Hospital-Based Surveillance for Japanese Encephalitis at Four Sites in Bangladesh, 2003–2005

Abstract

Abstract. We investigated the epidemiology and etiology of encephalitis at four tertiary hospitals in Bangladesh during [2003][2004][2005]. Patients who met a clinical case definition for acute encephalitis and had cerebrospinal fluid (CSF) pleocytosis were eligible for enrollment; a standardized sampling pattern was used to enroll eligible patients. Recent Japanese encephalitis virus (JEV) infection was defined by presence of IgM antibodies against JEV in CSF or serum. Twenty (4%) of 492 cases had laboratory evidence of recent JEV infection; two died. All JE cases occurred during May-December, and cases were identified among all age groups. All cases resided in rural areas. Fifteen patients were re-assessed 4-6 weeks after hospitalization; 5 (33%) patients had physical disabilities and 7 (47%) reported cognitive difficulties. Infection with JEV is clearly an etiology of encephalitis in Bangladesh. Population-based studies to quantify burden of disease could assess options for targeted immunization programs.

Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four prevalent infections

“…The median age of patients is less than 10 years old among unvaccinated populations, with the majority of deaths occurring in this phase of childhood [83]. The duration of acute, nonlethal disease (DW = 0.616) is two to three weeks.…”

A Novel Low-Cost Approach to Estimate the Incidence of Japanese Encephalitis in the Catchment Area of Three Hospitals in Bangladesh

“…[29][30][31] Identifying the highest JE incidence in the Rajshahi Medical College Hospital catchment area is consistent with the hospital-based JE study conducted in [2003][2004][2005], where over half of the cases (11 of 20) were identified from this hospital among four study hospitals. 9 A higher number of JE cases in Rajshahi may result from the local ecology. The mosquito vector of JE breeds prolifically in wet fields, especially in paddy fields.…”

“…8 A hospital-based study conducted from 2003 to 2005 to assess the etiologies of encephalitis at four hospitals in Bangladesh found that among 492 patients with clinical encephalitis, 20 (4%) cases had laboratory evidence of recent JEV infection. 9 The incidence of JE has been reduced dramatically in Japan, Korea, Taiwan, China, and Thailand since the introduction of a JE vaccine into the national immunization programs of these countries. [10][11][12][13][14] Widely used live attenuated SA 14-14-12 JE vaccine is inexpensive and with a single dose provides 80-96% protection.…”

Clinical and Epidemiological Profile of Paediatric Encephalitis Patients in a Tertiary Care Hospital

“…The clinical case definition of acute encephalitis include new onset of fever (temparetureeˆ38 0 C) or history of fever during the present illness along with altered mental status (confusion, disorientation, coma) and/ or neurological deficit (focal or diffuse neurological dysfunction or new onset of seizure-either focal or generalized) 8 . Pyogenic meningitis was excluded by Cerebro-spinal fluid (CSF) study, culture, latex agglutination test and severe malarial cases were excluded by RDT (Rapid Diagnostic Test) for malaria positive or Blood slide examination (BSE) positive cases.…”

“…Two years hospital based surveillance in Bangladesh was found 4% JEV infection. 8 Encephalitis is a serious infection in children with usually no specific treatment and the mortality rate is also high. 9 It is endemic throughout the year with occasional epidemics in various localities in our country.…”