Japanese encephalitis virus infection in non-encephalitic acute febrile illness patients

Ma’roef, Chairin Nisa; Dhenni, Rama; Megawati, Dewi; Fadhilah, Araniy; Lucanus, Anton; Artika, I Made; Masyeni, Sri; Lestarini, Asri; Sari, Kartika; Suryana, Ketut; Yudhaputri, Frilasita A.; Jaya, Ungke Anton; Sasmono, R. Tedjo; Ledermann, Jeremy P.; Powers, Ann M.; Myint, Khin Saw Aye

doi:10.1371/journal.pntd.0008454

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…A recent prospective study performed in hospitalized patients with dengue-negative febrile illness in Indonesia found that 6% had serological evidence of recent JEV infection. Thrombocytopenia was common during the acute phase of illness in these non-encephalitic cases (69%) but did not occur as frequently as dengue cases from the same study (92%) [ 87 ].…”

Section: Resultsmentioning

confidence: 99%

Thrombocytopenia in Virus Infections

Raadsen

Toit

Langerak

et al. 2021

JCM

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Thrombocytopenia, which signifies a low platelet count usually below 150 × 109/L, is a common finding following or during many viral infections. In clinical medicine, mild thrombocytopenia, combined with lymphopenia in a patient with signs and symptoms of an infectious disease, raises the suspicion of a viral infection. This phenomenon is classically attributed to platelet consumption due to inflammation-induced coagulation, sequestration from the circulation by phagocytosis and hypersplenism, and impaired platelet production due to defective megakaryopoiesis or cytokine-induced myelosuppression. All these mechanisms, while plausible and supported by substantial evidence, regard platelets as passive bystanders during viral infection. However, platelets are increasingly recognized as active players in the (antiviral) immune response and have been shown to interact with cells of the innate and adaptive immune system as well as directly with viruses. These findings can be of interest both for understanding the pathogenesis of viral infectious diseases and predicting outcome. In this review, we will summarize and discuss the literature currently available on various mechanisms within the relationship between thrombocytopenia and virus infections.

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Section: Resultsmentioning

confidence: 99%

Thrombocytopenia in Virus Infections

Raadsen

Toit

Langerak

et al. 2021

JCM

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“…Classic transmission cycle of JE virus involves pigs as reservoir or amplifying hosts, while the virus itself is transmitted to humans through mosquito bites, mainly Culex species ( Choe et al, 2018 ; Yun and Lee, 2014 ). Although Indonesia belongs to endemic area of JE, routine screening in individuals presenting with acute encephalitis syndrome has been lacking due to limited data on true prevalence of the disease in many provinces ( Ma'roef et al, 2020 ). Sporadic cases have been reported in a number of areas in the past 20 years, including Bali and several cities in Java and Kalimantan (Borneo) island ( Kari et al, 2006 ; Konishi et al, 2009 ; Liu et al, 2010 ; Maha et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

The detection of Japanese encephalitis virus in Megachiropteran bats in West Kalimantan, Indonesia: A potential enzootic transmission pattern in the absence of pig holdings

Diptyanusa

Herini

Indarjulianto

et al. 2021

International Journal for Parasitology: Parasites and Wildlife

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The West Kalimantan province in Borneo island, Indonesia belongs to endemic area of Japanese encephalitis (JE) that accounts for approximately 30% of total cases yearly. As the presence of pig holdings is uncommon in West Kalimantan, another reservoir host might have played a role in the local transmission of JE virus in this area. Current study aimed to identify the potential role of bats in the local transmission of JE by performing molecular detection of JE virus in bats and mosquitoes using RT-PCR. Sample collection was performed in 3 districts in West Kalimantan, covering 3 different ecosystems: forest, coastal, and residential areas. Bat collection was performed using mist net and harp net, while mosquito collection was carried out using animal-baited trap and human landing collection. A total of 373 blood samples from bats were tested for JE virus, among which 21 samples (5.6%) showed positive results, mainly from Cynopterus brachyotis (lesser short-nosed fruit bat) found in residential areas. Out of 53 mosquito pools, 3 JE-positive pools of Culex tritaeniorhynchus and Cx. vishnui were collected at the same location as JE-positive bats. Current study showed the first evidence of JE virus detection in several species of Megachiropteran bats in Indonesia, demonstrated the potential role of frugivorous bats in local transmission of JE in West Kalimantan. More aggressive measures are required in JE risk mitigation, particularly in initiating JE vaccination campaign and in avoiding disruption of bats’ natural habitats through changes in land-use.

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“…The most likely source of wind-blown infected mosquitoes into the Tiwi Islands is Indonesia or Timor Leste, although Papua New Guinea cannot be ruled out as a potential source. JEV PLOS NEGLECTED TROPICAL DISEASES is believed to be enzootic in Indonesia, with virus isolations from mosquitoes or serological evidence of infection in pigs found in parts of Java, Bali, Lombok, Flores, West Timor and Papua Province (reviewed in [10,11,66]). A clinical case of JE from Irian Jaya (West Papua) was reported from Timika in 1996 [21], supported by serological evidence of human infection [67].…”

Section: Discussionmentioning

confidence: 99%

Molecular detection and characterisation of the first Japanese encephalitis virus belonging to genotype IV acquired in Australia

et al. 2022

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Background A fatal case of Japanese encephalitis (JE) occurred in a resident of the Tiwi Islands, in the Northern Territory of Australia in February 2021, preceding the large JE outbreak in south-eastern Australia in 2022. This study reports the detection, whole genome sequencing and analysis of the virus responsible (designated JEV/Australia/NT_Tiwi Islands/2021). Methods Reverse transcription quantitative PCR (RT-qPCR) testing was performed on post-mortem brain specimens using a range of JE virus (JEV)-specific assays. Virus isolation from brain specimens was attempted by inoculation of mosquito and mammalian cells or embryonated chicken eggs. Whole genome sequencing was undertaken using a combination of Illumina next generation sequencing methodologies, including a tiling amplicon approach. Phylogenetic and selection analyses were performed using alignments of the Tiwi Islands JEV genome and envelope (E) protein gene sequences and publicly available JEV sequences. Results Virus isolation was unsuccessful and JEV RNA was detected only by RT-qPCR assays capable of detecting all JEV genotypes. Phylogenetic analysis revealed that the Tiwi Islands strain is a divergent member of genotype IV (GIV) and is closely related to the 2022 Australian outbreak virus (99.8% nucleotide identity). The Australian strains share highest levels of nucleotide identity with Indonesian viruses from 2017 and 2019 (96.7–96.8%). The most recent common ancestor of this Australian-Indonesian clade was estimated to have emerged in 2007 (95% HPD range: 1998–2014). Positive selection was detected using two methods (MEME and FEL) at several sites in the E and non-structural protein genes, including a single site in the E protein (S194N) unique to the Australian GIV strains. Conclusion This case represents the first detection of GIV JEV acquired in Australia, and only the second confirmed fatal human infection with a GIV JEV strain. The close phylogenetic relationship between the Tiwi Islands strain and recent Indonesian viruses is indicative of the origin of this novel GIV lineage, which we estimate has circulated in the region for several years prior to the Tiwi Islands case.

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Japanese encephalitis virus infection in non-encephalitic acute febrile illness patients

Cited by 5 publications

References 37 publications

Thrombocytopenia in Virus Infections

Thrombocytopenia in Virus Infections

The detection of Japanese encephalitis virus in Megachiropteran bats in West Kalimantan, Indonesia: A potential enzootic transmission pattern in the absence of pig holdings

Molecular detection and characterisation of the first Japanese encephalitis virus belonging to genotype IV acquired in Australia

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