Oral Presentation 8th Australasian Virology Society Meeting and 11th Annual Meeting of the Australian Centre for Hepatitis & HIV Virology Meeting 2015

Pathogenesis of viral encephalitis. lessons from the Australian CHILDHOOD ENCEPHALITIS (ACE) STUDY (#12)

Cheryl Jones 1 2 3
  1. Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  2. Marie Bashir Institute of Infectious Diseases and Biosecurity Institute (MBI), University of Sydney, Sydney, NSW, Australia
  3. Department of Infectious Diseases and Microbiology, Children’s Hospital at Westmead, Sydney, NSW, Australia

Encephalitis, or inflammation of the brain with cerebral dysfunction, is an important cause of mortality and morbidity worldwide and a marker syndrome of emerging infectious diseases.  Viral encephalitis can result from direct invasion of the brain or indirectly by viruses triggering immune mediated pathology. Viral associated encephalopathies such as those associated with influenza virus infection are not usually associated with detection of virus in the CSF. The causes of viral encephalitis are influenced by geographic location, age, immune competency, the availability of effective vaccines or antivirals and the season. Outbreaks of viral encephalitis can indicate emerging viral pathogens of public health significance or spread of vector borne and zoonotic viral encephalitides to new geographic locations. Increases of zoonotic encephalitis indicate a global need for a one health (animal and human) approach to prevention. Viral encephalitis continues to cause ongoing high burden of death and disability, particularly in childhood. Results from two years national surveillance of childhood encephalitis in Australia (the Australian Childhood Encephalitis (ACE) study), and 15 years surveillance for neonatal and infant HSV infection including CNS disease will be presented. Recent virus epidemics causing childhood neurological disease such as influenza, human parechovirus and enterovirus 71 will be reviewed, together with opportunities for treatment and prevention. Empiric antiviral therapy should be commenced early in suspected viral encephalitis cases but promptly ceased when herpes simplex virus encephalitis has been excluded. There may be a role for early institution of immune suppression in some forms of viral encephalitis. Many cases of encephalitis are lost opportunities for prevention due to missed opportunities for vaccination or  ineffective immunization programs vaccines. National and international consensus guidelines resulting from our research will be discussed, and knowledge gaps and priorities for future research identified.