ENCEPHALITIS Edited by Sergey Tkachev Encephalitis http://dx.doi.org/10.5772/46041 Edited by Sergey Tkachev Contributors Zakareya Gamie, Almas Khawar Ahmed, Mohammed M Hassoon, Karunamoorthi Annamalai Kaliyaperumal, Resat Ozaras, Ilker Balkan, Shailendra K Saxena, Hiroshi Shoji, Natalia Plekhova, Larisa Somova, Galina Leonova, Yurii Kaminsky, Anna Fisenko, Yongxin Yu, Durga Datt Joshi, Justin Jang Hann Chu, Wei-June Chen, Guey-Chuen Perng, Sergey Tkachev, SEREFNUR Oztürk, Hakan Ekmekci, Fahrettin Ege, Chieko Kai, Tomoyuki Honda, Misako Yoneda, Hiroki Sato, Halyna Biletska, Ihor Lozynski Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2013 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. 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Publishing Process Manager Ana Pantar Technical Editor InTech DTP team Cover InTech Design team First published January, 2013 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Encephalitis, Edited by Sergey Tkachev p. cm. ISBN 978-953-51-0925-9 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface VII Section 1 Encephalitis Clinical Diagnostics and Treatment 1 Chapter 1 The Clinical Management of the Patient with Encephalitis 3 Almas Khawar Ahmed, Zakareya Gamie and Mohammed M. Hassoon Chapter 2 Cerebrospinal Fluid Abnormalities in Viral Encephalitis 21 Hakan Ekmekci, Fahrettin Ege and Serefnur Ozturk Chapter 3 Spontaneous Intracranial Hypotension: What An Infectious Disease Physician Should Know? 33 Ilker Inanc Balkan and Resat Ozaras Chapter 4 Acute Viral Encephalitis/Encephalopathy in an Emergency Hospital in Japan: A Retrospective Study of 105 Cases in 2002 – 2011 43 Hiroshi Shoji, Masaki Tachibana, Tomonaga Matsushita, Yoshihisa Fukushima and Shimpei Sakanishi Chapter 5 Review on Japanese Encephalitis Outbreak Cases in Nepal During the Year 2011 55 Durga Datt Joshi and Jeevan Smriti Marg Section 2 Encephalitis Causative Agents 71 Chapter 6 Arboviral Encephalitis 73 Guey-Chuen Perng and Wei-June Chen Chapter 7 Genetic and Biological Properties of Original TBEV Strains Group Circulating in Eastern Siberia 95 I.V. Kozlova, M.M. Verkhozina, T.V. Demina, Yu.P. Dzhioev, S.E. Tkachev, L.S. Karan, E.K. Doroshchenko, O.V. Lisak, O.V. Suntsova, A.I. Paramonov, O.O. Fedulina, A.O. Revizor and V.I. Zlobin Chapter 8 The Pathomorphology of Far Eastern Tick-Borne Encephalitis 113 Larisa M. Somova, Galina N. Leonova, Natalia G. Plekhova, Yurii V. Kaminsky and Anna Y. Fisenko Chapter 9 Active Natural Foci of Tick-Borne Neuroinfection in the North- West Region of Ukraine 145 I. Lozynski, H. Biletska, O. Semenyshyn, V. Fedoruk, O. Drul, I. Ben, A. Shulgan and R. Morochkovski Chapter 10 Japanese Encephalitis Virus: The Complex Biology of an Emerging Pathogen 161 Shailendra K. Saxena, Sneham Tiwari, Rakhi Saxena, Asha Mathur and Madhavan P. N. Nair Chapter 11 Development of Japanese Encephalitis Attenuated Live Vaccine Virus SA14-14-2 and its Charcteristics 181 Yongxin Yu Chapter 12 Yellow Fever Encephalitis: An Emerging and Resurging Global Public Health Threat in a Changing Environment 207 Kaliyaperumal Karunamoorthi Chapter 13 The Fatal Case of Lyssavirus Encephalitis in the Russian Far East 231 Galina N. Leonova, Larisa M. Somova, Sergei I. Belikov, Il’ya G. Kondratov, Natalya G. Plekhova, Natalya V. Krylova, Elena V. Pavlenko, Mikhail P. Tiunov and Sergey E. Tkachev Chapter 14 Pathogenesis of Encephalitis Caused by Persistent Measles Virus Infection 251 Tomoyuki Honda, Misako Yoneda, Hiroki Sato and Chieko Kai Chapter 15 Viral Encephalitis with Focus on Human Enteroviruses 263 Po-Ying Chia and Justin Jang Hann Chu ContentsVI Preface Encephalitises are a group of inflammatory human and animal diseases of brain caused essentially by different pathogens. In spite of evident success in approaches for prevention, diagnostics and treatment during the last decades, the encephalitises of different etiology still constitute a menace for thousands of people all around the world. Recently, three-volume book was published by InTech, including the first “Flavivirus Encephalitis” (edited by Daniel Růžek), the second “Non-Flavivirus Encephalitis” (edited by Sergey Tkachev) and the third “Pathogenesis of Encephalitis” (edited by Daisuke Hayasaka) parts, which can be found on InTech site (http://www.intechopen.com). But a lot of different aspects and information were not included in these volumes so we decided to publish the additional book. The first part of this book is devoted to encephalitis clinical diagnostics and treatment. Proper diagnosis definition is an important step in encephalitis treatment so the 1st chapter considers the questions of clinical management of the patient and includes step-by-step instructions for encephalitis diagnostics. In some cases the abnormalities in encephalitis clinical course or symptoms similar to encephalitis can be observed so the physicians should pay special attention to such patients. The 2nd and 3rd chapter describe the cerebrospinal fluid abnormalities that could be seen in some cases during the viral encephalitis and the cases of spontaneous intracranial hypotension that could be erroneously taken for encephalitis. One of the important questions of any pathogen study is the epidemiology and monitoring and prediction of the epidemiological situation. Chapters 4 and 5 give the example of such monitoring of the encephalitis cases caused by viral pathogens in Japan and Nepal. The members of different virus species are known to be the causative agents of encephalitis, so the second part of the book is devoted to viral pathogens, their epidemiology, pathology and diagnostics. Probably, the arboviruses (and especially members of the genus Flavivirus) are known to be one of the most known and frequent causative agents of encephalitis, so the following chapters are about arboviruses-induced encephalitises. The short review on causative agents of arboviral encephalitis is presented in Chapter 6. Chapters 7-12 are devoted to flaviviruses, their epidemiology, pathology and vaccine design. The attention should be paid to chapter seven which presents new tick-borne encephalitis virus group that was demonstrated to cause focal forms of tick-borne encephalitis with lethal outcome and has high pathogenic potential. Other virus species are also known to be the causative agents of encephalitis, so the last chapters are devoted to non-arbovirus pathogens. Chapter 13 describes the fatal case of Lissavirus encephalitis on the Russian Far-East. The detailed characteristics of the genetic, biological and pathological properties of isolated virus strain were determined. Chapter 14 is devoted to issues of pathogenesis of encephalitis caused by measles virus. The last chapter of the book focuses on encephalitis caused by enteroviruses which (especially Enterovirus71 (EV71)) have been documented to cause epidemics. The authors and editors of the book hope that this work might increase the interest in this field of research and that the readers will find it useful for their investigations and clinical usage. Also I would like to thank my family, parents and colleagues who gave me a lot of support during the work on this book. Sergey Tkachev Laboratory of Molecular Microbiology, Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia PrefaceVIII Section 1 Encephalitis Clinical Diagnostics and Treatment [...]... Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St Louis encephalitis virus, Europe West Nile virus, Tick-born encephalitis virus, India, Nepal Rabies virus, Japanese encephalitis virus, Middle East West Nile virus Russia Tick-born encephalitis virus, South America Rabies virus, Eastern equine encephalitis virus, Western equine encephalitis. .. panencephalitis (SSPE)) Parkinsonism Japanese encephalitis virus, St Louis encephalitis virus, West Nile virus, Nipah virus, Poliomyelitis-like flaccid paralysis Japanese encephalitis virus, West Nile virus, Tick-born encephalitis virus, Enterovirus (enterovirus-71, coxsackieviruses), Poliovirus Rhombencephalitis HSV, West Nile virus, Enterovirus 71 Table 2 Possible etiological agents of viral Encephalitis. .. or even malignancy The Clinical Management of the Patient with Encephalitis http://dx.doi.org/10.5772/55171 Pathogen Incubation HSV 2-1 2 days1 West Nile virus 1-6 days2 JE 5-1 5 days3 EBV 3 0-5 0 days4 Mycoplasma 7-2 1 days5 Bartonella henselae 7-1 4 days6 syphilis 9-6 0 days1 1 INCUBATION PERIOD OF DISEASE Epidemiology Review (1983) 5(1): 1-1 5 Oxford Journals 2 Vector Competence of California Mosquitoes... http://dx.doi.org/10.5772/54590 Epidemiology or risk factors Possible infectious agent(s) for encephalitis Mosquitoes Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus, St Louis encephalitis virus, Murray Valley encephalitis virus, Japanese encephalitis virus, West Nile virus Ticks Tick-born encephalitis virus, Powassan virus, Occupation Exposure to animals Rabies... encephalitis virus, Western equine encephalitis virus, St Louis encephalitis virus, Southeast Asia, China, Pasific Rim Japanese encephalitis virus, Tick-born encephalitis virus, Nipah virus Unvaccinated status VZV, Japanese encephalitis virus, Poliovirus, Measles virus, Mumps virus, Rubella virus Table 1 Possible Etiology of Viral Encephalitis [1] 23 24 Encephalitis Clinical findings (physical and specific neurological... November 1996 - Vol‐ ume 15 - Issue 11 - pp 101 8-1 024 [9] Viral Encephalitis Richard J Whitley, M.D : New England Journel OF Medicine 1990; 323: pages 24 2-2 50 : July 26, 1990 [10] Enteroviral Infections in Primary Immunodeficiency (PID): A Survey of Morbidity and Mortality : E Halliday, J Winkelstein, A.D.B Webster: science direct: Journal of Infection, Volume 46, Issue 1, Page 1 [11] Herpes Simplex Encephalitis. .. performed by RT-PCR and cell culture in suspected cases HSV-1 PCR, quantitative PCR, routine serology HSV-2 PCR, routine serology, culture EBV PCR, routine serology CMV PCR HHV-6, HHV-7 PCR, routine serology, culture VZV PCR, routine serology, VZV Ge Table 4 Diagnostic methods in herpesviridae family BACTERIAL FUNGAL MENENGITIS LOW CSF GLUCOSE TBC MENENGIT IS LCMV MUMPS HERPES/VZV (rare) ENCEPHALITIS. .. (Figure 2) IFN-γ, TNF-α, IL-2, IL-6, CD8 CNS INFECTIONS NfH-SM135, GFAP-SM126 S100B Macrophage migration inhibitory factor (MIF) Figure 2 Several biomarkers elevating in CSF during the course of central nervous system infections FLAVIVIRUS INFECTIONS Elevated protein, high cell count (initially neutrophilic; mononuclear pleocytosis after a certain time), normal glucose concentrations RT-PCR, IgM ELISA... puncture as defined by computed cranial tomography : D J Gower, A L Baker, W O Bell, M R Ball : Journal Of Neurology and Neurosurgery and Psychiatry 1987; Pages 50:107 1-1 074 doi:10.1136/jnnp.50.8.1071 [57] Routine diagnosis of herpes simplex virus (HSV) encephalitis by an internal DNA controlled HSV PCR and an IgG-capture assay for intrathecal synthesis of HSV anti‐ bodies Fomsgaard A, Kirkby N, Jensen IP,... Infant and children Eastern equine encephalitis virus, Japanese encephalitis virus, Murray Valley encephalitis virus, Influenza virus, La crosse virus Elderly persons Eastern equine encephalitis virus, St Louis encephalitis virus, West Nile virus, sporadic Creutzfeldt –Jacob disease (sCJD) Animal contacts Bats Rabies virus, Nipah virus Birds West Nile virus, Eastern equine encephalitis virus, Cats Japanese . first “Flavivirus Encephalitis (edited by Daniel Růžek), the second “Non-Flavivirus Encephalitis (edited by Sergey Tkachev) and the third “Pathogenesis of Encephalitis (edited by Daisuke Hayasaka) parts,. orders@intechopen.com Encephalitis, Edited by Sergey Tkachev p. cm. ISBN 97 8-9 5 3-5 1-0 92 5-9 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface VII Section 1 Encephalitis. ENCEPHALITIS Edited by Sergey Tkachev Encephalitis http://dx.doi.org/10.5772/46041 Edited by Sergey Tkachev Contributors Zakareya Gamie, Almas Khawar