Venezuelan equine encephalitis (VEE) is a zoonotic disease caused by the Venezuelan equine encephalitis virus (VEEV) complex. This disease has not yet been reported in China, and it is therefore essential to establish a rapid and accurate method for detection of the virus in order to prevent and control this disease. In this study, a one-step real-time quantitative RT-PCR method was developed for the detection of the VEEV complex. A pair of specific primers and a Taqman probe were designed corresponding to a conserved region of the VEEV gene nspl, allowing the detection of all known strains of different sub- types of the virus. Using RNA synthesized by in vitro transcription as template, the sensitivity of this method was measured at 3.27 x 10(2) copies/microL. No signal was generated in response to RNA from Chikungunya virus (CHIKV), nor to RNA encoding the nsp1 fragment of Eastern equine encephalitis virus (EE-EV) or Western equine encephalitis virus (WEEV), all of which belong to the same genus as VEEV. This indicates that the method has excellent specificity. These results show that this one-step real-time quantitative RT-PCR method may provide an effective tool for the detection of VEEV in China.
China ; DNA Primers ; genetics ; Encephalitis Virus, Venezuelan Equine ; classification ; genetics ; isolation & purification ; Encephalomyelitis, Venezuelan Equine ; virology ; Humans ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; methods

Introduction: The etiology of encephalitis involves an enormous range and can be classified as infectious or immune-mediated. There are several factors influencing its prognosis and has been associated with significant morbidity and mortality. This study aims to evaluate the clinico-epidemiologic characteristics and outcomes of infectious and immune-mediated encephalitis among pediatric patients. Methodology: Retrospective descriptive cross-sectional study that included patients aged 6 months to 17 years old with encephalitis in a tertiary hospital between January 2010 to December 2020 Results: A total of 23 cases were reviewed and 60.87% were infectious while that of immune-mediated was 39.13%. Among those with identified infectious cause, Mycoplasma pneumonia was the most common (28.57%). Infectious encephalitis was more common among younger males (35.71%) while immune-mediated affected female adolescents more (55.56%). The most common neurologic manifestation was altered mental status and/or behavioral changes. Treatment such as antibiotics (78.26%), anticonvulsant therapy (78.26%), and steroids (43.48%) were given. All immune-mediated cases received steroids. More than half of patients had complete recovery (56.52%). Conclusion Pediatric encephalitis should be considered among patients with neurologic dysfunction with or without systemic involvement. Behavioral changes in an apparently well child should prompt clinicians to consider anti-NMDAR encephalitis, especially if viral studies are negative and with no other known cause. Viruses remain to be the most common etiology, but other possible causes should be highly considered such as anti-NMDAR and Mycoplasma. A normal CSF analysis, imaging and/or encephalography (EEG) may not totally exclude encephalitis. Prognosis is relatively good hence an early diagnosis and initiation of appropriate management is important.
Encephalitis ; Infectious Encephalitis ; Encephalitis, Viral ; Mycoplasma

In this review, we mainly focus on zoonotic encephalitides caused by arthropod-borne viruses (arboviruses) of the families Flaviviridae (genus Flavivirus) and Togaviridae (genus Alphavirus) that are important in both humans and domestic animals. Specifically, we will focus on alphaviruses (Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus) and flaviviruses (Japanese encephalitis virus and West Nile virus). Most of these viruses were originally found in tropical regions such as Africa and South America or in some regions in Asia. However, they have dispersed widely and currently cause diseases around the world. Global warming, increasing urbanization and population size in tropical regions, faster transportation and rapid spread of arthropod vectors contribute in continuous spreading of arboviruses into new geographic areas causing reemerging or resurging diseases. Most of the reemerging arboviruses also have emerged as zoonotic disease agents and created major public health issues and disease epidemics.
Africa ; Alphavirus* ; Animals, Domestic ; Arboviruses* ; Arthropod Vectors ; Asia ; Encephalitis ; Encephalitis Virus, Venezuelan Equine ; Encephalitis Virus, Western Equine ; Encephalitis Viruses ; Encephalomyelitis, Equine ; Epidemiology* ; Flaviviridae ; Flavivirus* ; Global Warming ; Humans ; Population Density ; Public Health ; South America ; Togaviridae ; Transportation ; Urbanization ; Zoonoses

