Etiology and clinico-epidemiological profile of acute viral encephalitis in children of western Uttar Pradesh, India

OBJECTIVES: To study the etiology of viral encephalitis (VE) in the children of western Uttar Pradesh, India and to assess the clinico-epidemiological profile of these children in relation to VE. METHODS: Both cerebrospinal fluid and serum samples were collected from pediatric patients suffering from encephalitis hospitalized at Jawaharlal Nehru Medical College, Aligarh from July 2004 to November 2006. Viral isolation was done on RD cells, HEp-2 cells, and Vero cells from the cerebrospinal fluid samples of children with suspected VE. A microneutralization test was performed for enterovirus 71. An enzyme immunoassay for IgM antibodies was performed for measles virus, mumps virus, varicella zoster virus, herpes simplex virus 1, and Japanese encephalitis virus. RESULTS: Eighty-seven patients were enrolled in the study. The most common etiology of VE was enterovirus 71 (42.1%), followed by measles (21.1%), varicella zoster virus (15.8%), herpes simplex virus (10.5%), and mumps (10.5%). Japanese encephalitis virus was not found in any case. Enterovirus 71 infection caused significant morbidity in children; mortality occurred in 50%. A preponderance of cases occurred in December. In our study generalized convulsions along with altered sensorium were the significant findings in patients with VE. CONCLUSIONS: Enterovirus 71, the major etiology of VE in our study, was associated with significant mortality and morbidity. Such studies should be conducted frequently to assess the role of emerging VE in different regions.