Open AccessJapanese encephalitis virus infection in non-encephalitic acute febrile illness patients
Author(s) -
Chairin Nisa Ma’roef,
Rama Dhenni,
Dewi Megawati,
Araniy Fadhilah,
Anton Lucanus,
I Made Artika,
Sri Masyeni,
Asri Lestarini,
Kartika Sari,
Ketut Suryana,
Frilasita A. Yudhaputri,
Ungke Anton Jaya,
R. Tedjo Sasmono,
Jeremy P. Ledermann,
Ann M. Powers,
Khin Saw Aye Myint
Publication year - 2020
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0008454
Subject(s) - japanese encephalitis , medicine , dengue fever , plaque reduction neutralization test , dengue virus , leukopenia , virus , encephalitis , virology , disease , immunology , pediatrics , titer , chemotherapy
Although Japanese encephalitis virus (JEV) is considered endemic in Indonesia, there are only limited reports of JEV infection from a small number of geographic areas within the country with the majority of these being neuroinvasive disease cases. Here, we report cases of JEV infection in non-encephalitic acute febrile illness patients from Bali, Indonesia. Paired admission (S1) and discharge (S2) serum specimens from 144 acute febrile illness patients (without evidence of acute dengue virus infection) were retrospectively tested for anti-JEV IgM antibody and confirmed by plaque reduction neutralization test (PRNT) for JEV infection. Twenty-six (18.1%) patients were anti-JEV IgM-positive or equivocal in their S2 specimens, of which 5 (3.5%) and 8 (5.6%) patients met the criteria for confirmed and probable JEV infection, respectively, based on PRNT results. Notably, these non-encephalitic JE cases were less likely to have thrombocytopenia, leukopenia, and lower hematocrit compared with confirmed dengue cases of the same cohort. These findings highlight the need to consider JEV in the diagnostic algorithm for acute febrile illnesses in endemic areas and suggest that JEV as a cause of non-encephalitic disease has likely been underestimated in Indonesia.