• 1.

    Swe T, Thein S, Myint MS, 1979. Pilot sero-epidemiological survey on Japanese encephalitis in north-western Burma. Biken J 22: 125129.

  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 7.

    Biologicals DoVa, 2008. WHO-Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases Guideline. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 9.

    Inoue S et al. 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.

    • Search Google Scholar
    • Export Citation
  • 10.

    Ngwe Tun MM et al. 2013. Serological characterization of dengue virus infections observed among dengue hemorrhagic fever/dengue shock syndrome cases in upper Myanmar. J Med Virol 85: 12581266.

    • Search Google Scholar
    • Export Citation
  • 11.

    Maeki T et al. 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.

    • Search Google Scholar
    • Export Citation
  • 12.

    Igarashi A, 1978. Isolation of a Singh’s Aedes albopictus cell clone sensitive to dengue and chikungunya viruses. J Gen Virol 40: 531544.

    • Search Google Scholar
    • Export Citation
  • 13.

    Morita K, Tanaka M, Igarashi A, 1991. Rapid identification of dengue virus serotypes by using polymerase chain reaction. J Clin Microbiol 29: 21072110.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 18.

    Kyaw Kyaw A et al. 2018. Isolation and genomic characterization of Culex flaviviruses from mosquitoes in Myanmar. Virus Res 247: 120124.

  • 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.

    • Search Google Scholar
    • Export Citation
  • 20.

    Sharief MK, Thompson EJ, 1989. Immunoglobulin M in the cerebrospinal fluid: an indicator of recent immunological stimulation. J Neurol Neurosurg Psychiatry 52: 949953.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 22.

    Misra UK, Kalita J, Syam UK, Dhole TN, 2006. Neurological manifestations of dengue virus infection. J Neurol Sci 244: 117122.

  • 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.

    • Search Google Scholar
    • Export Citation
  • 24.

    Solomon T, 2004. Flavivirus encephalitis. N Engl J Med 351: 370378.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Japanese Encephalitis- and Dengue-Associated Acute Encephalitis Syndrome Cases in Myanmar

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  • 1 Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan;
  • | 2 Department of Medical Research (Pyin Oo Lwin Branch), Ministry of Health and Sports, Pyin Oo Lwin, Mandalay Region, Myanmar;
  • | 3 Research and Biotechnology, St. Luke’s Medical Center, Quezon City, Philippines;
  • | 4 Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
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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.

Author Notes

Address correspondence to Mya Myat Ngwe Tun, Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. E-mail: myamyat@tm.nagasaki-u.ac.jp

Financial support: This work was supported by the Japan Initiative for Global Research Network on Infectious Diseases (JGRID, 18fm0108001); Japan–United States Cooperative Medical Science Program from Japan Agency for Medical Research and Development (AMED, JP18fk0108035); Research Program on Emerging and Re-emerging Infectious Diseases of the Japan Agency for Medical Research and Development (AMED) under Grant Number (17fk0108108h1401); and Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University.

Authors’ addresses: Aung Kyaw Kyaw, Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, and Virology Research Division, Department of Medical Research, Pyin Oo Lwin, Myanmar, E-mail: akkyawdmr@gmail.com. Mya Myat Ngwe Tun, Takeshi Nabeshima, Tsuyoshi Ando, Shingo Inoue, Daisuke Hayasaka, and Kouichi Morita, Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, E-mails: myamyat@tm.nagasaki-u.ac.jp, mtmikami@tm.nagasaki-u.ac.jp, t-ando@tm.nagasaki-u.ac.jp, pampanga@nagasaki-u.ac.jp, hayasaka@nagasaki-u.ac.jp, and moritak@nagasaki-u.ac.jp. Corazon C. Buerano, Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, and Research and Biotechnology, St. Luke’s Medical Center, Quezon City, Philippines, E-mail: ccbuerano@hotmail.com. Chang Kweng Lim and Masayuki Saijo, Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan, E-mails: ck@nih.go.jp and msaijo@nih.go.jp. Hlaing Myat Thu and Kyaw Zin Thant, Virology Research Division, Department of Medical Research, Pyin Oo Lwin, Myanmar, E-mails: hmyatthu28@gmail.com and drkz.thant@googlemail.com.

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