Epidemiology and Etiology of Acute Encephalitis Syndrome in North India

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  • Jain Parul
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Jain Amita
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Kumar Arvind
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Prakash Shantanu
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Khan Danish Nasar
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Singh Kaleshwar Prasad
    Virology Laboratory, Department of Microbiology, King George's Medical University
  • Garg Ravindra Kumar
    Department of Neurology, King George's Medical University
  • Kumar Rashmi
    Department of Paediatrics, King George's Medical University
  • Kumar G. Arun
    Manipal Center for Virus Research, Manipal University

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Abstract

Acute encephalitis syndrome (AES) is a major public health problem in eastern Uttar Pradesh, claiming thousands of lives every year. Here we report the common viral etiologic agents of AES and its epidemiology in the vicinity of Lucknow in Uttar Pradesh, North India. Cerebrospinal fluid (CSF) samples collected from patients with AES, who were referred to a viral diagnostic laboratory from January 2011 to December 2012, were tested for IgM antibodies against Japanese encephalitis virus (JEV), dengue virus (DV), herpes simplex virus (HSV), measles virus, mumps virus, varicella zoster virus (VZV), and enterovirus using commercial enzyme immuno-assays. Of the 1,578 enrolled patients, JEV was the most commonly detected (16.2%), followed by DV (10.8%), HSV (9.3%), measles virus (8.9%), mumps virus (8.7%), VZV (4.4%), and enterovirus (0%). Co-positivity with more than 1 virus was observed in 12 patients. The demographic distribution of patients pertaining to age, sex, and geographic and seasonal variation is discussed. Maximum mortality was caused by JEV infection, while patients with HSV infection had maximum residual neuro-psychiatric disability. JEV and DV are the chief causative agents of AES in North India, although other viruses should also be considered in a differential diagnosis.

Journal

  • Japanese Journal of Infectious Diseases

    Japanese Journal of Infectious Diseases 67 (3), 197-203, 2014

    National Institute of Infectious Diseases, Japanese Journal of Infectious Diseases Editorial Committee

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