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Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

2010; Public Library of Science; Volume: 4; Issue: 10 Linguagem: Inglês

10.1371/journal.pntd.0000854

1935-2735

Le Van Tan, Phan Tu Qui, Do Quang Ha, Nguyen Bach Hue, Lam Quoi Bao, Bach Van Cam, Truong Huu Khanh, Tran Tinh Hien, Nguyễn Văn Vĩnh Châu, Tran Tan Tram, Vo Minh Hien, Tran Vu Thieu Nga, Constance Schultsz, Jeremy Farrar, H. Rogier van Doorn, Menno D. de Jong,

Mosquito-borne diseases and control

Background Acute encephalitis is an important and severe disease in children in Vietnam. However, little is known about the etiology while such knowledge is essential for optimal prevention and treatment. To identify viral causes of encephalitis, in 2004 we conducted a one-year descriptive study at Children's Hospital Number One, a referral hospital for children in southern Vietnam including Ho Chi Minh City. Methodology/Principal Findings Children less than 16 years of age presenting with acute encephalitis of presumed viral etiology were enrolled. Diagnostic efforts included viral culture, serology and real time (RT)-PCRs. A confirmed or probable viral causative agent was established in 41% of 194 enrolled patients. The most commonly diagnosed causative agent was Japanese encephalitis virus (n = 50, 26%), followed by enteroviruses (n = 18, 9.3%), dengue virus (n = 9, 4.6%), herpes simplex virus (n = 1), cytomegalovirus (n = 1) and influenza A virus (n = 1). Fifty-seven (29%) children died acutely. Fatal outcome was independently associated with patient age and Glasgow Coma Scale (GCS) on admission. Conclusions/Significance Acute encephalitis in children in southern Vietnam is associated with high mortality. Although the etiology remains unknown in a majority of the patients, the result from the present study may be useful for future design of treatment and prevention strategies of the disease. The recognition of GCS and age as predictive factors may be helpful for clinicians in managing the patient.