Acute encephalitis syndrome in eastern uttar pradesh. Early stabilization and institution of nonspecific supportive measures is the cornerstone of management. Pdf a retrospective study of acute encephalitis syndrome. For surveillance of acute encephalitis syndrome with special reference to japanese encephalitis for surveillance of acute encephalitis syndrome with special reference to japanese encephalitis directorate of national vector borne diseases control programme directorate general of health services, ministry of health and family welfare november. Sequelae following acute encephalitis syndrome caused by. Epidemiology of acute encephalitis syndrome in india.
Scrub typhus as a cause of acute encephalitis syndrome. Acute encephalitis syndrome national health portal of india. Understanding and managing acute encephalitis fresearch. Nov, 2018 encephalitis encephalitis is inflammation of the brain parenchyma and is associated with neurologic dysfunction. Acute encephalitis syndrome aes is characterized by an acute onset of fever and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma. Acute encephalitis syndrome surveillance, kushinagar. Consolidates todays available information and guidance on acute encephalopathy and encephalitis in infancy, in addition to related disorders, into one convenient resource. Here we report the common viral etiologic agents of aes and its epidemiology in the vicinity of lucknow in uttar. Japanese encephalitis virus endemic districts in india source. Under it teams will go door to door in every village of states 75 districts to create awareness about communicable diseases as well as acute encephalitis syndrome and japanese encephalitis. Possible factors causing acute encephalitis syndrome. Viruses are the main causative agents in aes cases, although other sources such as bacteria, fungus, parasites, spirochetes, chemicals, toxins and noninfectious agents have also.
Acute necrotizing encephalopathy ane is a rare disease characterized by brain damage encephalopathy that usually follows an acute febrile disease, mostly viral infections most of the reported cases are from previously healthy japanese and taiwanese children, but it is now known that the disease may affect anybody in the world. Our findings revealed a high proportion of aes cases with orientia tsutsugamushi igm and igg, indicating that scrub typhus is a cause of aes. The world health organisation who in 2006, coined the term aes to signify a group of diseases which seem similar to one another but are difficult to differentiate in the chaotic environment. The term acute encephalitis syndrome aes was coined by the world health organisation in 2008.
Japanese encephalitis je is one of the most common. Acute encephalitis syndrome in eastern uttar pradesh, india. Acute encephalitis syndrome aes has a diverse etiology and japanese encephalitis virus je is the most common etiological agent implicated in its causation. In june 2019, an outbreak of acute encephalitis syndrome aes occurred in muzaffarpur and the adjoining districts in bihar state of india resulting in deaths of more than 150 children, mainly due to hypoglycemia. Challenges and the way forward aakash shrivastava abstract japanese encephalitis, an arboviral infection, is a serious public health problem in the asian region. Encephalitis is a condition of inflammation of the brain parenchyma, occurs as a result of infectious or autoimmune causes, and can lead to encephalopathy, seizures, focal neurological deficits, neurological disability, and death. Acute encephalitis constitutes a medical emergency. Viruses have been mainly attributed to be the cause of aes in india although other sources such as bacteria, fungus, parasites, spirochetes, chemical, and. National vector borne disease control program, government of india chapter 3 table 1. Aes simply known as brain fever is a constellation of symptoms and signs, characterized by the presence of fever and the development of altered behavior, with or without seizures or neurological deficits. For surveillance of acute encephalitis syndrome with special reference to japanese encephalitis directorate of national vector borne diseases control programme directorate general of health services, ministry of health and family welfare november 2006. Viral encephalitis can occur either as a direct effect of an acute infection, or as one of the sequelae of a latent infection. The present study was conducted to find out the clinicoepidemiological profile of the aes non je and je during its outbreaks from the year 2014 to 2016 in tertiary care centre, tezpur assam. Encephalitis caused by the herpes simplex virus is the leading cause of more severe cases in all ages, including newborns.
However, with many underlying causes and short window period for treatment, aes still remains challenging for the healthcare system for its prevention and. Large outbreaks of aes affecting particularly children. Outbreaks of acute encephalitis syndrome aes have been occurring in gorakhpur division, uttar pradesh, india, for several years. Infectious encephalitis often starts with flulike symptoms or headache and evolves to altered mental status and problems with thinking, remembering and reasoning. Acute encephalitis syndrome aes is a major public health concern in india. We are reporting a child presented with fever and acute onset of encephalopathy. This disease has remained for over two decades without determining a cause for it. Review diagnosis and treatment of viral encephalitis. In india, as per the national vectorborne disease control. Acute encephalitis syndrome a complex zoonotic disease. Acute encephalitis syndrome is characterized by acute onset of fever and neurological signs. Characteristic clinical features include altered mental status decreased level of consciousness, lethargy, personality change, unusual behavior, seizures, andor focal neurologic signs, often accompanied by fever, headache. May 02, 2020 acute encephalitis syndrome aes is considered a very complex disease as it can be caused by various agents including bacteria, fungi, virus and many other agents. Jun 12, 2019 acute encephalitis syndrome aes is a serious public health problem in india.
