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Etiology of Meningoencephalitis in children aged less than 5 years
Vivek K Mishra1, Tanzeela Khan1, Amar Jeet1
1Department of Microbiology, KG Medical University, Lucknow, Uttar Pradesh, India.
Background:
The incidence of meningoencephalitis (ME) in India is poorly understood, and the exact etiological diagnosis is often not possible. This study was planned to elucidate the bacterial and viral etiological diagnosis of ME in children less than 5 years of age.
Materials And Methods:
The present study was conducted in Virus Research and Diagnostic Laboratory (VRDL), Department of Microbiology, King George's Medical University, Lucknow, from July 2020 to June 2022. Serum, cerebrospinal fluid (CSF), and nose/throat swabs were collected from all the enrolled cases of meningoencephalitis in children below 5 years of age and tested for various etiological agents by ELISA and/or real-time PCR.
Results:
Of 130 enrolled cases, 50 (38.5%) cases tested positive for one or more etiological agents. Etiological agents of ME detected were Japanese encephalitis virus (JEV) (8.46%), adenovirus (6.92%), influenza virus (5.38%), dengue virus (3.85%), Parvo B-19 virus (3.08%), Orientia tsutsugamushi (3.08%), Herpes Simplex Virus-1 (HSV-1) (1.54%), measles virus (1.54%), and Varicella-Zoster Virus (VZV) (1.54%). Rubella virus, Chikungunya virus (CHKV), Mumps virus, Enteroviruses, Parecho virus, John Cunningham virus (JC), BK virus, Nipah virus, Kyasanur Forest Disease virus (KFD), Chandipura virus, Herpes Simplex Virus (HSV-2), SARS CoV-2, N. Meningitides , and H. Influenzae were tested but not detected in any of the cases.
Conclusion:
We identified the etiological agents in 50/130 (38.5%) suspected ME cases in children less than 5 years of age, using molecular and ELISA-based diagnostic methods. The four most common pathogens detected were JEV, adenovirus, influenza virus, and dengue virus.
Insights
This study identified etiological agents in pediatric meningoencephalitis (ME) cases in India. Japanese encephalitis virus, adenovirus, influenza virus, and dengue virus were the most common causes in children under five.
Area of Science:
- Pediatric infectious diseases
- Virology
- Neurology
Background:
- Meningoencephalitis (ME) incidence and causes in India are not well-understood.
- Accurate etiological diagnosis of ME is frequently challenging.
- This study aimed to identify bacterial and viral causes of ME in young children.
Purpose of the Study:
- To determine the bacterial and viral etiological agents responsible for meningoencephalitis (ME) in children under five years of age in India.
- To improve diagnostic capabilities for ME in pediatric populations.
- To understand the epidemiology of ME in the studied region.
Main Methods:
- Collected serum, cerebrospinal fluid (CSF), and respiratory swabs from children under 5 with suspected ME.
- Utilized Enzyme-Linked Immunosorbent Assay (ELISA) and real-time Polymerase Chain Reaction (PCR) for etiological diagnosis.
- Tested for a comprehensive range of viral and bacterial pathogens.
Main Results:
- Diagnosed etiological agents in 50 out of 130 (38.5%) suspected ME cases.
- Japanese encephalitis virus (JEV) was detected in 8.46% of cases.
- Adenovirus (6.92%), influenza virus (5.38%), and dengue virus (3.85%) were also significant findings.
- Other detected agents included Parvo B-19 virus, Orientia tsutsugamushi, HSV-1, measles virus, and VZV.
Conclusions:
- Successfully identified causative agents in over a third of pediatric ME cases using molecular and ELISA methods.
- Japanese encephalitis virus, adenovirus, influenza virus, and dengue virus were the predominant pathogens identified.
- Findings highlight the importance of these viruses in pediatric ME in India and inform diagnostic and public health strategies.
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