Beghi E, Nicolosi A, Kurland L T, Mulder D W, Hauser W A, Shuster L
Ann Neurol. 1984 Sep;16(3):283-94. doi: 10.1002/ana.410160304.
All cases fulfilling stated criteria for encephalitis and aseptic meningitis in Olmsted County, Minnesota, for the period 1950 through 1981 were identified. This is, to our knowledge, the first such incidence and trend study in a delineated population, providing rates per 100,000 person-years of 7.4 for encephalitis (189 cases) and 10.9 for aseptic meningitis (283 cases). These are about twelve and six times higher, respectively, than the rates reported by the Centers for Disease Control. The rates have been stable over successive 5- or 10-year periods except for a recent increase in aseptic meningitis. Both conditions were more common in the summer months, in childhood, and among males. Viral identification using conventional laboratory tests has improved with time; in the period 1970 through 1981, virus type was specified in about one-fourth of the cases. The most common agents identified were California and mumps viruses in encephalitis, and entero and mumps viruses in aseptic meningitis. Antecedent and/or concurrent infections were noted in 42 and 35% of encephalitis and aseptic meningitis cases, respectively. No case due to mumps, measles, or rubella viruses has occurred since 1972, reflecting the impact of immunizations. Recovery was reported at the end of the acute phase in 95% of patients with aseptic meningitis, and there were no deaths. Seventy-eight percent of encephalitis patients recovered completely; the case fatality rate was 3.8%. Of the encephalitis cases, 2% were diagnosed initially postmortem.
我们确定了明尼苏达州奥姆斯特德县1950年至1981年期间所有符合脑炎和无菌性脑膜炎既定标准的病例。据我们所知，这是在一个划定人群中进行的首次此类发病率和趋势研究，脑炎的发病率为每10万人年7.4例（189例），无菌性脑膜炎为每10万人年10.9例（283例）。这些发病率分别比疾病控制中心报告的发病率高出约12倍和6倍。除了最近无菌性脑膜炎有所增加外，发病率在连续的5年或10年期间一直保持稳定。这两种疾病在夏季、儿童期和男性中更为常见。随着时间的推移，使用传统实验室检测进行病毒鉴定的情况有所改善；在1970年至1981年期间，约四分之一的病例确定了病毒类型。在脑炎中鉴定出的最常见病原体是加利福尼亚病毒和腮腺炎病毒，在无菌性脑膜炎中是肠道病毒和腮腺炎病毒。分别在42%的脑炎病例和35%的无菌性脑膜炎病例中发现了前驱和/或并发感染。自1972年以来，未出现由腮腺炎、麻疹或风疹病毒引起的病例，这反映了免疫接种的影响。据报告，95%的无菌性脑膜炎患者在急性期结束时康复，且无死亡病例。78%的脑炎患者完全康复；病死率为3.8%。在脑炎病例中，2%最初是在尸检后确诊的。