Consensus guidelines on evaluation and management of. The districts sensitive for the vectorborne diseases such as encephalitis, dengue, kalaazar, malaria, chickungunya, etc. Acute encephalitis syndrome aes is a problem in the indian subcontinent and is endemic to certain regions of india. Acute encephalitis syndrome aes is a major public health problem in eastern uttar pradesh, claiming thousands of lives every year. Acute encephalitis syndrome aes is characterized by an acute onset of fever and clinical neurological manifestation that includes mental. It is characterized as acuteonset of fever and a change in mental status mental confusion, disorientation, delirium, or coma andor newonset of seizures in a person of any age at any time of the year. Acute encephalitis syndrome aes which encompasses infections of the central.
This revision was done in 2009 and the detailed guidelines are as follows. Routine vaccination has greatly reduced encephalitis due to some viruses, including. Acute encephalitis syndrome aes is be defined as the acuteonset of fever with change in mental status including symptoms such as confusion, disorientation, coma, or inability to talk and often with new onset of seizures excluding simple febrile convulsion in a person of any age at any time of the year solomon et al. Case management of acute encephalitis syndromejapanese. In subsequent months more cases and deaths were reported. Malnutrition, climate, hygiene, inadequate health facilities, and lack of awareness are. Viruses have been mainly attributed to be the cause of aes in india although other sources such as bacteria, fungus, parasites, spirochetes, chemical, and toxins have been reported over the past few decades. Acute encephalitis syndrome is a group of conditions of that mainly affect the brain and is caused by a wide range of viruses, bacteria, fungi, spirochetes, parasites, chemicals and toxins. Acute encephalitis shows up with an onset of symptoms that get worse over the course of days to weeks. Magnetic resonance imaging brain was suggestive of acute necrotizing encephalopathy.
All casualties are children, the maximum in muzaffarpur 43 recorded in june. The common causes include encephalitis, meningitis, severe sepsis, cerebral malaria, reyes syndrome, etc. The epidemiologic features of acute encephalitis syndrome in. Pdf acute encephalitis syndrome aes is characterized by an acute onset of fever and clinical neurological manifestation that includes. Gore abstract acute encephalitis syndrome aes is an epidemiological term used to describe central nervous system disease due to infectious causative organism. Acute encephalitis in immunocompetent adults sciencedirect. Infection with japanese encephalitis virus may cause febrile illness, meningitis, myelitis or encephalitis, and is clinically indistinguishable from other causes of an acute encephalitis syndrome aes. The most important cause is infectionboth viral and nonviral. Fever and symptoms gradually or suddenly disappear. Clinically, a case of acute encephalitis syndrome is defined as a person of. Weekly number of acute encephalitis syndrome cases, by month, in kushinagar district, uttar pradesh state, india, 20112012. Suspected case in close geographic and temporal relationship to a laboratory confirmed case of aesje in an outbreak. While japanese encephalitis virus jev is a leading cause of acute encephalitis syndrome in india ranging from 535%, the etiology in a large number of cases however. Acute encephalitis syndrome aes is a serious public health problem in india.
A case of acute limbic encephalitis with sjogrens syndrome. Acute disseminated encephalomyelitis is a noninfective inflammatory encephalitis that may require to be treated with steroids. Sep 19, 2018 acute encephalitis is a common cause of death and neurodevelopmental problems in children. Acute encephalitis syndrome aes is defined as acute onset of fever and a change in mental status andor new onset of seizures in a person of any age, in any geographical region, at. Encephalitis often causes only mild flulike signs and symptoms such as a fever or headache or no symptoms at all. Acute encephalopathy denotes a constellation of syndromes presenting with severe and prolonged coma of acute onset, following a febrile infectious disease, with widespread, noninflammatory brain edema classification.
To reduce severe morbidity and mortality, it is important to. Neuroimaging often shows marked inflammation of the thalamus and basal ganglia in these patients. Autoimmune encephalitis typically progresses over the course of weeks. Acute encephalitis syndrome is a severe case of encephalitis transmitted by mosquitoes and is characterized by high fever and inflammation of the brain. The symptoms of aes include an acute onset of fever and associated clinical neurological manifestations such as mental confusion, disorientation, delirium, convulsions, or coma. Feb 23, 2017 acute necrotizing encephalopathy ane is a rare disease characterized by brain damage encephalopathy that usually follows an acute febrile disease, mostly viral infections most of the reported cases are from previously healthy japanese and taiwanese children, but it is now known that the disease may affect anybody in the world. Viral agents include primary neurotropic viruses such as arboviruses, herpesviruses, and rabies virus as well as other incidental nervous system pathogens such as entero, orthomyxo, paramyxo, and adenoviruses, which primarily cause disease elsewhere in the body and involve the central.
