A Nationwide Survey of Pediatric-onset Japanese Encephalitis in Japan
| Autor: | Tetsuya Sato, Shouichi Ohga, Etsuro Nanishi, Katsuki Hirai, Kenji Okada, Masaaki Yanai, Yasunari Sakai, Masafumi Sanefuji, Hiroyuki Torisu, Katsuhiko Kitazawa, Kaori Nikaido, Akihiko Maeda, Takayuki Hoshina, Ryo Kadoya, Yukie Arahata, Yoshimichi Hirayama |
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| Rok vydání: | 2018 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) Pediatrics medicine.medical_specialty 030106 microbiology Neuroimaging Nationwide survey 03 medical and health sciences 0302 clinical medicine Japan medicine Humans Public Health Surveillance 030212 general & internal medicine Geography Medical Child Encephalitis Japanese Retrospective Studies Coma business.industry Incidence Viral encephalitis Incidence (epidemiology) Vaccination Infant Japanese encephalitis medicine.disease Hospitalization Infectious Diseases Vaccination policy Child Preschool Encephalitis Viruses Japanese Acute disseminated encephalomyelitis Female medicine.symptom business |
| Zdroj: | Clinical Infectious Diseases. 68:2099-2104 |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciy816 |
| Popis: | Background Japanese encephalitis (JE) is the leading cause of viral encephalitis with high mortality and morbidity in Asia. In Japan, however, the active recommendation of JE vaccine was retracted in 2005 because of the potential risk of acute disseminated encephalomyelitis. We aimed to determine the recent incidence of childhood-onset JE after the domestic change of vaccination policy in Japan, and to analyze the clinical features of affected children. Methods A retrospective nationwide survey was conducted for pediatric patients with JE in Japan from 1995 to 2015. The national surveillance system was used to identify the pediatric patients with JE. Follow-up questionnaires were sent to analyze their clinical and neuroimaging profiles. Results Among a total of 109 patients registered to the national surveillance, 10 (9%) were less than age 15 years. The annual incidence rate of childhood-onset JE was higher during 2005-15 than that during 1995-2004 (4.3 × 10-3 vs 1.1 × 10-3 per 100000, respectively; P = .04). Endemic regions overlapped with prefectures that farmed pigs harboring antibodies against JE virus with high prevalence. Detailed clinical data were collected from 9 patients. None of them died, but 5 of 9 patients (56%) had neurological sequelae after recovery. One patient who was partially vaccinated with 2 doses of JE vaccine fully recovered from a coma. The age of 3 years or less was associated with unfavorable neurological prognosis. Conclusions Our data provide evidence for the importance and prophylactic effect of the JE vaccine in young children in the endemic area. |
| Databáze: | OpenAIRE |
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