title: A comparison of clinical features of Japanese encephalitis virus infection in the adult and pediatric age group with Acute Encephalitis Syndrome.
abstract: BACKGROUND
  Japanese encephalitis (JE) has traditionally been regarded as a disease of children. The age shift in JE patients in Assam, India in last few years has become a cause of concern. Comparison on clinical features of adult and pediatric JE patients has not been evaluated.
  
  
  OBJECTIVE
  To compare clinical features of adult and pediatric with JE virus infection.
  
  
  METHODS
  From January 2008 to January 2010, 550 hospitalized patients with Acute Encephalitis Syndrome were enrolled. 259 (47.1%) were serologically confirmed as JE of which 66.4% were adult and 33.6% were pediatric. Data extracted from these patients were analyzed.
  
  
  RESULTS
  Fever was the most common symptom in both the adult and pediatric. When compared with adult, significantly higher percentage of pediatric had neck rigidity, convulsions, abnormal behavior, seizures and elevated aspartate transaminase (P<0.05). Serum bilirubin levels were higher in 2.3% of adult but normal in all the pediatric. We found significantly higher mean elevated level of protein and WBC in CSF in adult (P<0.001) and mean elevated aspartate transaminase level (P<0.001) in pediatrics. There was no difference in mortality rate between pediatric and adult (8.2% vs. 4.4%, P=0.647).
  
  
  CONCLUSIONS
  This study provides some significant differences in clinical features of pediatric and adult with JE. Age shift may be due to the invasion of the disease into new demography or some change in the virus strain over time. The Government of India has initiated an adult JE vaccination programme for the first time in Assam in 2011.
authors.affiliation: Regional Medical Research Centre, ICMR, Northeast Region, Post Box No. 105, PIN 786 001 Dibrugarh, Assam, India.
authors.forename: Jani
authors.initials: J
authors.lastname: Borah
authors.forename: Prafulla
authors.initials: P
authors.lastname: Dutta
authors.forename: Siraj A
authors.initials: SA
authors.lastname: Khan
authors.forename: Jagadish
authors.initials: J
authors.lastname: Mahanta
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004664:Encephalitis Virus, Japanese / Q000276:immunology*; D004672:Encephalitis, Japanese / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged
chemical_list: D000914:Antibodies, Viral