Acute encephalitis syndrome aes is a group of clinical neurologic manifestation caused by wide range of viruses, bacteria, fungus, parasites, spirochetes, chemical and toxins. Surveillance studies of acute encephalitis syndrome in india 19572008 figure 4. Acute encephalitis syndrome national health portal of. The epidemiologic features of acute encephalitis syndrome. May 06, 2020 acute encephalitis syndrome aes is a viral disease, which causes mild flulike symptoms such as high fever, convulsions, and headaches. Acute encephalitis syndrome surveillance, kushinagar district. In india, quality surveillance for acute encephalitis syndrome aes, including laboratory testing, is necessary for understanding the epidemiology and etiology of aes, planning interventions, and developing policy. Our findings revealed a high proportion of aes cases with orientia tsutsugamushi igm and igg, indicating that scrub typhus is. Acute encephalitis in immunocompetent adults the lancet. Acute encephalitis syndrome latest health tips, news and. However, aes in different geographical locations have distinct etiological agents that may have seasonal variability, miscellaneous presentations and outcome. Bihar has recorded 188 cases of acute encephalitis syndrome, with 45 deaths, since january. Acute encephalopathy and encephalitis in infancy and its.
Request pdf a case of acute limbic encephalitis with sjogrens syndrome a 52yearold woman developed abnormal behavior and disturbance of consciousness subsequent to several days with a cold. Acute necrotizing encephalopathy genetic and rare diseases. Sep 09, 2016 acute encephalitis syndrome aes is characterized by an acute onset of fever and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma. According to national vector borne diseases control programme nvbdcp, 10,485 aes cases were diagnosed in 2018 with 632 deaths across 17 states. Covers diagnostic strategy, subtypes of acute encephalopathy, and management of acute encephalopathy and encephalitis. Investigations are aimed at recognition of etiological agent for specific therapeutic and control measures. Acute encephalitis syndrome is marked by an acute onset of fever and a change in mental status, ranging from mental confusion, disorientation, delirium, seizures, or even coma. Diagnostic approach to viral acute encephalitis syndrome aes in. The causative agents are numerous including infectious agents such as viruses, bacteria, mycobacteria and protozoa. In the year 2006, west nile wn virus emerged as another cause of acute encephalitis syndrome in india. Acute encephalitis syndrome aes has a very complex etiology.
In 2011, a total of 721 aes cases from kushinagar district were identified through brd medical college. Pdf study of acute encephalitis syndrome in children. Viral causes account for the largest proportion, but in the last decade there has been growing recognition of antineuronal antibody syndromes. Epidemiology and etiology of acute encephalitis syndrome. Acute encephalitis syndrome with an unusual diagnosis. Encephalitis ensefuhlietis is inflammation of the brain. Diagnosis and management of acute encephalitis in children. We evaluated 146 patients with acute encephalitis syndrome caused by orientia tsutsugamushi, after median interval of 5 months of hospitalization, to estimate the proportion and spectrum of disability. The most common causes of acute viral encephalitis are japanese encephalitis virus, west nile virus wnv, eastern equine encephalitis virus eeev, western equine encephalitis virus weev, venezuelan equine. In most cases, the presence of focal neurological signs and focal seizures will distinguish encephalitis from encephalopathy. Consensus guidelines on evaluation and management of acute viral encephalitis in indian children are provided. Acute encephalitis syndrome in children in muzaffarpur. Acute encephalitis syndrome aes is categorized by an acute onset of fever and clinical manifestation such as high fever.
Aetiology and laboratory diagnosis of acute encephalitis syndrome. Acute encephalitis syndrome aes who recommended case definition a person of any age, at any time of year with the acute onset of fever and a change in mental status including symptoms such as confusion, disorientation, coma or inability to talk andor new onset of seizures excluding simple febrile seizures. Temporal profile of acute encephalitis syndrome aes cases n183 and. There are several causes, but the most common is a viral infection.
With vaccine drive japanese encephalitis je has been declined. Causative agents of aes include a wide variety of viruses, bacteria, protozoa, fungi, and non infectious agents. The world health organization who defined acute encephalitis syndrome aes as an acute onset of fever and change in mental status including symptoms such as confusion, disorientation, coma, or inability to talk andor new onset of seizures excluding simple febrile seizures among a person of any age, at any time of year. Some people may take several months to fully recover.
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