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Volume 21, Number 9—September 2015
THEME ISSUE
Emerging Infections Program
CME ACTIVITY - Research

Encephalitis Surveillance through the Emerging Infections Program, 1997–2010

Karen C. BlochComments to Author  and Carol A. Glaser
Author affiliations: Vanderbilt University, Nashville, Tennessee, USA (K.C. Bloch); Kaiser Permanente, Oakland, California, USA (C.A. Glaser)

Main Article

Table 1

Case definition for encephalitis in the Emerging Infections Program Encephalitis Project, 1997–2010*

Criteria
Major criterion (required): Altered mental status lasting ≥24 h
Plus >1 of 6 minor criteria:
1. Fever ≥38°C occurring ≤72 h before or after hospital admission
2. Seizures
3. Focal neurologic deficits not previously present on examination
4. Cerebrospinal fluid pleocytosis (≥5 leukocytes/mm3)
5. Abnormal electroencephalogram
6. Abnormal neuroimaging (computed tomography or magnetic resonance imaging) representing an acute process

*International Encephalitis Consortium case definition requires the presence of the major criteria plus ≥3 minor criteria for confirmed/probable; ≥2 for probable encephalitis (4).

Main Article

References
  1. Vora  NM, Holman  RC, Mehal  JM, Steiner  CA, Blanton  J, Sejvar  J. Burden of encephalitis-associated hospitalizations in the United States, 1998–2010. Neurology. 2014;82:44351 . DOIPubMedGoogle Scholar
  2. Khetsuriani  N, Holman  RC, Anderson  LJ. Burden of encephalitis-associated hospitalizations in the United States, 1988–1997. Clin Infect Dis. 2002;35:17582 . DOIPubMedGoogle Scholar
  3. Lakeman  FD, Whitley  RJ. Diagnosis of herpes simplex encephalitis: application of polymerase chain reaction to cerebrospinal fluid from brain-biopsied patients and correlation with disease. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. J Infect Dis. 1995;171:85763 . DOIPubMedGoogle Scholar
  4. Venkatesan  A, Tunkel  AR, Bloch  KC, Lauring  AS, Sejvar  J, Bitnun  A, ; International Encephalitis Consortium. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the International Encephalitis Consortium. Clin Infect Dis. 2013;57:111428. DOIPubMedGoogle Scholar
  5. DuBray  K, Anglemyer  A, LaBeaud  AD, Flori  H, Bloch  K, Joaquin  KS, Epidemiology, outcomes and predictors of recovery in childhood encephalitis: a hospital-based study. Pediatr Infect Dis J. 2013;32:83944 .PubMedGoogle Scholar
  6. Campbell  WP, Huang  C. Sequence comparisons of medium RNA segment among 15 California serogroup viruses. Virus Res. 1999;61:13744. DOIPubMedGoogle Scholar
  7. Huang  C, Campbell  W, Grady  L, Kirouac  I, LaForce  FM. Diagnosis of Jamestown Canyon encephalitis by polymerase chain reaction. Clin Infect Dis. 1999;28:12947. DOIPubMedGoogle Scholar
  8. Huang  C, Morse  D, Slater  B, Anand  M, Tobin  E, Smith  P, Multiple-year experience in the diagnosis of viral central nervous system infections with a panel of polymerase chain reaction assays for detection of 11 viruses. Clin Infect Dis. 2004;39:6305. DOIPubMedGoogle Scholar
  9. Bloch  KC, Glaser  C. Diagnostic approaches for patients with suspected encephalitis. Curr Infect Dis Rep. 2007;9:31522. DOIPubMedGoogle Scholar
  10. Hicar  MD, Edwards  K, Bloch  K. Powassan virus infection presenting as acute disseminated encephalomyelitis in Tennessee. Pediatr Infect Dis J. 2011;30:868. DOIPubMedGoogle Scholar
