title: Japanese encephalitis in a French traveler to Nepal.
abstract: Japanese encephalitis is frequent in Asia, with a severe prognosis, but rare in travelers. Culex mosquitoes transmit Japanese encephalitis virus. Risk factors are destination, duration of stay, summer and fall seasons, outdoor activities, and type of accommodation. We report the case of a French traveler to Nepal with neutralization-based serological confirmed Japanese encephalitis. He presented classical clinical (viral syndrome before an encephalitis status with behavioral disorder, global hypotonia, mutism, movement disorders, seizure, and coma), radiological (lesions of thalami, cortico-spinal tracts, and brainstem) and biological features (lymphocytic meningitis). Nowadays, the presence of Japanese encephalitis virus in Nepal, including mountain areas, is established but Japanese encephalitis remains rare in travelers returning from this area and neurologist physicians need to become familiar with this. We recommend vaccination for travelers spending a long period of time in Nepal and having at-risk outdoor activities.
authors.affiliation: Department of Clinical Neurosciences, Unit of Neurology, AP-HM Timone Hospital, 264, rue Saint Pierre, 13005, Marseille, France, stanislas.lagarde@ap-hm.fr.
authors.forename: S
authors.initials: S
authors.lastname: Lagarde
authors.forename: J-C
authors.initials: JC
authors.lastname: Lagier
authors.forename: R
authors.initials: R
authors.lastname: Charrel
authors.forename: G
authors.initials: G
authors.lastname: Quérat
authors.forename: J
authors.initials: J
authors.lastname: Vanhomwegen
authors.forename: P
authors.initials: P
authors.lastname: Desprès
authors.forename: J
authors.initials: J
authors.lastname: Pelletier
authors.forename: E
authors.initials: E
authors.lastname: Kaphan
mesh_terms: D004672:Encephalitis, Japanese / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008297:Male; D009390:Nepal; D014195:Travel; D044465:White People; D055815:Young Adult