Skip to main content Accessibility help
×
Home

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study

  • K. EASTWOOD (a1) (a2), B. J. PATERSON (a1) (a2) (a3), C. LEVI (a2) (a3) (a4), R. GIVNEY (a3) (a5), M. LOEWENTHAL (a3) (a4), T. DE MALMANCHE (a3) (a5), K. LAI (a3) (a4), J. GRANEROD (a6) and D. N. DURRHEIM (a1) (a2) (a3)...

Summary

Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: Dr K. Eastwood, Hunter New England Population Health, Locked Bag 10, Wallsend, New South Wales 2287, Australia. (Email: Keith.Eastwood@hnehealth.nsw.gov.au)

References

Hide All
1. Granerod, J, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infectious Diseases 2010; 10: 835844.
2. Huppatz, C, et al. Etiology of encephalitis in Australia, 1990–2007. Emerging Infectious Diseases 2009; 15: 13591365.
3. Khetsuriani, N, Holman, RC, Anderson, LJ. Burden of encephalitis-associated hospitalizations in the United States, 1988–1997. Clinical Infectious Diseases 2002; 35: 175182.
4. Chaudhuri, A, Kennedy, PG. Diagnosis and treatment of viral encephalitis. Postgraduate Medical Journal 2002; 78: 575583.
5. Huppatz, C, et al. Should there be a standardised approach to the diagnostic workup of suspected adult encephalitis? A case series from Australia. BMC Infectious Diseases 2010; 10: 353.
6. Granerod, J, et al. Challenge of the unknown. A systematic review of acute encephalitis in non-outbreak situations. Neurology 2010; 75: 924932.
7. Tack, DM, et al. Trends in encephalitis-associated deaths in the United States, 1999–2008. Neuroepidemiology 2014; 43: 18.
8. Paterson, BJ, et al. A review of the epidemiology and surveillance of viral zoonotic encephalitis and the impact on human health in Australia. NSW Public Health Bulletin 2011; 22: 99104.
9. Buehler, JW, et al. Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group. Morbidity and Mortality Weekly Report. Recommendations and Reports 2004; 53: 111.
10. German, RR, et al. Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. Morbidity and Mortality Weekly Report. Recommendations and Reports 2001; 50: 135.
11. Bernard, S, Mailles, A, Stahl, JP. Epidemiology of infectious encephalitis, differences between a prospective study and hospital discharge data. Epidemiology & Infection 2013; 141: 22562268.
12. Venkatesan, A, et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the International Encephalitis Consortium. Clinical Infectious Diseases 2013; 57: 11141128.
13. Skull, SA, et al. A retrospective search for lyssavirus in humans in the Northern Territory. Australian and New Zealand Journal of Public Health 1999; 23: 305308.
14. Granerod, J, et al. Causality in acute encephalitis: defining aetiologies. Epidemiology & Infection 2010; 138: 783800.
15. Singh, T, Fugate, J, Rabinstein, A. The spectrum of acute encephalitis: causes, management, and predictors of outcomes. Neurology 2015; 84: 359366.

Keywords

Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study

  • K. EASTWOOD (a1) (a2), B. J. PATERSON (a1) (a2) (a3), C. LEVI (a2) (a3) (a4), R. GIVNEY (a3) (a5), M. LOEWENTHAL (a3) (a4), T. DE MALMANCHE (a3) (a5), K. LAI (a3) (a4), J. GRANEROD (a6) and D. N. DURRHEIM (a1) (a2) (a3)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed