title: Murray Valley encephalitis: a review of clinical features, diagnosis and treatment.
abstract: Murray Valley encephalitis virus (MVEV) is a mosquito-borne virus that is found across Australia, Papua New Guinea and Irian Jaya. MVEV is endemic to northern Australia and causes occasional outbreaks across south-eastern Australia. 2011 saw a dramatic increase in MVEV activity in endemic regions and the re-emergence of MVEV in south-eastern Australia. This followed significant regional flooding and increased numbers of the main mosquito vector, Culex annulirostris, and was evident from the widespread seroconversion of sentinel chickens, fatalities among horses and several cases in humans, resulting in at least three deaths. The last major outbreak in Australia was in 1974, during which 58 cases were identified and the mortality rate was about 20%. With the potential for a further outbreak of MVEV in the 2011-2012 summer and following autumn, we highlight the importance of this disease, its clinical characteristics and radiological and laboratory features. We present a suspected but unproven case of MVEV infection to illustrate some of the challenges in clinical management. It remains difficult to establish an early diagnosis of MVEV infection, and there is a lack of proven therapeutic options.
authors.affiliation: Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Knox
authors.forename: Raquel U
authors.initials: RU
authors.lastname: Cowan
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Doyle
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Ligtermoet
authors.forename: John S
authors.initials: JS
authors.lastname: Archer
authors.forename: James N C
authors.initials: JN
authors.lastname: Burrow
authors.forename: Steven Y C
authors.initials: SY
authors.lastname: Tong
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.forename: John S
authors.initials: JS
authors.lastname: Mackenzie
authors.forename: David W
authors.initials: DW
authors.lastname: Smith
authors.forename: Mike
authors.initials: M
authors.lastname: Catton
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Moran
authors.forename: Craig A
authors.initials: CA
authors.lastname: Aboltins
authors.forename: Jack S
authors.initials: JS
authors.lastname: Richards
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D018068:Encephalitis Virus, Murray Valley / Q000302:isolation & purification*; D004671:Encephalitis, Arbovirus / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D017809:Fatal Outcome; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors