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PubMed2002

Severe tick-borne encephalitis in Slovenia: epidemiological, clinical and laboratory findings.

The aim of this retrospective study was to determine epidemiological, clinical and laboratory characteristics in adult patients with the severe form of tick-borne encephalitis. Thirty-one patients with a severe course of disease admitted to the intensive care unit of the Department of Infectious Diseases at the University Medical Centre Ljubljana, Slovenia, between 1996 and 2000 were included in the study. Tick-borne encephalitis virus infection was confirmed by the demonstration of specific IgM and IgG antibodies in serum using routine serological screening tests. All the patients had specific IgM antibodies at admission and IgG antibodies were present in 90.3%. Nineteen patients suffered from severe meningoencephalitis, 11 from meningoencephalomyelitis, and dysfunction of the autonomic nervous system was found in one patient. The mortality rate was 3.3%. Tick bite was recorded in 58% and a characteristic biphasic course of the disease was found in 16 patients. The median cerebrospinal fluid leukocyte count was 112 x 10(6)/l, and in 93.5% of patients the cerebrospinal fluid protein concentration was greater than the cut-off value of 0.45 g/l. The findings of the present study indicate some clinical, epidemiological and laboratory distinctions between published data on the mild or moderately severe form of tick-borne encephalitis and our patients with severe disease.

Adolescent↗
PubMedDate not supplied

St. Louis encephalitis outbreak in Louisiana in 2001.

A description of the St. Louis encephalitis (SLE) outbreak in Northeast Louisiana is presented. In the fall of 2001 there were 63 cases of St. Louis encephalitis in Monroe and West Monroe and seven additional cases in the neighboring parishes of Richland, Morehouse and Franklin. All cases had a clinical presentation of encephalitis and were confirmed serologically. Clinically most cases presented with fever, meningitis syndrome with altered mental status. Tremors were common (56% of cases). There were three deaths. Age-group distribution showed a predominance among 45 and older. The epidemic curve based on diagnosis date showed an explosive outbreak starting August 8, 2001, reaching a peak by the second week, and progressively slowing down. The curve showed that by the time the first case was diagnosed, 60% or more of the cases were already infected. Most of the cases come from low socio-economic areas. Houses were often run down, many with screens in disrepair. Backyards were usually large, with heavy brush and many trees. There was an abundance of sources of mosquito larvae, particularly for Culex quinquefasciatus which is the main vector. Mosquito pools confirmed the presence of SLE virus. As soon as the first case was reported, a campaign of health education and increased mosquito adulticiding were implemented.

Adolescent↗
PubMed2002

Seasonal prevalence of Culex vishnui subgroup, the major vectors of Japanese encephalitis virus in an endemic district of Andhra Pradesh, India.

Seasonal prevalence of members of the Culex vishnui subgroup, the major vectors of Japanese encephalitis virus (JE) in an endemic district of Andhra Pradesh, was investigated. Approximately 15,500 mosquitoes belonging to 2 genera and 5 species were collected by indoor-resting collections. The predominant species were found to be from the Cx. vishnui subgroup, which comprised 42.6% of the total collection, followed by Anopheles subpictus (40.4%), An. hyrcanus (12.8%), Cx. gelidus (3.5%), and An. barbirostris (0.8%). Mosquitoes of the Cx. vishnui subgroup were collected throughout the year, and densities of females ranged from 2.3/man-hour in January 1999 to 26.0/man-hour in December 1999. Ninety-three cases of Japanese encephalitis (27 confirmed serologically) were reported, mainly during the monsoon months of November and December. A significant positive correlation between densities of mosquitoes of the Cx. vishnui subgroup and occurrence of Japanese encephalitis cases (r = 0.765, P < 0.01) was observed. The factors responsible for transmission of JE in the endemic district are discussed.

Animals↗
PubMed2003

Acute undifferentiated fever caused by infection with Japanese encephalitis virus.

To determine the proportion of acute undifferentiated fevers without neurologic deficits related to infection with Japanese encephalitis (JE) virus, flavivirus serology (dengue and JE) was performed in a cohort of 156 adults presenting to a hospital in Chiangrai, Thailand. Recent flavivirus infection was diagnosed for any individual with an IgM result > 40 units. A ratio of dengue virus IgM to JE virus IgM < 0.91 defined a JE virus infection. Diagnostic criteria for Japanese encephalitis were met in 22 individuals (14%), and were unequivocal in 8 patients. The admission findings in these eight subjects were similar to those described for other flavivirus infections. Thrombocytopenia was the most striking laboratory abnormality (median platelet count = 119,000/mm3, range = 44,000-236,000/mm3). Headache (75%), nausea (50%), myalgia (38%), rash (38%), and diarrhea (25%) were the most frequently encountered signs and symptoms. Infection with Japanese encephalitis virus is an underappreciated cause of acute undifferentiated fever in Asia.

Acute Disease↗
PubMed2003

MR findings in Murray Valley encephalitis.

Murray Valley encephalitis (MVE) is caused by a flavivirus related to West Nile and St. Louis encephalitis viruses. We report a case of MVE resulting in quadriplegia and respiratory failure. MR imaging demonstrated thalamic hyperintensity on T2-weighted images, with similar involvement of the red nucleus, substantia nigra, and cervical cord. These findings preceded serologic diagnosis and are similar to those of Japanese encephalitis. In the appropriate setting, thalamic T2 hyperintensity is suggestive of flavivirus infection.

Diagnosis, Differential↗
PubMed2003

[Meningitis and encephalitis in Poland in 2001].

2367 cases of meningitis and 571 of encephalitis were reported in Poland in 2001. Among meningitis 1324 cases were classified as viral and 838 as bacterial. Among encephalitis cases, 117 were classified as bacterial and 383 as viral. Etiological factor was determined in 419 (44%) cases of bacterial meningitis/encephalitis. Among them Neisseria meningitidis was found in 106 cases, Haemophilus influenzae in 75 cases and Streptococcus pneumoniae in 99 cases. As in the past type B was the predominant type of N. meningitidis cultured from patients. 210 cases of tick borne encephalitis were reported in Poland in 2001, most of them from endemic areas of north-eastern part of the country.

Adolescent↗
PubMed1962

Prophylactic effect of antivaccinia gamma-globulin against post-vaccinal encephalitis.

In the Netherlands, the frequency of encephalitis after smallpox vaccination is estimated to be 1 in 4000 primary vaccinations in adults and 1 in 50 000 revaccinations. Since immunity seems to reduce the frequency of this complication, it was thought that it might be possible to prevent post-vaccinal encephalitis by a combination of passive and active immunization, a basic immunity being obtainable without risk by the injection of antivaccinia gamma-globulin (AGG). This theory was tested in Dutch military recruits in a double-blind experiment. At the time of primary vaccination the recruits were given an injection in the other arm, either of 2 ml of 16% AGG (treated group) or of 2 ml of placebo solution (control group).It appeared that administration of AGG had a prophylactic effect, since only 3 cases of post-vaccinal encephalitis occurred among the 53 630 recruits in the treated group, as compared with 13 among the 53 044 recruits in the control group. The difference of 10 is significant. The best estimate of the reduction in the frequency brought about by injection of 2 ml of 16% AGG is 77%; the lower limit of this reduction is 29%.The administration of 2 ml of 16% AGG did not interfere with the development of active immunity.

Adult↗
PubMed2003

Serological evidence for Japanese encephalitis virus and West Nile virus infections in water frequenting and terrestrial wild birds in Kolar District, Karnataka State, India. A retrospective study.

In a serological survey of birds in a Japanese encephalitis (JE) endemic area of Kolar District, Karnataka State, India, 859 bird sera were tested by hemagglutination-inhibition test (HIT) for JE encephalitis and West Nile encephalitis (WNE) viruses. Only 2 (0.002%) and 178 (20.72%) sera were positive for JE virus (JEV) and WNE virus (WNV), respectively. Only 160 (18.63%) of 859 sera could be subjected to neutralizing test (NT). Of these, 20 (12.50%) and 62 (38.75%) were positive for JEV and WNV antibodies, respectively. These findings indicate that bird species such as Pond Herons and Little Egrets among ardeid birds and Grey Partridges and Quails among terrestrial birds are infected with JEV and WNV and play probably a role in the maintenance of these viruses in the abovementioned part of India.

