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A Murine Model of Dengue Virus-induced Acute Viral Encephalitis-like Disease
Published on: April 28, 2019
Aetiology of acute meningoencephalitis in Cambodian children, 2010-2013
Paul F Horwood1, Veasna Duong1, Denis Laurent2
1Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia.
Insights
Acute meningoencephalitis in Cambodian children is often caused by Japanese encephalitis virus and other preventable pathogens. Early diagnosis and treatment are crucial for improving outcomes in these pediatric cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neuroscience
Background:
- Acute meningoencephalitis (AME) presents a significant health challenge in developing nations, contributing to substantial childhood morbidity and mortality.
- Identifying the specific causes of AME is critical for effective treatment and prevention strategies in affected regions.
Purpose of the Study:
- To determine the primary etiological agents responsible for acute meningoencephalitis in children in Cambodia.
- To investigate the prevalence of various pathogens, including arboviruses and bacteria, in pediatric AME cases.
Main Methods:
- Collected cerebrospinal fluid (CSF) and blood samples from 1160 children with AME over a three-year period (July 2010-December 2013).
- Employed molecular diagnostics, cell culture, and serological testing to screen for a wide range of potential pathogens.
- Utilized a diagnostic algorithm to confirm or highly suspect etiological agents.
Main Results:
- An etiological agent was identified in 35.0% of cases, with an additional 9.2% classified as suspected, totaling 44.2% with defined causes.
- Japanese encephalitis virus (JEV) was the most frequent pathogen (24.4%), followed by Orientia tsutsugamushi (4.7%), dengue virus (DENV) (4.6%), enteroviruses (3.5%), chikungunya virus (CHIKV) (2.0%), and Streptococcus pneumoniae (1.6%).
- A significant proportion of identified causes were vaccine-preventable or treatable with antimicrobials.
Conclusions:
- The study highlights JEV as the leading cause of pediatric AME in Cambodia.
- Findings underscore the importance of vaccination and prompt antimicrobial treatment for managing AME in this population.
- Further research and public health interventions targeting these identified pathogens are warranted.
Abstract:
Acute meningoencephalitis (AME) is associated with considerable morbidity and mortality in children in developing countries. Clinical specimens were collected from children presenting with AME at two Cambodian paediatric hospitals to determine the major aetiologies associated with AME in the country. Cerebrospinal fluid (CSF) and blood samples were screened by molecular and cell culture methods for a range of pathogens previously associated with AME in the region. CSF and serum (acute and convalescent) were screened for antibodies to arboviruses such as Japanese encephalitis virus (JEV), dengue virus (DENV), and chikungunya virus (CHIKV). From July 2010 through December 2013, 1160 children (one month to 15 years of age) presenting with AME to two major paediatric hospitals were enroled into the study. Pathogens associated with AME were identified using molecular diagnostics, cell culture and serology. According to a diagnostic algorithm, a confirmed or highly probable aetiologic agent was detected in 35.0% (n=406) of AME cases, with a further 9.2% (total: 44.2%, n=513) aetiologies defined as suspected. JEV (24.4%, n=283) was the most commonly identified pathogen followed by Orientia tsutsugamushi (4.7%, n=55), DENV (4.6%, n=53), enteroviruses (3.5%, n=41), CHIKV (2.0%, n=23) and Streptococcus pneumoniae (1.6%, n=19). The majority of aetiologies identified for paediatric AME in Cambodia were vaccine preventable and/or treatable with appropriate antimicrobials.