Three dimensional structures of envelope protein from Korean isolates and Nakayama-NIH strain of Japanese encephalitis virus (JEV) were deduced by a computer program (HyperChem 4.0 Chemplus 1.0) based on the data of the three dimentional structure of Tick-borne encephalitis virus. In the three dimensional structure of envelope protein, neutralizing epitope and T-helper cell recognition site of C-terminal region of Korean isolates were structually similar to those of Nakayama-NIH but the N-terminal region was not. Korean JE isolates were compared with Nakayama-NIH strain by using cross-neutralization antibody test. Neutralizing activities of Korean isolates derived from guinea pigs were higher than those of Nakayama-NIH strain against Korean isolates, although the polyclonal antibody titers of Nakayama-NIH showed 1:160 to 1:640 against Korean isolates. According to the results from three dimentional structures and cross-neutralization analyses, the antigenic difference between Korean JE isolates and Nakayama-NIH strain may be dependent on structural difference of envelope protein.
Animals ; Encephalitis Virus, Japanese ; Encephalitis Viruses* ; Encephalitis Viruses, Tick-Borne ; Encephalitis* ; Guinea Pigs ; Korea*

Various new technologies have been applied for developing vaccines against various animal diseases. Virus-like particle (VLP) vaccine technology was used for manufacturing the porcine circovirus type 2 and RNA particle vaccines based on an alphavirus vector for porcine epidemic diarrhea (PED). Although VLP is classified as a killed-virus vaccine, because its structure is similar to the original virus, it can induce long-term and cell-mediated immunity. The RNA particle vaccine used a Venezuela equine encephalitis (VEE) virus gene as a vector. The VEE virus partial gene can be substituted with the PED virus spike gene. Recombinant vaccines can be produced by substitution of the target gene in the VEE vector. Both of these new vaccine technologies made it possible to control the infectious disease efficiently in a relatively short time.
Alphavirus ; Animal Diseases ; Animals* ; Circovirus ; Communicable Diseases ; Diarrhea ; Encephalitis Virus, Venezuelan Equine ; Encephalomyelitis, Equine ; Immunity, Cellular ; Porcine epidemic diarrhea virus ; RNA ; Vaccines ; Vaccines, Synthetic ; Vaccines, Virus-Like Particle ; Venezuela

Analyzing HI tests of 110 cases of clinical Japanese Encephalitis in 1982, the following results are obtained. 1. The results of HI test are positive in 39 (35.5%), borderline positive in 19 (9.1%), negative in 14 (12.7%) and undetermined in 47 (43.7%) cases. 2. In 49 cases of positive HI test, 14 cases reveal the positive result on the first HI test requested in 5-27 days after the clinical onset of symptoms, and 35 cases show increasing HI titers on the follow-up studies. There is a tendency of increasing HI titers upto 3-4 weeks of onset and sustaining the value for more than two months. 3. In 35 cases with increasing titers on follow-up study, the highest titer is 1:80 in 5 cases, and the half of HI negative cases maintain that value throughout the course. 4. There is no significant statistical differences in clinical characteristics, laboratory and cerebrospinal fluid studies between the patient group of HI positive or borderline and group of HI negative or undermined, except mean hospital day and incidence of coma and death.
Cerebrospinal Fluid ; Coma ; Encephalitis, Arbovirus* ; Encephalitis, Japanese ; Follow-Up Studies ; Hemagglutination Inhibition Tests* ; Hemagglutination* ; Humans ; Incidence ; Korea*

OBJECTIVETo develop a rapid, cost effective RT-PCR method for the mass scale diagnosis of such diseases at the viremia stage to find out the actual disease burden in that area.

METHODSFor this purpose, cases with the history of only short febrile illness were considered. Thus 157 samples with the history of dengue/chikungunya like illness and only 58 samples with a history of acute encephalitis syndrome (AES) were selected.

RESULTSOut of 157 samples, 42 and 74 were detected as dengue and chikungunya, respectively and out of 58 AES cases only 23 could be detected as Japanese encephalitis by this RT-PCR method.

CONCLUSIONSThis cost effective RT-PCR method can detect the total positive cases that remain undetected by ELISA method. Moreover, this method is capable to detect the viral RNA from patients' sera even after the appearance of IgM antibody at one fifth costs as compared with the other commercially available kits.

