Seilesh Kadambari1, Ifeanyichukwu Okike1, Sonia Ribeiro2, Mary E Ramsay2, Paul T Heath1, Mike Sharland1, Shamez N Ladhani3. 1. Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK. 2. Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. 3. Paediatric Infectious Diseases Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, UK; Immunisation Department, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK. Electronic address: shamez.ladhani@phe.gov.uk.
Abstract
OBJECTIVES: In highly immunised populations viruses contribute to a substantially higher proportion of meningo-encephalitis cases. This national study aimed to describe population trends in laboratory-confirmed, viral meningo-encephalitis reports in England and Wales over a ten-year period. METHODS: Laboratory-confirmed, viral meningo-encephalitis cases submitted by National Health Service hospitals in England and Wales during 2004-13 were analysed. RESULTS: There were 9941 laboratory-confirmed reports of viral meningo-encephalitis in England and Wales over the 10-year period. Number of reports increased across all age-groups and for all viruses from 311 (incidence, 0.6/100,000) in 2004 to 2168 in 2013 (incidence, 3.9/100,000). Median age at diagnosis was 30.6 (IQR, 1.3-51.5) years, with a third of cases diagnosed in children. In 2013, infants aged <3 months accounted for 27% (588/2168) of cases, but had the highest incidence (329/100,000). Enteroviruses were responsible for 52% (5133/9941) of all cases and 92% (1952/2121) in <3 month-olds (incidence, 313/100,000 in 2013, equivalent to 77/100,000 live-births) followed by herpes simplex (2885/9941; 29%) and varicella zoster (1342/9941; 13%), mainly among ≥45 year-olds. CONCLUSION: Increasing use of molecular testing has led to a 7-fold increase in laboratory-confirmed, viral meningo-encephalitis reports. Large clinical-observational studies are necessary to determine the burden of viral meningo-encephalitis, especially in infants.
OBJECTIVES: In highly immunised populations viruses contribute to a substantially higher proportion of meningo-encephalitis cases. This national study aimed to describe population trends in laboratory-confirmed, viral meningo-encephalitis reports in England and Wales over a ten-year period. METHODS: Laboratory-confirmed, viral meningo-encephalitis cases submitted by National Health Service hospitals in England and Wales during 2004-13 were analysed. RESULTS: There were 9941 laboratory-confirmed reports of viral meningo-encephalitis in England and Wales over the 10-year period. Number of reports increased across all age-groups and for all viruses from 311 (incidence, 0.6/100,000) in 2004 to 2168 in 2013 (incidence, 3.9/100,000). Median age at diagnosis was 30.6 (IQR, 1.3-51.5) years, with a third of cases diagnosed in children. In 2013, infants aged <3 months accounted for 27% (588/2168) of cases, but had the highest incidence (329/100,000). Enteroviruses were responsible for 52% (5133/9941) of all cases and 92% (1952/2121) in <3 month-olds (incidence, 313/100,000 in 2013, equivalent to 77/100,000 live-births) followed by herpes simplex (2885/9941; 29%) and varicella zoster (1342/9941; 13%), mainly among ≥45 year-olds. CONCLUSION: Increasing use of molecular testing has led to a 7-fold increase in laboratory-confirmed, viral meningo-encephalitis reports. Large clinical-observational studies are necessary to determine the burden of viral meningo-encephalitis, especially in infants.
Authors: Nguyen Thi Thuy Chinh B'Krong; Ngo Ngoc Quang Minh; Phan Tu Qui; Tran Thi Hong Chau; Ho Dang Trung Nghia; Lien Anh Ha Do; Nguyen Ngoc Nhung; Nguyen Van Vinh Chau; Guy Thwaites; Le Van Tan; H Rogier van Doorn; Tran Tan Thanh Journal: Virol J Date: 2018-04-12 Impact factor: 4.099
Authors: Fiona McGill; Michael J Griffiths; Laura J Bonnett; Anna Maria Geretti; Benedict D Michael; Nicholas J Beeching; David McKee; Paula Scarlett; Ian J Hart; Kenneth J Mutton; Agam Jung; Guleed Adan; Alison Gummery; Wan Aliaa Wan Sulaiman; Katherine Ennis; Antony P Martin; Alan Haycox; Alastair Miller; Tom Solomon Journal: Lancet Infect Dis Date: 2018-06-29 Impact factor: 25.071