Tom Solomon

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..Japanese Encephalitis (JE) accounts for approximately one-quarter of cases. Although poor prognostic features for JE have been identified, and guide management, relatively little is reported on the remaining three-quarters of AES cases...

..The tick-borne haemorrhagic flaviviruses, Omsk haemorrhagic fever and Kyasanur Forrest disease are localized in small areas...

..Interferon alpha was the most promising drug in small open trials, but a recent double-blind placebo controlled trial showed that it did not affect the outcome in children with JE...

..Detailed molecular analysis suggested that, although our patient received a blood transfusion infected with WNV, the virus that caused his initial infection and encephalitis was probably acquired naturally from a mosquito...

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..Starting with anatomical and neurophysiological considerations, this article examines data on AFP caused by WNV, and considers recent data on paralysis caused by enteroviruses, and Guillain-Barré syndrome (GBS)...

..liv.ac.uk/braininfections)...

..Results from in-vitro studies and work in animals have shown inteferon alfa has antiviral activity on Japanese encephalitis and other flaviviruses; therefore, we aimed to assess the efficacy of inteferon alfa-2a in Japanese encephalitis...

..However, after 10 months, he deteriorated suddenly and died before further intraventricular treatment could be instituted. Further trials are needed to evaluate long-term combination therapy in subacute sclerosing panencephalitis...

..Our data, together with recent evidence on the origins of other emerging viruses, including dengue virus and Nipah virus, imply that tropical southeast Asia may be an important zone for emerging pathogens...

..To assess the field-test version of the new WHO Japanese encephalitis (JE) surveillance standards...

..We aimed to audit the regional management of central nervous system (CNS) infection in children...

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..7%) children infected with enterovirus 75 among 106 children with acute encephalitis syndrome during 2005-2007 in southern India. Throat swab specimens may be useful for diagnosis of enterovirus 75 infection...

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..Vaccines being developed include inactivated whole-virus, live attenuated, subviral particle, and DNA vaccines...

..Milrinone might be helpful in patients with cardiac dysfunction...

..A high-throughput pyrosequencing screen detected human parvovirus 4 DNA in cerebrospinal fluid of 2 children with encephalitis of unknown etiology...

..In such patients, CT scanning before LP is not needed...

..01). CMV was detected in 11 of 115 HIV-infected patients, 8 of whom died. The mechanisms by which EBV and CMV contribute to poor outcome require further investigation...

..Early recognition of children at risk is the key to reduce acute mortality and morbidity...

..These findings suggest that in JE, seizures and raised ICP may be important causes of death. The outcome may be improved by measures aimed at controlling these secondary complications...

..To investigate how infants and children with suspected viral encephalitis are currently managed in a UK tertiary children's hospital...

..5%) of 133 cases. Four patients had unusual clinical manifestations, and rabies was only diagnosed postmortem. Three (11.5%) of 26 fatal cases originally attributed to cerebral malaria were due to rabies...

..The clinical contraindications to lumbar puncture must be considered before the procedure is carried out, and nurses need to have an understanding of how best to inform, support and reassure patients...

..This review aims to provide information to determine what minimum annual incidence of AES should be reported to show that the surveillance programme is active...

..To develop a simple tool for assessing the severity of disability resulting from Japanese encephalitis and whether, as a result, a child is likely to be dependent...

..CHIKV was also detected in the cerebrospinal fluid of 3 children...

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..Enterovirus 71 (EV71) causes large outbreaks of hand, foot, and mouth disease (HFMD), with severe neurological complications and cardio-respiratory compromise, but the pathogenesis is poorly understood...

..The potential importance of the two sites in the evolution and ecology of JEV merits further investigation...

..We report a 9-year-old child with congenital human immunodeficiency virus infection who presented with cytomegalovirus polyradiculopathy and made an excellent response to cytomegalovirus treatment...

..Vesicle swabs give a high diagnostic yield, with the added advantage of being from a sterile site...

..Finally, we describe the acute and longer-term management of encephalitis-related seizures and their potential pathophysiologic mechanisms, concluding with the emerging etiologic role of human herpesvirus 6...

..In addition, beta-amyloid precursor protein staining indicated impaired axonal transport. Whether these findings are caused by viral replication in the vascular endothelium or the immune response merits further investigation...

..The use of the lumbar puncture in the diagnosis of central nervous system infection in acutely ill children is controversial. Recommendations have been published but it is unclear whether they are being followed...

..Further, mutating all three of the amino acids of the NS1(130-132) glycosylation motif (NTT-QQA) along with NS1(175) and NS1(207) asparagine to alanine mutations gave the most stable and attenuated strain...

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..No strong evidence for positive selection was found between JEV strains of the five genotypes and the E gene has generally been subjected to strong purifying selection...

..This review assesses the known risks of contracting Japanese encephalitis and the risks associated with the vaccine and tries to develop an appropriate way to recommend this vaccine to travelers who may be at significant risk...

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..A positive test should prompt close observation or early hospital referral, but a negative test does not exclude dengue infection...

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..Despite the availability of antitoxin and antibiotics, the mortality rate for diphtheria remains high, mostly because of cardiac complications...

..The occurrence of these unusual adenovirus infections during an outbreak of EV71-associated HFMD suggests that an interaction between the 2 viruses may have occurred...

..Japanese encephalitis is a major public health problem in Asia. However, there is little data on the long-term outcome of Japanese encephalitis survivors...

..More detailed recommendations will be drafted following further consultations to serve as WHO guidelines for evaluation and licensure for new JE vaccines...

..However, further modifications will be required in the fever section, particularly for dengue. The impact of using the IMCI chart in peripheral health stations remains to be evaluated...

..Human enterovirus (HEV)-71 causes large outbreaks of hand-foot-and-mouth disease with central nervous system (CNS) complications, but the role of HEV-71 genogroups or dual infection with other viruses in causing severe disease is unclear...

..In children and adolescents with diphtheritic myocarditis and severe conduction defects, temporary insertion of a cardiac pacemaker may improve the outcome...

..A better understanding of these mechanisms may lead to therapeutic strategies to reduce brain injury and neurological sequelae...