Association of leptospirosis and scrub typhus in acute encephalitis syndrome in a tertiary care hospital in Odisha, India

Trans R Soc Trop Med Hyg. 2021 Sep 3;115(9):1088-1090. doi: 10.1093/trstmh/trab063.

Abstract

Background: Acute encephalitis syndrome (AES) is a major public health concern in India, causing febrile illness principally associated with viral infection. Bacteria-like scrub typhus and leptospirosis also cause acute febrile illness. Therefore, this study was conceived to address the possible etiological agents contributing to sporadic AES in a tertiary care center in Odisha, India.

Method: This was a prospective hospital-based study that enrolled 92 consecutive patients with clinically diagnosed AES whose blood/cerebrospinal fluid samples were tested for IgM antibodies to dengue, Japanese encephalitis (JE), herpes simplex virus (HSV), Epstein-Barr virus (EBV), leptospirosis and scrub typhus.

Results: Viral antibodies to dengue were detected in three (3.26%) cases, HSV1 in four (4.34%) and HSV2 in three (3.26%) cases. Significantly, antibodies to EBV in 22 (23.591%) and to JE in 27 (29.34%) cases were detected. Notably, 30 (32.60%) and 11(12.0%) of patients had IgM antibodies to leptospirosis and scrub typhus, respectively.

Conclusion: This observation indicates an association of leptospirosis and scrub typhus infection in sporadic cases of AES, besides other viruses.

Keywords: Odisha; acute encephalitis syndrome; leptospirosis; scrub typhus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Febrile Encephalopathy* / epidemiology
  • Acute Febrile Encephalopathy* / etiology
  • Epstein-Barr Virus Infections*
  • Herpesvirus 4, Human
  • Humans
  • India / epidemiology
  • Leptospirosis* / complications
  • Leptospirosis* / diagnosis
  • Leptospirosis* / epidemiology
  • Orientia tsutsugamushi*
  • Prospective Studies
  • Scrub Typhus* / complications
  • Scrub Typhus* / diagnosis
  • Scrub Typhus* / epidemiology
  • Tertiary Care Centers