Volume 100, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This study was conducted to find the burden of dengue virus (DENV) and Japanese encephalitis virus (JEV) among children under the age of 13, who presented with acute encephalitis syndrome at Mandalay Children Hospital in Myanmar in 2013. Molecular and serological investigations were performed on 123 cerebrospinal fluid (CSF) samples collected from these patients. By neutralization tests and/or virus isolation, four (3.3%) JEV- and one DENV-associated encephalitis cases (0.8%) were confirmed. Antibody titer against JEV Genotype 3 was the highest among the laboratory-confirmed JEV cases. One strain of DENV-1 with Genotype 1 was isolated from the CSF sample of the dengue encephalitis patient; this was similar to the virus circulating in the study area and neighboring countries. This study shows that flaviviruses are important pathogens causing encephalitis in Myanmar. Active disease surveillance, vector control, and vaccination programs should be enforced to reduce the morbidity and mortality caused by flavivirus encephalitis.


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  1. Swe T, Thein S, Myint MS, , 1979. Pilot sero-epidemiological survey on Japanese encephalitis in north-western Burma. Biken J 22: 125129. [Google Scholar]
  2. Thu HM, Lowry K, Myint TT, Shwe TN, Han AM, Khin KK, Thant KZ, Thein S, Aaskov J, , 2004. Myanmar dengue outbreak associated with displacement of serotypes 2, 3, and 4 by dengue 1. Emerg Infect Dis 10: 593597. [Google Scholar]
  3. Mon Oo P, Hlaing T, Lwin S, Pittyawonganon C, Srichasinthop J, Khine SK, , 2016. A large outbreak of Japanese encephalitis in Rakhine state, Myanmar: implication for vaccine policy. Outbreak, Surveill Invest Rep 9: 815. [Google Scholar]
  4. Thein S, Aung H, Sebastian AA, , 1988. Study of vector, amplifier, and human infection with Japanese encephalitis virus in a Rangoon community. Am J Epidemiol 128: 13761382. [Google Scholar]
  5. Thisyakorn U, Thisyakorn C, Limpitkul W, Nisalak A, , 1999. Dengue infection with central nervous system manifestation. Southeast Asian J Trop Med Public Health 30: 504506. [Google Scholar]
  6. A-Nuegoonpipat A, Panthuyosri N, Anantapreecha S, Chanama S, Sa-Ngasang A, Sawanpanyalert P, Kurane I, , 2008. Cross-reactive IgM responses in patients with dengue or Japanese encephalitis. J Clin Virol 42: 7577. [Google Scholar]
  7. Biologicals DoVa, 2008. WHO-Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases Guideline. Geneva, Switzerland: World Health Organization. [Google Scholar]
  8. Bundo K, Igarashi A, , 1985. Antibody-capture ELISA for detection of immunoglobulin M antibodies in sera from Japanese encephalitis and dengue hemorrhagic fever patients. J Virol Methods 11: 1522. [Google Scholar]
  9. Inoue S, 2010. Evaluation of a dengue IgG indirect enzyme-linked immunosorbent assay and a Japanese encephalitis IgG indirect enzyme-linked immunosorbent assay for diagnosis of secondary dengue virus infection. Vector Borne Zoonotic Dis 10: 143150. [Google Scholar]
  10. Ngwe Tun MM, 2013. Serological characterization of dengue virus infections observed among dengue hemorrhagic fever/dengue shock syndrome cases in upper Myanmar. J Med Virol 85: 12581266. [Google Scholar]
  11. Maeki T, 2018. Comparison of neutralizing antibody titers against Japanese encephalitis virus genotype V strain with those against genotype I and III strains in the sera of Japanese encephalitis patients in Japan in 2016. Jpn J Infect Dis 71: 360364. [Google Scholar]
  12. Igarashi A, , 1978. Isolation of a Singh’s Aedes albopictus cell clone sensitive to dengue and chikungunya viruses. J Gen Virol 40: 531544. [Google Scholar]
  13. Morita K, Tanaka M, Igarashi A, , 1991. Rapid identification of dengue virus serotypes by using polymerase chain reaction. J Clin Microbiol 29: 21072110. [Google Scholar]
  14. Guindon S, Dufayard JF, Lefort V, Anisimova M, Hordijk W, Gascuel O, , 2010. New algorithms and methods to estimate maximum-likelihood phylogenies: assessing the performance of PhyML 3.0. Syst Biol 59: 307321. [Google Scholar]
  15. Robinson JS, Featherstone D, Vasanthapuram R, Biggerstaff BJ, Desai A, Ramamurty N, Chowdhury AH, Sandhu HS, Cavallaro KF, Johnson BW, , 2010. Evaluation of three commercially available Japanese encephalitis virus IgM enzyme-linked immunosorbent assays. Am J Trop Med Hyg 83: 11461155. [Google Scholar]
  16. Latt AZ, Thu HM, Aye KT, Aye KS, Oo KK, Thu HM, Yoksan S, , 2011. Isolation and identification of Japanese encephalitis virus from piglets in Dike Oo pig farm. Myanmar Health Sci Res J 23: 2125. [Google Scholar]
  17. Latt AZ, Aye KM, Win HM, Aung KM, Oo KK, Thu HM, Win MM, Thu HM, Yoksan S, , 2015. Isolation and identification of Japanese encephalitis virus from piglets in Thakata township, Yangon. Myanmar Health Sci Res J 27: 16. [Google Scholar]
  18. Kyaw Kyaw A, 2018. Isolation and genomic characterization of Culex flaviviruses from mosquitoes in Myanmar. Virus Res 247: 120124. [Google Scholar]
  19. Hills S, Dabbagh A, Jacobson J, Marfin A, Featherstone D, Hombach J, Namgyal P, Rani M, Solomon T, , 2009. Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance. BMC Infect Dis 9: 214. [Google Scholar]
  20. Sharief MK, Thompson EJ, , 1989. Immunoglobulin M in the cerebrospinal fluid: an indicator of recent immunological stimulation. J Neurol Neurosurg Psychiatry 52: 949953. [Google Scholar]
  21. Jarman RG, Nisalak A, Anderson KB, Klungthong C, Thaisomboonsuk B, Kaneechit W, Kalayanarooj S, Gibbons RV, , 2011. Factors influencing dengue virus isolation by C6/36 cell culture and mosquito inoculation of nested PCR-positive clinical samples. Am J Trop Med Hyg 84: 218223. [Google Scholar]
  22. Misra UK, Kalita J, Syam UK, Dhole TN, , 2006. Neurological manifestations of dengue virus infection. J Neurol Sci 244: 117122. [Google Scholar]
  23. Bordignon J, Strottmann DM, Mosimann AL, Probst CM, Stella V, Noronha L, Zanata SM, Dos Santos CN, , 2007. Dengue neurovirulence in mice: identification of molecular signatures in the E and NS3 helicase domains. J Med Virol 79: 15061517. [Google Scholar]
  24. Solomon T, , 2004. Flavivirus encephalitis. N Engl J Med 351: 370378. [Google Scholar]

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  • Received : 25 Jun 2018
  • Accepted : 14 Nov 2018
  • Published online : 07 Jan 2019

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