Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
Faculty of Medicine and Health Sciences, Warmadewa University, Denpasar, Bali, Indonesia.
PLoS Negl Trop Dis. 2020 Jul 14;14(7):e0008454. doi: 10.1371/journal.pntd.0008454. eCollection 2020 Jul.
Although Japanese encephalitis virus (JEV) is considered endemic in Indonesia, there are only limited reports of JEV infection from a small number of geographic areas within the country with the majority of these being neuroinvasive disease cases. Here, we report cases of JEV infection in non-encephalitic acute febrile illness patients from Bali, Indonesia. Paired admission (S1) and discharge (S2) serum specimens from 144 acute febrile illness patients (without evidence of acute dengue virus infection) were retrospectively tested for anti-JEV IgM antibody and confirmed by plaque reduction neutralization test (PRNT) for JEV infection. Twenty-six (18.1%) patients were anti-JEV IgM-positive or equivocal in their S2 specimens, of which 5 (3.5%) and 8 (5.6%) patients met the criteria for confirmed and probable JEV infection, respectively, based on PRNT results. Notably, these non-encephalitic JE cases were less likely to have thrombocytopenia, leukopenia, and lower hematocrit compared with confirmed dengue cases of the same cohort. These findings highlight the need to consider JEV in the diagnostic algorithm for acute febrile illnesses in endemic areas and suggest that JEV as a cause of non-encephalitic disease has likely been underestimated in Indonesia.
虽然日本脑炎病毒（JEV）被认为在印度尼西亚流行，但该国仅有少数地理区域有少量 JEV 感染报告，而且大多数是神经侵袭性疾病病例。在这里，我们报告了来自印度尼西亚巴厘岛非脑炎性急性发热疾病患者的 JEV 感染病例。对 144 例急性发热疾病患者（无急性登革热病毒感染证据）的入院时（S1）和出院时（S2）配对血清标本进行了回顾性检测，以检测抗-JEV IgM 抗体，并通过蚀斑减少中和试验（PRNT）对 JEV 感染进行了确认。26 例（18.1%）患者的 S2 标本中抗-JEV IgM 阳性或可疑，其中 5 例（3.5%）和 8 例（5.6%）患者根据 PRNT 结果分别符合确诊和可能的 JEV 感染标准。值得注意的是，与同一队列中确诊的登革热病例相比，这些非脑炎性 JE 病例的血小板减少症、白细胞减少症和低血细胞比容发生率较低。这些发现强调了在流行地区的急性发热疾病诊断算法中需要考虑 JEV，并且表明 JEV 作为非脑炎性疾病的病因在印度尼西亚可能被低估了。
