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Herpes simplex encephalitis in Iceland 1987-2011.

Heiður Mist Dagsdóttir1, Bryndís Sigurðardóttir2, Magnús Gottfreðsson3

  • 1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.

Springerplus
|October 4, 2014
PubMed
Summary

Herpes simplex encephalitis (HSE) affects 4.3 per million annually in Iceland. Despite treatment, most patients experience severe neurological impairment or death.

Keywords:
Herpes simplex encephalitisHerpes simplex virusNeurological sequelaeViral encephalitis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Herpes simplex encephalitis (HSE) is a severe neurological condition with significant mortality and long-term neuropsychiatric consequences.
  • Understanding HSE incidence and outcomes is crucial for public health and clinical management.

Purpose of the Study:

  • To determine the long-term incidence and clinical outcomes of HSE in Iceland.
  • To analyze the relationship between symptom onset to treatment delay and patient outcomes.

Main Methods:

  • A 25-year nationwide study (1987-2011) in Iceland.
  • Clinical data reviewed from patient records; diagnosis confirmed via CSF DNA PCR and antibody assays.
  • HSE cases classified as definite, possible, or rejected based on clinical, virological, laboratory, and imaging criteria.

Main Results:

  • Identified 30 definite HSE cases, yielding an incidence of 4.3 cases/10^6 inhabitants/year.
  • Common symptoms included fever, cognitive deficits, impaired consciousness, headache, and seizures.
  • 10% mortality within one year; 75% of survivors had significant neurological deficits (memory loss, dysphasia, seizures).

Conclusions:

  • Iceland's HSE incidence is higher than previously reported in some national studies.
  • Delayed treatment (mean 6 days) correlated with adverse outcomes.
  • Despite advances, HSE remains a devastating disease with high rates of death or severe neurological impairment.