Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar

Area of Science:

• Virology
• Epidemiology
• Pediatrics

Background:

• Acute encephalitis syndrome (AES) poses a significant health burden in children.
• Dengue virus (DENV) and Japanese encephalitis virus (JEV) are known flaviviruses causing neurological disease.
• Limited data exists on the specific burden of DENV and JEV in pediatric AES cases in Myanmar.

Purpose of the Study:

• To determine the prevalence and burden of DENV and JEV infections in children under 13 presenting with AES.
• To identify the specific genotypes of DENV and JEV circulating in Myanmar.
• To provide etiological data for flavivirus encephalitis in the region.

Main Methods:

• Cerebrospinal fluid (CSF) samples were collected from 123 pediatric AES patients at Mandalay Children Hospital in 2013.
• Molecular and serological investigations, including neutralization tests and virus isolation, were performed.
• DENV and JEV specific antibody titers and viral RNA were analyzed.

Main Results:

• Four cases (3.3%) of JEV-associated encephalitis and one case (0.8%) of DENV-associated encephalitis were confirmed.
• The highest antibody titers were observed against JEV Genotype 3.
• A DENV-1 Genotype 1 strain, similar to local and regional strains, was isolated from a dengue encephalitis case.

Conclusions:

• Flaviviruses, including JEV and DENV, are significant causative agents of encephalitis in children in Myanmar.
• The findings underscore the importance of flaviviruses in pediatric neurological disease in the region.
• Enhanced disease surveillance, vector control, and vaccination strategies are crucial to mitigate flavivirus encephalitis morbidity and mortality.