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Am. J. Trop. Med. Hyg., 25(5), 1976, pp. 733-738
Copyright © 1976 by The American Society of Tropical Medicine and Hygiene

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Persistence of Virus-Specific IgM and Clinical Recovery after Japanese Encephalitis*

Robert Edelman{dagger}, Robert J. Schneider{ddagger}, Athasit Vejjajiva, Rungsri Pornpibul AND Prathan Voodhikul
Departments of Virology and Neuropsychiatry, SEATO Medical Research Laboratory and Department of Medicine, Division of Neurology, Ramathibodi Hospital and Medical School, Bangkok, Thailand, and Department of Medicine, Division of Neurology, Chiangmai University Medical School and Department of Pediatrics, McCormick Hospital, Chiangmai, Thailand

We have searched for evidence of a chronic Japanese encephalitis virus (JEV) infection in six Thai patients convalescing from acute Japanese encephalitis (JE) in whom JEV-specific IgM antibody was last detected 116 to 350 days after their acute illness. These six patients were compared with 94 other JE patients matched for age, sex and serological response and in whom JEV-specific IgM was either short-lived (<90 days) or not tested. All patients were evaluated for the presence or absence of seven abnormal neurological signs over a 1- to 2-year period. During the first 30 days of illness the mean numbers (± S.E.M.) of abnormal signs per patients for the IgM and control groups were 3.8 ± 0.3 and 2.3 ± 0.1, respectively (P < 0.01). After 1 year the six IgM patients still had significantly more abnormal neurological signs than controls (1.3 ± 0.3 and 0.6 ± 0.1, respectively [P < 0.01]). By 2 years, the IgM group showed no neurological impairment; examination of cerebrospinal fluids revealed no evidence of subclinical viral infections. The recovery of the six IgM patients between 1 and 2 years after their relatively severe acute illness suggests that IgM antibody persistence was related to acute virulence rather than chronicity of the JEV infection.

Accepted for publication January 30, 1976.


* Address reprint requests to: LTC R. Edelman, U. S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21701.


{dagger} Present address: Virology Division, U. S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21701.


{ddagger} Present address: Division of Neuropsychiatry, Walter Reed Army Institute of Research, Washington, D. C. 20012.






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Copyright © 1976 by the American Society of Tropical Medicine and Hygiene.