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Mumps in Patients with Acute Encephalitis Syndrome in Assam, India during January 2018 to July 2021
Kimmi Sarmah1, Kishore Sarma2, Prasanta Kumar Borah3
1Scientist B (Non-Medical), State Level VRDL, Department of Virology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
Abstract:
Acute encephalitis syndrome (AES), a major public health problem, has been reported worldwide. The potential etiology of AES varies from viruses, bacteria, fungi, and parasites with viruses being most prevalent. The virus-mediated AES in Assam is not well characterized. Most viruses causing AES lack specific treatment, but encephalitis caused by mumps virus (MuV) can be effectively treated. Therefore, the present study was undertaken to identify MuV positivity in AES cases during January 2018-July 2021. Using enzyme immunoassay MuV immunoglobulin M antibodies were tested in 317 samples (cerebrospinal fluid and serum) of which positivity was found in 22.0% (70/317), with higher prevalence in males and bulk of cases occurring in July. Quantitative reverse transcription-polymerase chain reaction positive MuV cases were genotyped targeting small hydrophobic gene which revealed the circulation of genotypes C and G during the studied period. Despite Japanese encephalitis (JE) being considered the major viral etiology for AES, the present study highlights the emergence of MuV over JE with time.
Insights
Mumps virus (MuV) causes acute encephalitis syndrome (AES) in Assam, India. This study found MuV in 22% of AES cases, highlighting its significant role and potential for treatment.
Area of Science:
- Virology
- Neurology
- Public Health
Background:
- Acute encephalitis syndrome (AES) is a global health concern with diverse etiologies, primarily viral.
- The viral causes of AES in Assam, India, remain under-investigated.
- Encephalitis caused by mumps virus (MuV) is treatable, unlike many other viral AES causes.
Purpose of the Study:
- To determine the prevalence of mumps virus (MuV) positivity in patients with acute encephalitis syndrome (AES).
- To characterize MuV genotypes circulating in AES cases in Assam, India.
- To assess the temporal trends of MuV as an AES etiology compared to Japanese encephalitis (JE).
Main Methods:
- Enzyme immunoassay (EIA) was used to detect MuV immunoglobulin M (IgM) antibodies in 317 cerebrospinal fluid and serum samples.
- Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was performed on positive samples.
- MuV-positive cases were genotyped targeting the small hydrophobic (SH) gene.
Main Results:
- MuV IgM antibodies were detected in 22.0% (70/317) of AES cases.
- Higher MuV prevalence was observed in males, with a peak incidence in July.
- Genotyping revealed the circulation of mumps virus genotypes C and G during the study period (January 2018–July 2021).
Conclusions:
- Mumps virus (MuV) is a significant etiological agent of acute encephalitis syndrome (AES) in Assam, India.
- The study indicates an increasing emergence of MuV over Japanese encephalitis (JE) as a cause of AES in the region.
- Timely diagnosis and treatment of MuV-associated encephalitis are crucial for patient outcomes.
