title: Litchi-associated acute encephalitis in children, Northern Vietnam, 2004-2009.
abstract: Since the end of the 1990s, unexplained outbreaks of acute encephalitis in children coinciding with litchi harvesting (May-July) have been documented in the Bac Giang Province in northern Vietnam. A retrospective ecologic analysis of data for 2004-2009 involving environmental, agronomic, and climatic factors was conducted to investigate the suspected association between the outbreaks and litchi harvesting. The clinical, biological, and immunologic characteristics of the patients suggested a viral etiology. The ecologic study revealed an independent association between litchi plantation surface proportion and acute encephalitis incidence: Incidence rate ratios were 1.52 (95% CI 0.90-2.57), 2.94 (95% CI 1.88-4.60), and 2.76 (95% CI 1.76-4.32) for second, third, and fourth quartiles, respectively, compared with the lowest quartile. This ecologic study confirmed the suspected association between incidence of acute encephalitis and litchi plantations and should be followed by other studies to identify the causative agent for this syndrome.
authors.affiliation: Unité d’Epidémiologie des Maladies Emergentes, Bâtiment Laveran 3ème étage, Institut Pasteur, Paris, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Paireau
authors.forename: Nguyen Hai
authors.initials: NH
authors.lastname: Tuan
authors.forename: Rémi
authors.initials: R
authors.lastname: Lefrançois
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Buckwalter
authors.forename: Ngu Duy
authors.initials: ND
authors.lastname: Nghia
authors.forename: Nguyen Tran
authors.initials: NT
authors.lastname: Hien
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poirée
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Manuguerra
authors.forename: Antoine
authors.initials: A
authors.lastname: Gessain
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Albert
authors.forename: Paul T
authors.initials: PT
authors.lastname: Brey
authors.forename: Phan Thi
authors.initials: PT
authors.lastname: Nga
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D032125:Litchi / Q000009:adverse effects*; D008297:Male; D014744:Vietnam / Q000453:epidemiology