Animals↗
PubMed1951

Western equine and St. Louis encephalitis in man, California, 1945-1950.

A large group of etiologic agents, some known and some unknown, produce in man a clinical syndrome now labeled "infectious encephalitis."The separation, from this larger group, of single disease entities which cause similar clinical symptoms is possible, but calls for diagnostic acumen plus supporting laboratory evidence. Two etiologically specific entities, western equine encephalitis and St. Louis encephalitis, are frequently encountered in rather well-defined areas of California, the Central Valley and Imperial Valley; and there is a definite seasonal pattern of occurrence-June through October. There are certain guides that are helpful in differential diagnosis. Establishing a diagnosis on the basis of clinical evidence is difficult. Laboratory studies are of great importance not only for diagnosis in the individual case but for advancement of etiology. Specimens are worthless unless taken at proper intervals and submitted by methods described. It is probable that encephalitides caused by still unknown agents exist in California. The isolation and identification of new encephalitogenic viral agents will depend in large measure upon the submission by physicians of suitable specimens from patients with central nervous system disease in which the cause is obscure.

Animals↗
PubMed2004

[A case report of recurrent limbic encephalitis caused by an enterovirus infection].

We reported a 28-year-old woman with recurrent focal encephalitis caused by an enterovirus infection. She showed convulsions, abnormal behavior, and consciousness disturbance on the first admission to our hospital in July 1998. A CSF study revealed lymphocyte-dominant pleocytosis (17/microl), and brain MRI revealed high signal intensity in the bilateral limbic system including the hippocampus. We treated her with acyclovir and steroid pulse therapy based on a diagnosis of limbic encephalitis. After that, her symptoms gradually disappeared without any sequelae. She became aware of memory disturbance at the end of April 2001. She was admitted to our hospital because of generalized convulsions on 2 May 2001. Her body temperature was 37.3 degrees C. Her consciousness was disturbed (Japan coma scale 2), but there was no nuchal rigidity. A CSF study failed to reveal pleocytosis (cell count, 2/microl). Brain MRI revealed a bilateral high signal intensity area in the limbic system. Her symptoms gradually improved, but the mild memory disturbance persisted on her discharge. An immunological study revealed no abnormality in either humoral or cell immunity. RT-PCR revealed enterovirus RNA in CSF samples obtained on 1 July 1998, 3 May 2001, and 25 July 2001. We diagnosed her as having recurrent limbic encephalitis caused by an enterovirus infection. This is the first report of recurrent limbic encepalitis caused by enterovirus infection in an host with an undetected defect of immune system.

Adult↗
PubMedDate not supplied

[A new rapid method for indication of tick-borne encephalitis viral antigen].

A coagglutinizing reagent has been designed, which makes it possible to make a rapid diagnosis of tick-borne encephalitis in the coagglutination test within 2-5 minutes. Laboratory tests of the agent have shown that the coagglutination test is sensitive and specific (it is many times more sensitive than indirect hemagglutination test and 2-4 times more sensitive than enzyme immunoassay). The trials conducted on natural and clinical materials also have confirmed the sensitivity and specificity of this method. The complex use of the coagglutination test and enzyme immunoassay to examine ticks whether they contain tick-borne encephalitis viral antigen allows their diagnostic effectiveness to be enhanced by 2.4 times. The clinical trial has indicated that the coagglutination test may be useful in detecting the antigen of tick-borne encephalitis virus in the blood of infected and sick patients in acute and chronic forms.

Agglutination Tests↗
PubMedDate not supplied

[Immunopathogenetic features of tick-borne encephalitis under long-term viral antigenemia].

