title: Adult encephalitis surveillance: experiences from an Australian prospective sentinel site study.
abstract: Few countries routinely collect comprehensive encephalitis data, yet understanding the epidemiology of this condition has value for clinical management, detecting novel and emerging pathogens, and guiding timely public health interventions. When this study was conducted there was no standardized diagnostic algorithm to aid identification of encephalitis or systematic surveillance for adult encephalitis. In July 2012 we tested three pragmatic surveillance options aimed at identifying possible adult encephalitis cases admitted to a major Australian hospital: hospital admissions searches, clinician notifications and laboratory test alerts (CSF herpes simplex virus requests). Eligible cases underwent structured laboratory investigation and a specialist panel arbitrated on the final diagnosis. One hundred and thirteen patients were initially recruited into the 10-month study; 20/113 (18%) met the study case definition, seven were diagnosed with infectious or immune-mediated encephalitis and the remainder were assigned alternative diagnoses. The laboratory alert identified 90% (102/113) of recruited cases including six of the seven cases of confirmed encephalitis suggesting that this may be a practical data source for case ascertainment. The application of a standardized diagnostic algorithm and specialist review by an expert clinical panel aided diagnosis of patients with encephalitis.
authors: Hunter New England Population Health,Newcastle,NSW,Australia.
authors: K
authors: K
authors: Eastwood
authors: Hunter New England Population Health,Newcastle,NSW,Australia.
authors: B J
authors: BJ
authors: Paterson
authors: Hunter Medical Research Institute,Newcastle,NSW,Australia.
authors: C
authors: C
authors: Levi
authors: University of Newcastle,Newcastle,NSW,Australia.
authors: R
authors: R
authors: Givney
authors: University of Newcastle,Newcastle,NSW,Australia.
authors: M
authors: M
authors: Loewenthal
authors: University of Newcastle,Newcastle,NSW,Australia.
authors: T
authors: T
authors: DE Malmanche
authors: University of Newcastle,Newcastle,NSW,Australia.
authors: K
authors: K
authors: Lai
authors: Public Health England,London,UK.
authors: J
authors: J
authors: Granerod
authors: Hunter New England Population Health,Newcastle,NSW,Australia.
authors: D N
authors: DN
authors: Durrheim
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D004660:Encephalitis / Q000175:diagnosis / Q000453:epidemiology*; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis / Q000453:epidemiology; D062665:Epidemiological Monitoring; D006801:Humans; D038801:International Classification of Diseases; D018579:Patient Selection; D011446:Prospective Studies; D018571:Sentinel Surveillance
keywords: Encephalitis; emerging infectious disease; epidemiology; surveillance