St. louis encephalitis A83.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

St. Louis encephalitis

History
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Webster, 1936

Definition
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viral encephalitis (arbovirosis) caused by the St. Louis encephalitis virus

Pathogen
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  • St. Louis encephalitis viurus, belonging to the Flaviviridae family, from the special group with Japanese encephalitis, Murray Valley encephalitis, West Nile fever and Ilheus fever.
  • Transmission by mosquitoes (Culex and Aedes species).

Occurrence/Epidemiology
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  • Main distribution area: North America (Eastern states: urban; Western states: rural); in areas with irrigation management or permanent flooding zones. The virus has also been isolated in South and Central America, but without comparable epidemiological and human significance as in North America.
  • Hosts are birds and bats. Humans are false hosts.
  • Between 1960 and 2005, about 5000 cases were registered in the USA.

Manifestation
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Older people with a severe course and high mortality (22%) are mainly affected.

Clinical features
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  • Incubation period: 4-21 days.
  • Inapperent and mild courses are common. Symptoms are often limited to headache and mild fever.
  • Severe courses: high fever, lymphadenopathy, meningism, disorientation, tremor, seizures (especially in children), tremor, spastic or flaccid paralysis.

Diagnosis
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  • Virus cultivation.
  • Virus DNA detection: RT-PCR.
  • Antigen detection (immunofluorescence microscopy) in cerebrospinal fluid and urine.
  • Antibody detection (ELISA) in CSF and serum.

Complication(s)
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  • High lethality rate of 22% for older people.
  • Healing is possible with neurological residuals such as gait and speech disorders.
  • Frequent complications in elderly people: heart, circulation and lungs.

Therapy
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Symptomatic.

Prophylaxis
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Mosquito protection and control.

Literature
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  1. Reisen W, Brault AC (2007) West Nile virus in North America: perspectives on epidemiology and intervention. Plague Manag Sci 63: 641-646
  2. Travel WK (2003) Epidemiology of St. Louis encephalitis virus. Adv Virus Res 61: 139-183

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020