  11. Tunkel  AR, Glaser  CA, Bloch  KC, Sejvar  JJ, Marra  CM, Roos  KL, ; Infectious Diseases Society of America. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2008;47:30327. DOIPubMedGoogle Scholar
  12. Glaser  CA, Gilliam  S, Schnurr  D, Forghani  B, Honarmand  S, Khetsuriani  N, ; California Encephalitis Project. In search of encephalitis etiologies: diagnostic challenges in the California Encephalitis Project, 1998–2000. Clin Infect Dis. 2003;36:73142. DOIPubMedGoogle Scholar
  13. Christie  LJ, Honarmand  S, Talkington  DF, Gavali  SS, Preas  C, Pan  CY, Pediatric encephalitis: what is the role of Mycoplasma pneumoniae? Pediatrics. 2007;120:30513. DOIPubMedGoogle Scholar
  14. Glaser  CA, Honarmand  S, Anderson  LJ, Schnurr  DP, Forghani  B, Cossen  CK, Beyond viruses: clinical profiles and etiologies associated with encephalitis. Clin Infect Dis. 2006;43:156577. DOIPubMedGoogle Scholar
  15. Glaser  CA, Gilliam  S, Honarmand  S, Tureen  JH, Lowenstein  DH, Anderson  LJ, Refractory status epilepticus in suspect encephalitis. Neurocrit Care. 2008;9:7482. DOIPubMedGoogle Scholar
  16. Singh  RK, Joshi  SM, Potter  DM, Leber  SM, Carlson  MD, Shellhaas  RA. Cognitive outcomes in febrile infection-related epilepsy syndrome treated with the ketogenic diet. Pediatrics. 2014;134:e14315. DOIPubMedGoogle Scholar
  17. Weinberg  A, Bloch  KC, Li  S, Tang  YW, Palmer  M, Tyler  KL. Dual infections of the central nervous system with Epstein-Barr virus. J Infect Dis. 2005;191:2347. DOIPubMedGoogle Scholar
  18. Yao  K, Honarmand  S, Espinosa  A, Akhyani  N, Glaser  C, Jacobson  S. Detection of human herpesvirus-6 in cerebrospinal fluid of patients with encephalitis. Ann Neurol. 2009;65:25767. DOIPubMedGoogle Scholar
  19. Gable  MS, Sheriff  H, Dalmau  J, Tilley  DH, Glaser  CA. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis. 2012;54:899904. DOIPubMedGoogle Scholar
  20. To  TM, Soldatos  A, Sheriff  H, Schmid  DS, Espinosa  N, Cosentino  G, Insights into pediatric herpes simplex encephalitis from a cohort of 21 children from the California Encephalitis Project, 1998–2011. Pediatr Infect Dis J. 2014;33:12878. DOIPubMedGoogle Scholar
  21. Fowlkes  AL, Honarmand  S, Glaser  C, Yagi  S, Schnurr  D, Oberste  MS, Enterovirus-associated encephalitis in the California encephalitis project, 1998–2005. J Infect Dis. 2008;198:168591. DOIPubMedGoogle Scholar
  22. Christie  LJ, Loeffler  AM, Honarmand  S, Flood  JM, Baxter  R, Jacobson  S, Diagnostic challenges of central nervous system tuberculosis. Emerg Infect Dis. 2008;14:14735. DOIPubMedGoogle Scholar
  23. Schuster  FL, Yagi  S, Gavali  S, Michelson  D, Raghavan  R, Blomquist  I, Under the radar: Balamuthia amebic encephalitis. Clin Infect Dis. 2009;48:87987. DOIPubMedGoogle Scholar
  24. Lynch  M, Lee  B, Azimi  P, Gentsch  J, Glaser  C, Gilliam  S, Rotavirus and central nervous system symptoms: cause or contaminant? Case reports and review. Clin Infect Dis. 2001;33:9328. DOIPubMedGoogle Scholar
  25. Arnold  JC, Singh  KK, Milder  E, Spector  SA, Sawyer  MH, Gavali  S, Human metapneumovirus associated with central nervous system infection in children. Pediatr Infect Dis J. 2009;28:105760. DOIPubMedGoogle Scholar
  26. Dalmau  J, Tüzün  E, Wu  HY, Masjuan  J, Rossi  JE, Voloschin  A, Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 2007;61:2536. DOIPubMedGoogle Scholar
