Encephalitis in the 21 st century.

As the 21st century begins, several outbreaks of encephalitis have been reported. An examination of these outbreaks brings into focus important epidemiological developments. Specifically, urbanization and encroachment on natural environments, the ease of world travel, and global trade can lead to spread of vectors and viruses from the developing world to the developed world. This review focuses on two recent epidemics of encephalitis: West Nile virus encephalitis in the eastern United States and Nipah virus encephalitis in Malaysia and Singapore. These examples demonstrate spread of a known viral agent from an endemic area to an area in which it had not previously been found and identification of a new viral agent. Infectious diseases in the developed world once considered "exotic" are now potential threats to all patients.