Kumar Vijayan Senthil, Sivasubramanian Srinivasan, Padmanabhan Padmapriya, Anupama Cherayi Padinjakare, Ramesh Kiruba, Gunasekaran Palani, Krishnasamy Kaveri, Kitambi Satish Srinivas
Department of Virology, State Viral Research and Diagnostic Laboratory, King Institute of Preventive Medicine and Research, Chennai, Tamil Nadu, India.
Department of Translational Sciences, Institute for Healthcare Education and Translational Sciences, Hyderabad, Telangana, India.
J Glob Infect Dis. 2023 May 2;15(2):52-58. doi: 10.4103/jgid.jgid_179_22. eCollection 2023 Apr-Jun.
Establishing the etiological cause of acute encephalitis syndrome (AES) is challenging due to the distinct distribution of various etiological agents. This study aims to determine the etiological profiles of both viruses and bacteria and their associated clinico-epidemiological features among the AES suspected cases in Tamil Nadu, India.
Samples of 5136 suspected AES cases from January 2016 to December 2020 (5 years) were subjected to the detection of etiological agents for AES through serological and molecular diagnosis methods. Further, the clinical profile, age- and gender-wise susceptibility of cases, co-infection with other AES etiological agents, and seasonality pattern with respect to various etiological agents were examined.
AES positivity was established in 1480 cases (28.82%) among the 5136 suspected cases and the positivity for male and female groups were 57.77% and 42.23%, respectively. The pediatric group was found to be more susceptible than others. Among the etiological agents tested, the Japanese encephalitis virus (JEV) was the predominant followed by , Herpes Simplex virus, Epstein-Barr virus, Varicella Zoster virus, and others. Co-infection with other AES etiological agents was observed in 3.5% of AES-positive cases. Seasonality was observed only for vector-borne diseases such as JEV, dengue virus, and West Nile virus infections in this study.
AES was found to be a significant burden for Tamil Nadu with a diverse etiological spectrum including both sporadic and outbreak forms. Overlapping clinical manifestations of AES agents necessitate the development of region-specific diagnostic algorithm with distinct etiological profiles for early detection and effective case management.
由于各种病原体的分布不同，确定急性脑炎综合征（AES）的病因具有挑战性。本研究旨在确定印度泰米尔纳德邦疑似AES病例中病毒和细菌的病因谱及其相关的临床流行病学特征。
对2016年1月至2020年12月（5年）期间5136例疑似AES病例的样本，通过血清学和分子诊断方法检测AES的病原体。此外，还检查了病例的临床特征、按年龄和性别划分的易感性、与其他AES病原体的合并感染情况以及各种病原体的季节性模式。
在5136例疑似病例中，1480例（28.82%）确诊为AES阳性，男性和女性组的阳性率分别为57.77%和42.23%。发现儿科组比其他组更易感染。在所检测的病原体中，日本脑炎病毒（JEV）占主导地位，其次是单纯疱疹病毒、爱泼斯坦-巴尔病毒、水痘-带状疱疹病毒等。3.5%的AES阳性病例存在与其他AES病原体的合并感染。本研究中仅观察到虫媒传播疾病如JEV、登革热病毒和西尼罗河病毒感染有季节性。
发现AES是泰米尔纳德邦的一个重大负担，其病因谱多样，包括散发性和暴发形式。AES病原体的重叠临床表现需要开发具有不同病因谱的区域特异性诊断算法，以便早期发现和有效管理病例。
