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Relapsed and late-onset Nipah encephalitis.

Chong Tin Tan1, Khean Jin Goh, Kum Thong Wong

  • 1Department of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. tlip@pl.jaring.my

Annals of Neurology
|July 12, 2002
PubMed
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Nipah virus infection can cause long-term neurological issues, including relapsed or late-onset encephalitis, in survivors. This follow-up study highlights the persistent threat of Nipah virus in the central nervous system.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • A Nipah virus outbreak in Malaysia (1998-1999) affected 265 individuals, causing 105 deaths.
  • This study investigates the long-term neurological consequences in survivors 24 months post-outbreak.

Purpose of the Study:

  • To identify and characterize late-onset or relapsing neurological disease following Nipah virus infection.
  • To understand the clinical presentation, imaging findings, and outcomes of these delayed neurological complications.

Main Methods:

  • Follow-up study of Nipah virus outbreak survivors.
  • Clinical assessment, neurological examination, and neuroimaging (MRI, SPECT) were performed.
  • Necropsy findings were analyzed in two cases.

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Main Results:

  • 12 survivors (7.5%) experienced relapsed encephalitis; 10 patients (3.4%) developed late-onset encephalitis.
  • Common symptoms included fever, headache, seizures, and focal neurological deficits.
  • MRI showed cortical lesions, and SPECT revealed evolving perfusion abnormalities. Necropsy confirmed Nipah virus encephalitis without demyelination.

Conclusions:

  • Persistent Nipah virus infection in the CNS can lead to unique relapsing or late-onset encephalitis.
  • These delayed neurological sequelae pose a significant long-term risk to Nipah virus survivors.