Viral Etiological Factors Causing Acute Encephalitis Syndrome (AES) In Gaya Division, India

Document Type: Original Article

Authors

1 Department of Epidemiology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

2 Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

3 Department of Pediatrics, Anugrah Narayan Magadh Memorial Medical College Hospital, Gaya- 823001, India

4 Department of Bioinformatics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

5 Department of Biochemistry, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

6 Department of Virology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

7 Department of Bio-Statistics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

8 Department of Microbiology, Anugrah Narayan Magadh Memorial Medical College Hospital, Gaya-823001, India

9 Department of Vector Biology and Control, ICMR- Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

10 Department of Molecular Biology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India

Abstract

Background: From Gaya and adjoining regions, the trend in patients admitted with acute neurological illness was investigated. Illnesses were identified as sudden outbreaks of Japanese virus encephalitis (JE), Herpes simplex virus encephalitis (HSV-1&2), and other acute encephalitis syndrome (AES).
Objective: In the current study, an investigation was carried out to assess potential infectious pathogens in patients aged 16 years or younger who were admitted to Anugrah Narayan Magadh Memorial Medical College Hospital, Gaya, with encephalitis-like symptoms.
Methods: Cross-epidemiological, serological, and molecular biological studies were performed on samples collected from 71 patients below 16 years of age. Patients’ clinical histories, i.e. fever, socio-demographic characteristics, and other clinical data, were extracted from patient files.
Results: The results showed confirmed AES cases, including 49.30% JE and 7.04% HSV positive patients. A higher case-fatality rate of 40% in JE and 40% HSV cases below 7 years of age were observed during treatment would become an unavoidable concern. The epidemical sex ratio was observed to be higher in girls than in boys (1.26:1).
Conclusion: The results suggested that JE virus was found to be a main causative risk factor responsible for disease transmission in the outbreak area.

