Hypoglycemic Toxins and Enteroviruses as Causes of Outbreaks of Acute Encephalitis-Like Syndrome in Children, Bac Giang Province, Northern Vietnam

Phan, Nga Thi; Gouilh, Meriadeg Ar; Paireau, Juliette; Phuong, Loan; Cheval, Justine; Ngu, Nghia Duy; Hébert, Charles; Nguyen, Tuan Hai; Lortholary, Olivier; Tondeur, Laura; Manuguerra, Jean-Claude; Barouki, Robert; Sander, Johannes; Janzen, Nils; Nguyen, Hien Tran; Brey, Paul T.; Fontanet, Arnaud; Eloit, Marc

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Hypoglycemic Toxins and Enteroviruses as Causes of Outbreaks of Acute Encephalitis-Like Syndrome in Children, Bac Giang Province, Northern Vietnam

Published Date:

Aug 2018

Source:

Emerg Infect Dis. 24(8):1435-1443.

Language:

English

[PDF-1.50 MB]

Details:

Personal Authors:

Phan, Nga Thi ; Gouilh, Meriadeg Ar ; Paireau, Juliette ; Phuong, Loan ; Cheval, Justine ; ... More ▼

Keywords:

[+]

Pubmed ID:

30014832

Pubmed Central ID:

PMC6056107

Description:

We investigated the cause of seasonal outbreaks of pediatric acute encephalitis-like syndrome associated with litchi harvests (May-July) in northern Vietnam since 2008. Nineteen cerebrospinal fluid samples were positive for human enterovirus B, and 8 blood samples were positive for hypoglycemic toxins present in litchi fruits. Patients who were positive for hypoglycemic toxins had shorter median times between disease onset and admission, more reports of seizures, more reports of hypoglycemia (glucose level <3 mmol/L), lower median numbers of leukocytes in cerebrospinal fluid, and higher median serum levels of alanine aminotransferase and aspartate transaminase than did patients who were positive for enteroviruses. We suggest that children with rapidly progressing acute encephalitis-like syndrome at the time of the litchi harvest have intoxication caused by hypoglycemic toxins, rather than viral encephalitis, as previously suspected. These children should be urgently treated for life-threatening hypoglycemia.

Document Type:

Journal Article

Collection(s):

Emerging Infectious Diseases

Place as Subject:

Vietnam

Supporting Files:

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