The occurrence of chronic tick-borne encephalitis viral antigenemia characterized by the asymptomatic course or minimal clinical manifestations is caused by the virus-immune cell interaction. Cellular immunity was studied in 183 patients with chronic (more than 6-month) tick-borne encephalitis viral antigenemia, by evaluating the immunophenotypic and cytogenetic statuses, structural and functional features, cytokine profile, and peripheral lymphocytic apoptosis. The findings suggest impairments in the cooperation of immunocompetent cells and in the classical scheme of antiviral immunity regulation in tick-borne encephalitis viral persistence due to the changes in lymphocytic structural and functional properties.

Antigens, Viral↗
PubMed1987

[Use of the specific rosette formation test in tick-borne encephalitis for the purpose of laboratory diagnosis].

In the study of blood samples collected from patients with tick-borne encephalitis, the modified antigen-specific rosette formation test with erythrocytes, loaded with tick-borne encephalitis virus antigen via the specific immunoglobulin, has been used. The number of rosette-forming cells has been the highest during the acute period of the disease. The use of this test has confirmed the clinical diagnosis of the disease, together with hemagglutination inhibition serving as the main diagnostic test, in 35% of cases. The results of this study make it possible to recommend the antigen-specific rosette formation test for the early diagnosis of tick-borne encephalitis.

Antibodies, Viral↗
PubMed1989

[Geographical variants in the immunological structure of the population in combined foci of tick-borne encephalitis and endemic rickettsiosis in the European part of the USSR].

The zonal study of the immunological structure of the population revealed an increase in the number of infective agents with which the population comes into contact in the southern regions. In the medial boreal forest zone contacts of low intensity only with tick-borne encephalitis virus were detected (the immune stratum was found to be 5.5%, 2,178 persons were examined); in the southern boreal forest zone the foci of tick-borne encephalitis actively manifested (the immune stratum reached 38.9%, 2,854 persons were examined), and Q fever was constantly detected (1.6%). In the forest-steppe zone the population was found to have contacts with the causative agent of tick-borne encephalitis (the immune stratum was found to be 13.3%, 2,056 persons were examined), Q fever (1.2%) and tick-borne rickettsiosis (1.1%).

Animals↗
PubMed1981

[Experimental monkey encephalitis caused by Powassan virus].

A comparative study of the experimental infection of monkeys caused by brain P-40 of Powassan virus isolated in the Primorye Territory of the USSR and by the prototype Canadian strain LB was carried out. Powassan virus was found to be pathogenic for Macaca rhesus. Clinical and pathomorphological picture of the experimental encephalitis was studied. Full identity of the infection caused in the monkeys by the strain P-40 and the Canadian strain LB of Powassan virus has been proved. On electronmicroscopic examination of the central nervous system the virus was detected in the neurons, glial cells and intercellular spaces. The virions of the strains studied have identical morphological parameters, being 37 to 45 nm in diameter and having spherical shape. The data obtained point to a marked neurotropism of the virus. They will contribute to elucidation of the virus role in the infectious pathology of man, and namely, in verification of encephalitis cases not associated etiologically with the virus of the spring-summer tick-borne encephalitis.

Animals↗
PubMedDate not supplied

[Donor immunization with an inactivated concentrated purified vaccine against tick-borne encephalitis to obtain immune blood preparations].

Vaccination of seronegative and seropositive donors with a concentrated purified vaccine (CV) against tick-borne encephalitis induced antibody synthesis in a concentration sufficient for preparation of donor immunoglobulin with antibody titres of 1:320 to 1:1280 by HI test. The resulting preparation showed a high antiviral activity both in vivo and in vitro against antigenically different strains of tick-borne encephalitis virus. The immune plasma derived from CV-immunized donors had a therapeutic effect in patients with tick-borne encephalitis. The optimal schedules for immunization of donors are discussed.

Adult↗
PubMed1984

Focal neurologic signs in western equine encephalitis.

Focal neurologic signs developed in a 75-year-old woman who had presented with encephalitis. A diagnosis of western equine encephalitis was made from serologic findings. Although she was improving clinically the patient died from acute dissection of an aortic aneurysm 11 days after admission to hospital. The pathological findings--perivascular infiltrates and multifocal necrosis in the deep grey matter--were consistent with the diagnosis of western equine encephalitis. Similar findings in the basal ganglia and spinal cord corresponded to the focal clinical signs.

Acute Disease↗