A comparison of clinical features of Japanese encephalitis virus infection in the adult and pediatric age group with Acute Encephalitis Syndrome
A comparison of clinical features of Japanese encephalitis virus infection in the adult and pediatric age group with Acute Encephalitis Syndrome
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DOI：
10.1016/j.jcv.2011.06.001
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发表时间：
2011-09-01
影响因子：
8.8
通讯作者：
Mahanta, Jagadish
中科院分区：
文献类型：
--
作者：
Borah, Jani;Dutta, Prafulla;Mahanta, Jagadish
背景：传统上认为日本脑炎（JE）是一种儿童疾病。近年来印度阿萨姆邦乙脑患者的年龄变化引起了人们的关注。成人和儿童乙脑患者临床特征的比较尚未得到评价。目的：比较成人与儿童乙脑病毒感染的临床特点。研究设计：2008年1月至2010年1月，纳入550例急性脑炎综合征住院患者。血清学确诊为乙脑259例（47.1%），其中成人66.4%，儿童33.6%。对这些患者的数据进行分析。结果：发热是成人和儿童最常见的症状。小儿颈僵、惊厥、行为异常、癫痫发作、天冬氨酸转氨酶升高的比例明显高于成人（P < 0.05）。2.3%的成人血清胆红素水平较高，但所有儿童血清胆红素水平正常。我们发现成人脑脊液中蛋白质和白细胞的平均升高（P < 0.001）和儿科中天冬氨酸转氨酶的平均升高（P < 0.001）。儿童和成人的死亡率无差异（8.2%比4.4%,P = 0.647）。结论：本研究提供了儿童和成人乙脑临床特征的一些显著差异。年龄的变化可能是由于疾病侵入新的人口结构，或者随着时间的推移，病毒株发生了一些变化。印度政府于2011年首次在阿萨姆邦启动了一项成人乙脑疫苗接种规划。(C) 2011 Elsevier B.V.版权所有
Background: Japanese encephalitis (JE) has traditionally been regarded as a disease of children. The age shift in JE patients in Assam, India in last few years has become a cause of concern. Comparison on clinical features of adult and pediatric JE patients has not been evaluated.Objective: To compare clinical features of adult and pediatric with JE virus infection.Study design: From January 2008 to January 2010, 550 hospitalized patients with Acute Encephalitis Syndrome were enrolled. 259 (47.1%) were serologically confirmed as JE of which 66.4% were adult and 33.6% were pediatric. Data extracted from these patients were analyzed.Results: Fever was the most common symptom in both the adult and pediatric. When compared with adult, significantly higher percentage of pediatric had neck rigidity, convulsions, abnormal behavior, seizures and elevated aspartate transaminase (P < 0.05). Serum bilirubin levels were higher in 2.3% of adult but normal in all the pediatric. We found significantly higher mean elevated level of protein and WBC in CSF in adult (P < 0.001) and mean elevated aspartate transaminase level (P < 0.001) in pediatrics. There was no difference in mortality rate between pediatric and adult (8.2% vs. 4.4%, P = 0.647).Conclusions: This study provides some significant differences in clinical features of pediatric and adult with JE. Age shift may be due to the invasion of the disease into new demography or some change in the virus strain over time. The Government of India has initiated an adult JE vaccination programme for the first time in Assam in 2011. (C) 2011 Elsevier B.V. All rights reserved.