  27. Gable  MS, Gavali  S, Radner  A, Tilley  DH, Lee  B, Dyner  L, Anti-NMDA receptor encephalitis: report of ten cases and comparison with viral encephalitis. Eur J Clin Microbiol Infect Dis. 2009;28:14219. DOIPubMedGoogle Scholar
  28. Armangue  T, Leypoldt  F, Málaga  I, Raspall-Chaure  M, Marti  I, Nichter  C, Herpes simplex virus encephalitis is a trigger of brain autoimmunity. Ann Neurol. 2014;75:31723 . DOIPubMedGoogle Scholar
  29. Pahud  BA, Glaser  CA, Dekker  CL, Arvin  AM, Schmid  DS. Varicella zoster disease of the central nervous system: epidemiological, clinical, and laboratory features 10 years after the introduction of the varicella vaccine. J Infect Dis. 2011;203:31623. DOIPubMedGoogle Scholar
  30. Melekhin  VV, Karem  KL, Damon  IK, Bloch  KC. Encephalitis after secondary smallpox vaccination. Clin Infect Dis. 2009;48:e12. DOIPubMedGoogle Scholar
  31. Pahud  BA, Rowhani-Rahbar  A, Glaser  C, Gavali  S, Salibay  CJ, Fireman  B, Lack of association between childhood immunizations and encephalitis in California, 1998–2008. Vaccine. 2012;30:24753. DOIPubMedGoogle Scholar
  32. Honarmand  S, Glaser  CA, Chow  E, Sejvar  JJ, Preas  CP, Cosentino  GC, Subacute sclerosing panencephalitis in the differential diagnosis of encephalitis. Neurology. 2004;63:148993. DOIPubMedGoogle Scholar
  33. Rellosa  N, Bloch  KC, Shane  AL, Debiasi  RL. Neurologic manifestations of pediatric novel H1N1 influenza infection. Pediatr Infect Dis J. 2011;30:1657. DOIPubMedGoogle Scholar
  34. Centers for Disease Control and Prevention. ArboNET. West Nile virus disease cases and deaths reported to CDC by year and clinical presentation, 1999–2013 [cited 2015 Feb 10]. http://www.cdc.gov/westnile/resources/pdfs/cummulative/99_2013_CasesAndDeathsClinicalPresentationHumanCases.pdf
  35. Briese  T, Jia  XY, Huang  C, Grady  LJ, Lipkin  WI. Identification of a Kunjin/West Nile-like flavivirus in brains of patients with New York encephalitis. Lancet. 1999;354:12612. DOIPubMedGoogle Scholar
  36. Francisco  AM, Glaser  C, Frykman  E, Cole  B, Cheung  M, Meyers  H, 2004 California pediatric West Nile virus case series. Pediatr Infect Dis J. 2006;25:814. DOIPubMedGoogle Scholar
  37. Jean  CM, Honarmand  S, Louie  JK, Glaser  CA. Risk factors for West Nile virus neuroinvasive disease, California, 2005. Emerg Infect Dis. 2007;13:191820. DOIPubMedGoogle Scholar
  38. Ayscue  P, Van Haren  K, Sheriff  H, Waubant  E, Waldron  P, Yagi  S, ; Centers for Disease Control and Prevention. Acute flaccid paralysis with anterior myelitis—California, June 2012–June 2014. MMWR Morb Mortal Wkly Rep. 2014;63:9036 .PubMedGoogle Scholar
  39. Centers for Disease Control and Prevention. Notes from the field: acute flaccid myelitis among persons aged ≤21 years—United States, August–November 2014. MMWR Morb Mortal Wkly Rep. 2015;63:12434 .PubMedGoogle Scholar
  40. Messacar  K, Schreiner  TL, Maloney  JA, Wallace  A, Ludke  J, Oberste  MS, A cluster of acute flaccid paralysis and cranial nerve dysfunction temporally associated with an outbreak of enterovirus D68 in children in Colorado, USA. Lancet. 2015;385:166271. DOIPubMedGoogle Scholar

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Page created: August 14, 2015
Page updated: August 14, 2015
Page reviewed: August 14, 2015
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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