Antibodies, Viral ; blood ; Arbovirus Infections ; diagnosis ; virology ; Arboviruses ; genetics ; Chikungunya Fever ; diagnosis ; virology ; Dengue ; diagnosis ; virology ; Encephalitis Virus, Japanese ; genetics ; Encephalitis, Japanese ; diagnosis ; virology ; Fever ; diagnosis ; virology ; Humans ; Immunoglobulin M ; blood ; Mass Screening ; RNA, Viral ; blood ; Reverse Transcriptase Polymerase Chain Reaction ; economics ; methods ; Sensitivity and Specificity ; Viremia ; diagnosis ; virology

No abstract available.
Leukoencephalopathy, Progressive Multifocal*

An increasing number of neuronal autoantibodies which target cell surface or synaptic proteins have been discovered over the last decade. Autoimmune encephalitis refers to this new category of autoimmune-mediated neurological disorders, which involve the central nervous system. Recent studies have established that autoimmune encephalitis is now the major cause of encephalitis, which was previously considered to be encephalitis of an unknown etiology. Moreover, the fact that autoimmune encephalitis is potentially treatable with immunomodulating therapy has changed the paradigm for the diagnosis and treatment of acute encephalitis syndrome. We herein review the pathophysiology, clinical manifestations, diagnosis, and treatment of autoimmune encephalitis with a focus on corticosteroid therapy as the first-line immunotherapy. In addition, regarding the diagnostic approach, we emphasize the differentiation between autoimmune and infectious encephalitis, because this distinction is not necessarily clear-cut in real clinical practice and should be considered when determining the initiation and type of immunotherapy.
Autoantibodies ; Autoimmune Diseases of the Nervous System ; Central Nervous System ; Diagnosis ; Encephalitis ; Glucocorticoids ; Immunotherapy ; Infectious Encephalitis ; Nervous System Diseases ; Neurons

In 2006, the annual number of Koreans traveling internationally increased to 11 million. With this increased number of Koreans traveling to developing countries, various infectious diseases have been reported to be imported into Korea. Immunization is an important tool for the prevention of such diseases. Vaccination offered to international travelers is divided into 3 categories, i.e., obligatory vaccination, vaccines against diseases with an increased risk in developing countries, and routine vaccination. Vaccination that is obligatory for travelers includes yellow fever vaccine for travelers entering yellow fever-endemic areas and meningococcal vaccination for pilgrims traveling to Saudi Arabia. Recent reports of the adverse event following yellow fever vaccination, i.e., vaccine-associated viscerotropic disease, pose a caution in the administration of yellow fever vaccine to the elderly or individuals with thymic diseases. Protein-conjugated meningococcal vaccines are generally preferred; however, polysaccharide vaccines are also effective in short-term travelers. The vaccinations recommended for the health of travelers include administration of hepatitis A (HAV), meningococcal, typhoid, rabies, tick-borne encephalitis, and plague vaccines. As many young Korean adults lack immunity against hepatitis A, the administration of the HAV vaccine is recommended for all Korean individuals in their 20s and all Korean seronegative individuals in their 30s. The risk of acquiring typhoid fever is high among travelers traveling to the rural areas of developing countries for 2 weeks or more. The rabies vaccine may be recommended for travelers traveling for longer than 3 months and animal handlers. Both tick-borne encephalitis and plague are rarely encountered among Korean travelers; furthermore, vaccines for these diseases are not available in Korea. As Japanese encephalitis is endemic in Korea, vaccination against encephalitis is not essential for Korean adults. Pre-travel counseling is an important opportunity for catch-up vaccination of healthy travelers who missed routine vaccinations.
Adult ; Aged ; Animals ; Communicable Diseases ; Counseling ; Developing Countries ; Encephalitis ; Encephalitis, Japanese ; Encephalitis, Tick-Borne ; Hepatitis A ; Humans ; Immunization ; Korea ; Meningococcal Vaccines ; Plague ; Rabies ; Rabies Vaccines ; Saudi Arabia ; Typhoid Fever ; Vaccination ; Vaccines ; Whooping Cough ; Yellow Fever ; Yellow Fever Vaccine