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Etiology of Encephalitis in Australia, 1990–2007

mixin

Well-known member
[snips]

In Australia, encephalitis, as a syndrome, is not a notifiable disease, and data about trends or even clusters of this disease are not routinely collected. Only laboratory-confirmed encephalitis cases due to certain pathogens (e.g., Murray Valley encephalitis virus, Japanese encephalitis virus, or Australian bat lyssavirus) are notifiable to public health units; thus, the occurrence of encephalitis is not well documented.

A single, small study conducted in Australia’s tropical Northern Territory found that 18 (53%) of 34 encephalitis patients admitted to the Royal Darwin Hospital during a 5-year period (1992–1996) had encephalitis with unexplained etiology. This level of unknown pathogen etiology suggests that Australia has a similar rate of pathogen identification as that reported in the overseas studies. However, the relative importance of different pathogens may differ because Australia has unique pathogens such as Murray Valley encephalitis virus, Hendra virus, and Australian bat lyssavirus).

Several countries have conducted large epidemiologic studies to assess the impact of disease caused by encephalitis and to determine its etiology. Davison et al. reviewed UK hospital records for a 9-year period (1989–1998) and found that the hospitalization rate for viral encephalitis in UK hospitals was 1.5 cases per 100,000 population; 60% of cases were recorded as unidentified viral infection. During the study period in the United Kingdom, 419 deaths were attributed to viral encephalitis (overall case-fatality rate 6.5/100 cases), but an etiologic organism was identified for only 50% of these deaths. A smaller prospective study conducted in Finland for a 25-year period (1967–1991) found no etiology for encephalitis in 49% of 322 patients hospitalized with this illness.

Khetsuriani et al. analyzed national data for the United States over a similar period (1988–1997) to estimate the impact of both viral and nonviral encephalitis hospitalizations. This study found that the hospitalization rate for encephalitis in the United States was 7.3 per 100,000 population, and no specific etiology was identified in 59.5% of cases. During the study period, a case-fatality rate of 7.4 per 100 cases was recorded. For those persons admitted with encephalitis for which an etiology was identified, most specified a viral etiology.

Also in the United States, the California Encephalitis Study, a large prospective study, found that 63% of hospitalized patients with encephalitis from 1998 through 2005 had encephalitis of unknown etiology, despite extensive laboratory testing. In another US study of persons whose deaths were associated with encephalitis, 81.5%–86.2% of the deaths resulted from encephalitis with an unknown etiology.

http://www.cdc.gov/eid/content/15/9/pdfs/08-1540.pdf
 
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