Keywords


  1. Narain JP, Dhariwal AC, MacIntyre CR. Acute encephalitis in India: An unfolding tragedy. Indian J Med Res. 2017;145(5):584- 587. doi:10.4103/ijmr.IJMR_409_17.
  2. Sen PK, Dhariwal AC, Jaiswal RK, Lal S, Raina VK, Rastogi A. Epidemiology of acute encephalitis syndrome in India: changing paradigm and implication for control. J Commun Dis. 2014;46(1):4-11.
  3. Granerod J, Crowcroft NS. The epidemiology of acute encephalitis. Neuropsychol Rehabil. 2007;17(4-5):406-428. doi:10.1080/09602010600989620.
  4. Le VT, Phan TQ, Do QH, et al. Viral etiology of encephalitis in children in southern Vietnam: results of a one-year prospective descriptive study. PLoS Negl Trop Dis. 2010;4(10):e854. doi:10.1371/journal.pntd.0000854.
  5. Borkotoki U, Borkotoki S, Barua P, et al. Japanese encephalitis (JE) among acute encephalitis syndrome (AES) cases-a hospital based study from upper Assam, India. Int J Health Sci Res. 2016;3:4-10. 6. Goel S, Chakravarti A, Mantan M, Kumar S, Ashraf MA. Diagnostic approach to viral acute encephalitis syndrome (AES) in paediatric age group: a study from New Delhi. J Clin Diagn Res. 2017;11(9):DC25-DC29. doi:10.7860/jcdr/2017/27413.10648.
  6. Nayak P, Papanna M, Shrivastava A, et al. Unexplained neurological illness in children, Malkangiri district, Odisha, India 2014. International Journal of Infectious Diseases. 2016;45:305. doi:10.1016/j.ijid.2016.02.668.
  7. Kumar P, Pisudde PM, Sarthi PP, Sharma MP, Keshri VR. Status and trend of acute encephalitis syndrome and Japanese encephalitis in Bihar, India. Natl Med J India. 2017;30(6):317- 320. doi:10.4103/0970-258X.239070.
  8. Ghosh S, Basu A. Acute Encephalitis Syndrome in India: The Changing Scenario. Ann Neurosci. 2016;23(3):131-133. doi:10.1159/000449177.
  9. Singh GK, Singh CM, Ranjan A, et al. Determinants of Acute Encephalitis Syndrome (AES) in Muzaffarpur district of Bihar, India: A case–control study. Clin Epidemiol Glob Health. 2016;4(4):181-187. doi:10.1016/j.cegh.2016.05.002.
  10. Kumar A, Kumar R, Kaur J. Japanese encephalitis: medical emergency in India. Asian J Pharm Clin Res. 2012;5(3):9-12.
  11. Jacobson J, Sivalenka S. Japanese encephalitis globally and in India. Indian J Public Health. 2004;48(2):49-56.
  12. Kumar M, Topno RK, Dikhit MR, et al. Molecular docking studies of chloroquine and its derivatives against P23(pro-zbd) domain of chikungunya virus: Implication in designing of novel therapeutic strategies. J Cell Biochem. 2019;120(10):18298- 18308. doi:10.1002/jcb.29139.
  13. Yang DK, Kim HH, Jo HY, Choi SS, Cho IS. Establishment of a multiplex RT-PCR for the sensitive and differential detection of Japanese encephalitis virus genotype 1 and 3. J Bacteriol Virol. 2016;46(4):231-238. doi:10.4167/jbv.2016.46.4.231.
  14. Mei L, Wu P, Ye J, et al. Development and application of an antigen capture ELISA assay for diagnosis of Japanese encephalitis virus in swine, human and mosquito. Virol J. 2012;9:4. doi:10.1186/1743-422X-9-4.
  15. Kumar M, Topno RK, Madhukar M, et al. Acute encephalitis syndrome child patient with multi-viral co-infection: A rare case report. J Med Allied Sci. 2019;9(2).
  16. Parida M, Dash PK, Tripathi NK, et al. Japanese Encephalitis Outbreak, India, 2005. Emerg Infect Dis. 2006;12(9):1427- 1430. doi:10.3201/eid1209.060200.
  17. Karthikeyan A, Shanmuganathan S, Pavulraj S, et al. Japanese encephalitis, recent perspectives on virus genome, transmission, epidemiology, diagnosis and prophylactic interventions. Journal of Experimental Biology and Agricultural Sciences. 2017;5(6):730-748. doi:10.18006/2017.5(6).730.748.
  18. Verma RK, Singh DP, Yadav R, Rawat R. Comparative evaluation of antigen detection ELISA and reverse transcriptase PCR in acute stage of Japanese encephalitis prevalent in endemic areas of North-Eastern part of Uttar Pradesh, India. Int J Res Med Sci. 2015;3(11):3217-3223. doi:10.18203/2320-6012.ijrms20151166.
  19. Robinson JS, Featherstone D, Vasanthapuram R, et al. Evaluation of three commercially available Japanese encephalitis virus IgM enzyme-linked immunosorbent assays. Am J Trop Med Hyg. 2010;83(5):1146-1155. doi:10.4269/ajtmh.2010.10-0212.
  20. Puri B, Henchal EA, Burans J, et al. A rapid method for detection and identification of flaviviruses by polymerase chain reaction and nucleic acid hybridization. Arch Virol. 1994;134(1-2):29-37. doi:10.1007/BF01379104.
  21. Murhekar MV, Mittal M, Prakash JA, et al. Acute encephalitis syndrome in Gorakhpur, Uttar Pradesh, India - Role of scrub typhus. J Infect. 2016;73(6):623-626. doi:10.1016/j.jinf.2016.08.014.
  22. Varghese GM, Rajagopal VM, Trowbridge P, Purushothaman D, Martin SJ. Kinetics of IgM and IgG antibodies after scrub typhus infection and the clinical implications. Int J Infect Dis. 2018;71:53-55. doi:10.1016/j.ijid.2018.03.018.
  23. Mittal M, Bondre V, Murhekar M, et al. Acute Encephalitis Syndrome in Gorakhpur, Uttar Pradesh, 2016: Clinical and Laboratory Findings. Pediatr Infect Dis J. 2018;37(11):1101-1106. doi: 0.1097/INF.0000000000002099.