailand, one in China and one in either Thailand, Laos or Cambodia. All three patients suffered severe, life-threatening illnesses, all were admitted to intensive care units and required medical evacuation back to the UK. One patient suffered a cardiac arrest during the acute stage but made a good recovery. The other two patients remain significantly paralysed and ventilator dependent. All three cases had clear indications for vaccination, and all have been left with life-changing neurological sequelae. CONCLUSIONS Travel health providers should be aware of the severity of JE, as well as the risk, allowing travellers to make fully informed decisions on JE vaccination.
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Affiliation(s)
- Lance Turtle
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Tropical & Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - Ava Easton
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Encephalitis Society, Malton, North Yorkshire, YO17 7DT, UK
| | - Sylviane Defres
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Tropical & Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - Mark Ellul
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| | - Begona Bovill
- Tropical and Infectious Diseases, North Bristol NHS Trust, Bristol, Southmead Road, Westbury-on-Trym, BS10 5NB, UK
| | - Jim Hoyle
- Neuro-Intensive Care Unit, Royal Hallamshire Hospital, Sheffield, Glossop Rd, S10 2JF, UK
| | - Agam Jung
- Leeds General Infirmary, Leeds, LS1 3EX, UK
| | - Penny Lewthwaite
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, Beckett Street, LS9 7TF, UK
| | - Tom Solomon
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
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18
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Connor BA, Hamer DH, Kozarsky P, Jong E, Halstead SB, Keystone J, Mileno MD, Dawood R, Rogers B, Bunn WB. Japanese encephalitis vaccine for travelers: risk-benefit reconsidered. J Travel Med 2019; 26:5487229. [PMID: 31073616 DOI: 10.1093/jtm/taz037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Bradley A Connor
- Department of Medicine, Weill Cornell Medical College and the New York Center for Travel and Tropical Medicine, NY, USA
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, and Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Phyllis Kozarsky
- Department of Medicine and Infectious Diseases, Emory University (Emerita), Atlanta, GA, and Time Solutions, Chesapeake, VA, USA
| | - Elaine Jong
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Scott B Halstead
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jay Keystone
- Tropical Disease Unit, Division of Infectious Disease, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Maria D Mileno
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School of Brown University, and Brown Medicine, Brown Physicians, Inc., The Miriam Hospital, Providence, RI, USA
| | | | - Bonnie Rogers
- North Carolina Occupational Safety and Health Education and Research Center, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - William B Bunn
- Division of Neurology, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, and Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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19
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Bharucha T, Sengvilaipaseuth O, Seephonelee M, Vongsouvath M, Vongsouvath M, Rattanavong S, Piorkowski G, Lecuit M, Gorman C, Pommier JD, Garson JA, Newton PN, de Lamballerie X, Dubot-Pérès A. Viral RNA Degradation Makes Urine a Challenging Specimen for Detection of Japanese Encephalitis Virus in Patients With Suspected CNS Infection. Open Forum Infect Dis 2019; 6:ofz048. [PMID: 30882014 PMCID: PMC6411208 DOI: 10.1093/ofid/ofz048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/23/2019] [Accepted: 01/31/2019] [Indexed: 11/14/2022] Open
Abstract
Background Japanese encephalitis virus (JEV) is a leading cause of central nervous system (CNS) infections in Asia and results in significant morbidity and mortality. JEV RNA is rarely detected in serum or cerebrospinal fluid (CSF), and diagnosis of JEV infection is usually based on serological tests that are frequently difficult to interpret. Unlike serum or CSF, urine is relatively easy to obtain, but, to date, there has been minimal work on the feasibility of testing urine for JEV RNA. Methods We investigated the use of lysis buffer and a Microsep device to optimize urine storage for detection of JEV RNA by reverse transcription real-time polymerase chain reaction (RT-qPCR). The best of the studied methods was then evaluated in consecutive patients admitted to the hospital with suspected CNS infections in Laos. Results We demonstrated degradation of JEV RNA in urine after even short storage periods at 4°C or –80°C. Although there was no advantage in using a Microsep concentration device alone, immediate addition of lysis buffer to fresh urine improved the detection of JEV RNA at the limit of detection. Conclusions In 2 studies of 41 patients with acute encephalitis syndrome, 11 (27%) were positive for JEV IgM in CSF and/or serum, and 2 (4.9%) were JEV RT-qPCR positive from throat swabs. JEV RNA was not detected in any of these patients’ urine samples. However, lysis buffer was only used during a prospective study, that is, for only 17/41 (41%) patient urine samples. Our findings suggest a need for larger studies testing urine for JEV RNA, with urine collected at different times from symptom onset, and using lysis buffer, which stabilizes RNA, for storage.
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Affiliation(s)
- Tehmina Bharucha
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Division of Infection and Immunity, University College London, London, UK
| | - Onanong Sengvilaipaseuth
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Malee Seephonelee
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Malavanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Manivanh Vongsouvath
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Sayaphet Rattanavong
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R
| | - Géraldine Piorkowski
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Marc Lecuit
- Biology of Infection Unit, Inserm U1117, Institut Pasteur, Paris, France.,Division of Infectious Diseases and Tropical Medicine, Necker-Enfants Malades University Hospital, Paris Descartes University, Paris, France
| | - Christopher Gorman
- Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Jean-David Pommier
- Institut Pasteur du Cambodge, Institut Pasteur International Network, Phnom Penh, Cambodia
| | - Jeremy A Garson
- Division of Infection and Immunity, University College London, London, UK.,Transfusion Microbiology, NHS Blood and Transplant, London, UK
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Churchill Hospital, Oxford, UK
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao P.D.R.,Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Churchill Hospital, Oxford, UK.,Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
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20
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Kenfak A, Eperon G, Schibler M, Lamoth F, Vargas MI, Stahl JP. Diagnostic approach to encephalitis and meningoencephalitis in adult returning travellers. Clin Microbiol Infect 2019; 25:415-421. [PMID: 30708123 DOI: 10.1016/j.cmi.2019.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/29/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Encephalitis and meningoencephalitis are severe, sometime life-threatening infections of the central nervous system. Travellers may be exposed to a variety of neurotropic pathogens. AIMS We propose to review known infectious causes of encephalitis in adults acquired outside Europe, and how to identify them. SOURCES We used Pubmed and Embase, to search the most relevant publications over the last years. CONTENT Microbiologic tests and radiological tools to best identify the causative pathogen in travellers presenting with encephalitis and ME are presented in this narrative review, as well as a diagnostic approach tailored to the visited area and types of exposures. IMPLICATIONS This review highlights the diagnostic difficulties inherent to exotic causes of central nervous system infections, and attempts to guide clinicians with respect to which microbiological tests to consider, in addition to brain MRI, when approaching a returning traveller presenting with encephalitis.
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Affiliation(s)
- A Kenfak
- Internal Medicine Service, Jura Bernois Hospital, Moutier, Switzerland
| | - G Eperon
- Tropical and Humanitarian Medicine Division, Geneva University Hospitals, Geneva, Switzerland
| | - M Schibler
- Infectious Diseases Division and Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland.
| | - F Lamoth
- Infectious Diseases Service and Institute of Microbiology, Lausanne University Hospital, Lausanne, Switzerland
| | - M I Vargas
- Diagnostic and Interventional Neuroradiology Division, Geneva University, Switzerland
| | - J P Stahl
- Infectious Diseases and Tropical Medicine, University Hospital, Grenoble, France
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21
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Hamer DH, Chen LH. Japanese encephalitis: vaccine options and timing of pre-travel vaccination. J Travel Med 2018; 25:5055553. [PMID: 30020497 DOI: 10.1093/jtm/tay047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/19/2018] [Indexed: 01/05/2023]
Affiliation(s)
- Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Section of Infectious Diseases, Boston, MA, USA
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA, USA
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