1
|
Tandale BV, Bondre VP, Sapkal GN, Gopalkrishna V, Gurav YK, Rao RK, Qazi MS, Narang R, Guduru VK, Niswade AK, Jain M. Childhood encephalitis hospitalizations associated with virus agents in medium-endemic states in India. J Clin Virol 2021; 144:104970. [PMID: 34560339 DOI: 10.1016/j.jcv.2021.104970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/28/2021] [Accepted: 09/05/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Japanese encephalitis (JE) is the leading cause of childhood acute encephalitis syndrome (AES) in India. We enhanced the AES surveillance in sentinel hospitals to determine trends and virus etiologies in central India. METHODS The neurological hospitalizations among children ≤15 years were tracked by using the AES case definition implemented by the national program. Acute and convalescent sera along with cerebrospinal fluid (CSF) specimens were collected and tested at the strengthened site hospital laboratories for anti-JE, anti-Dengue and anti-Chikungunya virus by IgM ELISA; along with Chandipura virus RT-PCR. Herpes simplex and enterovirus testing was undertaken at the reference laboratory. RESULTS Among 1619 pediatric neurological hospitalizations reported during 2015-16, AES case definition was fulfilled in 332 (20.5%) cases. After excluding 52 non-AES cases, 280 AES cases resident from study districts were considered eligible for study. The treating physicians diagnosed non-viral causes in 90 cases, therefore 190 (67.9%) of 280 AES cases were suspected with viral etiologies. We enrolled 140 (73.7%) of 190 eligible AES cases. Viral etiologies were confirmed in 31 (22.1%) of 140 enrolled AES cases. JE (n = 22) was the leading cause. Additional non-JE viral agents included Chikungunya (5), Dengue (2) and Chandipura (2). However, only 21 (9.4%) of 222 additional AES cases referred from peripheral hospitals were confirmed as JE. CONCLUSIONS Japanese encephalitis virus continues to be the leading cause of childhood acute encephalitis syndrome in central India despite vaccination program. Surveillance needs to be intensified for assessing the true disease burden of Japanese encephalitis following vaccination program implementation.
Collapse
Affiliation(s)
| | - Vijay P Bondre
- ICMR - National Institute of Virology, Pune, Maharashtra, India
| | | | | | - Yogesh K Gurav
- ICMR - National Institute of Virology, Pune, Maharashtra, India
| | - R Kondal Rao
- Kakatiya Medical College, Warangal, Telangana, India
| | | | - Rahul Narang
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | -
- ICMR - National Institute of Virology, Pune, Maharashtra, India; Kakatiya Medical College, Warangal, Telangana, India; Government Medical College, Nagpur, Maharashtra, India; Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| |
Collapse
|