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. 2022 Aug:153:105194.
doi: 10.1016/j.jcv.2022.105194. Epub 2022 May 28.

Infectious causes of acute encephalitis syndrome hospitalizations in Central India, 2018-20

Babasaheb V Tandale  1 , Shilpa J Tomar  2 , Vijay P Bondre  2 , Gajanan N Sapkal  2 , Rekha G Damle  2 , Rahul Narang  3 , Mohiuddin S Qazi  4 , Padmaja V Goteti  5 , Manish Jain  6 , Dipty Jain  4 , Vijay Kumar Guduru  5 , Jyoti Jain  6 , Rajesh V Gosavi  4 , V Chandra Sekhar  5 , Infectious-Encephalitis-Aetiologies Study-Group  7 , Daya V Pavitrakar  2 , Vasudha Shankarraman  2 , Shubhangi A Mahamuni  2 , Asha Salunkhe  2 , Poornima Khude  2 , Pravin S Deshmukh  2 , Pradeep R Deshmukh  8 , Abhishek V Raut  6 , Abhimanyu K Niswade  4 , Yogendra V Bansod  4 , Uday W Narlawar  4 , Manoj Talapalliwar  4 , Pragati Rathod  4 , Punam Kumari Jha  5 , R Kondal Rao  5 , K Jyothi  5 , Padmini Soujanya B  5 , Pavan Kumar M  5 , Kishore Kumar K J  5 , Amar Taksande  9 , Sunil Kumar  9 , Gargi Mudey  9 , B S Yelke  10 , Milind Kamble  10 , Supriya Tankhiwale  10
Affiliations

Infectious causes of acute encephalitis syndrome hospitalizations in Central India, 2018-20

Babasaheb V Tandale et al. J Clin Virol. 2022 Aug.

Abstract

Background: We enhanced surveillance of hospitalizations of all ages for acute encephalitis syndrome (AES) along with infectious aetiologies, including the Japanese encephalitis virus (JEV).

Methods: From October 2018 to September 2020, we screened neurological patients for AES in all age groups in Maharashtra and Telangana States. AES cases were enrolled at study hospitals along with other referrals and sampled with cerebrospinal fluid, acute and convalescent sera. We tested specimens for non-viral aetiologies viz. leptospirosis, typhoid, scrub typhus, malaria and acute bacterial meningitis, along with viruses - JEV, Dengue virus (DENV), Chikungunya virus (CHIKV), Chandipura virus (CHPV) and Herpes simplex virus (HSV).

Results: Among 4977 neurological hospitalizations at three study site hospitals over two years period, 857 (17.2%) were AES. However, only 287 (33.5%) AES cases were eligible. Among 278 (96.9%) enrolled AES cases, infectious aetiologies were identified in 115 (41.4%) cases, including non-viral in 17 (6.1%) cases - leptospirosis (8), scrub-typhus (3) and typhoid (6); and viral in 98 (35.3%) cases - JEV (58, 20.9%), HSV (22, 7.9%), DENV (15, 5.4%) and CHPV (3, 1.1%). JEV confirmation was significantly higher in enrolled cases than referred cases (10.2%) (p < 0.05). However, the contribution of JEV in AES cases was similar in both children and adults. JE was reported year-round and from adjacent non-endemic districts.

Conclusions: The Japanese encephalitis virus continues to be the leading cause of acute encephalitis syndrome in central India despite vaccination among children. Surveillance needs to be strengthened along with advanced diagnostic testing for assessing the impact of vaccination.

Keywords: Acute encephalitis; Central India; Hospitalization rates; Infectious causes; Sentinel surveillance; Viral etiologies.

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