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Etiology of encephalitis in Australia, 1990-2007.

Huppatz C, Durrheim DN, Levi C, Dalton C, Williams D, Clements MS, Kelly PM - Emerging Infect. Dis. (2009)

Bottom Line: Encephalitis was the primary discharge diagnosis for 5,926 hospital admissions; average annual hospitalization rate was 5.2/100,000 population.The most commonly identified pathogen was herpes simplex virus (n = 763, 12.9%).Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines.

View Article: PubMed Central - PubMed

Affiliation: Hunter New England Population Health, Newcastle, New South Wales, Australia.

ABSTRACT
Encephalitis is a clinical syndrome commonly caused by emerging pathogens, which are not under surveillance in Australia. We reviewed rates of hospitalization for patients with encephalitis in Australia's most populous state, New South Wales, from January 1990 through December 2007. Encephalitis was the primary discharge diagnosis for 5,926 hospital admissions; average annual hospitalization rate was 5.2/100,000 population. The most commonly identified pathogen was herpes simplex virus (n = 763, 12.9%). Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines. The average annual encephalitis case-fatality rate (4.6%) and the proportion of patients hospitalized with encephalitis with no identified pathogen (69.8%, range 61.5%-78.7%) were stable during the study period. The nonnotifiable status of encephalitis in Australia and the high proportion of this disease with no known etiology may conceal emergence of novel pathogens. Unexplained encephalitis should be investigated, and encephalitis hospitalizations should be subject to statutory notification in Australia.

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Toxoplasma encephalitis hospitalizations by year, New South Wales, Australia, 1990–2007.
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Figure 4: Toxoplasma encephalitis hospitalizations by year, New South Wales, Australia, 1990–2007.

Mentions: Herpes encephalitis accounted for a relatively stable proportion of encephalitis hospitalizations during the study period (Figure 3). Toxoplasma encephalitis hospitalizations increased early in the study period and peaked in 1993 (Figure 4). Few toxoplasmosis hospitalizations occurred during the last 10 years of the study period. Subacute sclerosing panencephalitis (SSPE) was the only other diagnosis that decreased most years after 1994. These decreases appeared to contribute to the overall downward trend in hospitalizations with encephalitis with a known etiology, although this trend was not statistically significant; SSPE hospitalizations declined throughout the 1990s (Figure 5).


Etiology of encephalitis in Australia, 1990-2007.

Huppatz C, Durrheim DN, Levi C, Dalton C, Williams D, Clements MS, Kelly PM - Emerging Infect. Dis. (2009)

Toxoplasma encephalitis hospitalizations by year, New South Wales, Australia, 1990–2007.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2819877&req=5

Figure 4: Toxoplasma encephalitis hospitalizations by year, New South Wales, Australia, 1990–2007.
Mentions: Herpes encephalitis accounted for a relatively stable proportion of encephalitis hospitalizations during the study period (Figure 3). Toxoplasma encephalitis hospitalizations increased early in the study period and peaked in 1993 (Figure 4). Few toxoplasmosis hospitalizations occurred during the last 10 years of the study period. Subacute sclerosing panencephalitis (SSPE) was the only other diagnosis that decreased most years after 1994. These decreases appeared to contribute to the overall downward trend in hospitalizations with encephalitis with a known etiology, although this trend was not statistically significant; SSPE hospitalizations declined throughout the 1990s (Figure 5).

Bottom Line: Encephalitis was the primary discharge diagnosis for 5,926 hospital admissions; average annual hospitalization rate was 5.2/100,000 population.The most commonly identified pathogen was herpes simplex virus (n = 763, 12.9%).Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines.

View Article: PubMed Central - PubMed

Affiliation: Hunter New England Population Health, Newcastle, New South Wales, Australia.

ABSTRACT
Encephalitis is a clinical syndrome commonly caused by emerging pathogens, which are not under surveillance in Australia. We reviewed rates of hospitalization for patients with encephalitis in Australia's most populous state, New South Wales, from January 1990 through December 2007. Encephalitis was the primary discharge diagnosis for 5,926 hospital admissions; average annual hospitalization rate was 5.2/100,000 population. The most commonly identified pathogen was herpes simplex virus (n = 763, 12.9%). Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines. The average annual encephalitis case-fatality rate (4.6%) and the proportion of patients hospitalized with encephalitis with no identified pathogen (69.8%, range 61.5%-78.7%) were stable during the study period. The nonnotifiable status of encephalitis in Australia and the high proportion of this disease with no known etiology may conceal emergence of novel pathogens. Unexplained encephalitis should be investigated, and encephalitis hospitalizations should be subject to statutory notification in Australia.

Show MeSH
Related in: MedlinePlus