Encephalitis in travellers : a prospective multicentre study
© International Society of Travel Medicine 2022. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: As the epidemiology of encephalitis varies from one country to another, international travel may be an important clue for the diagnostic workout of this puzzling disease.
METHODS: We performed an ancillary study using the ENCEIF prospective cohort conducted in 62 clinical sites in France from 2016 to 2019. All cases of encephalitis in adults that fulfilled a case definition derived from the International Encephalitis Consortium were included. Travellers were defined as patients who spent at least one night in a foreign country within the last six months.
RESULTS: Of the 494 encephalitis patients enrolled, 69 (14%) were travellers. As compared to non-travellers, they were younger (median age, 48 years [interquartile range, 36-69] vs 66 [49-76], P < 0.001), less likely to be immunocompromised: 2/69 (3%) vs 56/425 (13%), P = 0.02, and reported more arthralgia: 7/69 (10%) vs 11/425 (3%), P = 0.007. The risk of poor outcome at hospital discharge (Glasgow outcome scale ≤3), was similar for travellers and for non-travellers after adjustment (aOR 0.80 [0.36-1.80], P = 0.594). Arboviruses were the main causes of encephalitis in travellers: 15/69 (22%) vs 20/425 (5%) in non-travellers, P < 0.001, and Herpes simplex virus (HSV) was the second (9/69, 13%). Of note, in 19% (13/69) of cases, the risk of encephalitis in travellers may have been decreased with a vaccine.
CONCLUSION: The two primary causes of encephalitis in travellers are arboviruses and HSV. Empirical treatment of encephalitis in travellers must include acyclovir. Pre-travel advice and vaccination may decrease the risk of encephalitis in travellers.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
Journal of travel medicine - 30(2023), 2 vom: 05. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Picard, Léa [VerfasserIn] |
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| Links: |
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| Themen: |
Arbovirus |
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| Anmerkungen: |
Date Completed 07.04.2023 Date Revised 19.04.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jtm/taac145 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © International Society of Travel Medicine 2022. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: As the epidemiology of encephalitis varies from one country to another, international travel may be an important clue for the diagnostic workout of this puzzling disease | ||
| 520 | |a METHODS: We performed an ancillary study using the ENCEIF prospective cohort conducted in 62 clinical sites in France from 2016 to 2019. All cases of encephalitis in adults that fulfilled a case definition derived from the International Encephalitis Consortium were included. Travellers were defined as patients who spent at least one night in a foreign country within the last six months | ||
| 520 | |a RESULTS: Of the 494 encephalitis patients enrolled, 69 (14%) were travellers. As compared to non-travellers, they were younger (median age, 48 years [interquartile range, 36-69] vs 66 [49-76], P < 0.001), less likely to be immunocompromised: 2/69 (3%) vs 56/425 (13%), P = 0.02, and reported more arthralgia: 7/69 (10%) vs 11/425 (3%), P = 0.007. The risk of poor outcome at hospital discharge (Glasgow outcome scale ≤3), was similar for travellers and for non-travellers after adjustment (aOR 0.80 [0.36-1.80], P = 0.594). Arboviruses were the main causes of encephalitis in travellers: 15/69 (22%) vs 20/425 (5%) in non-travellers, P < 0.001, and Herpes simplex virus (HSV) was the second (9/69, 13%). Of note, in 19% (13/69) of cases, the risk of encephalitis in travellers may have been decreased with a vaccine | ||
| 520 | |a CONCLUSION: The two primary causes of encephalitis in travellers are arboviruses and HSV. Empirical treatment of encephalitis in travellers must include acyclovir. Pre-travel advice and vaccination may decrease the risk of encephalitis in travellers | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Encephalitis | |
| 650 | 4 | |a arbovirus | |
| 650 | 4 | |a herpes simplex virus | |
| 650 | 4 | |a prevention | |
| 650 | 4 | |a travellers | |
| 700 | 1 | |a Mailles, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Fillâtre, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Tattevin, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Stahl, Jean-Paul |e verfasserin |4 aut | |
| 700 | 0 | |a ENCEIF scientific committee |e verfasserin |4 aut | |
| 700 | 0 | |a investigators group |e verfasserin |4 aut | |
| 700 | 1 | |a Abgrall, Sophie |e investigator |4 oth | |
| 700 | 1 | |a Argaud, Laurent |e investigator |4 oth | |
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| 700 | 1 | |a Asseray, Nathalie |e investigator |4 oth | |
| 700 | 1 | |a Baille, Guillaume |e investigator |4 oth | |
| 700 | 1 | |a Baldolli, Aurélie |e investigator |4 oth | |
| 700 | 1 | |a Benghanem, Sarah |e investigator |4 oth | |
| 700 | 1 | |a Biberon, Julien |e investigator |4 oth | |
| 700 | 1 | |a Biron, Charlotte |e investigator |4 oth | |
| 700 | 1 | |a Blanchet-Fourcade, Geneviève |e investigator |4 oth | |
| 700 | 1 | |a Blot, Mathieu |e investigator |4 oth | |
| 700 | 1 | |a Bonnetain, Anne |e investigator |4 oth | |
| 700 | 1 | |a Botelho-Nevers, Elisabeth |e investigator |4 oth | |
| 700 | 1 | |a Bourdain, Frédéric |e investigator |4 oth | |
| 700 | 1 | |a Boutoille, David |e investigator |4 oth | |
| 700 | 1 | |a Brasme, Hélène |e investigator |4 oth | |
| 700 | 1 | |a Bruel, Cédric |e investigator |4 oth | |
| 700 | 1 | |a Bruneel, Fabrice |e investigator |4 oth | |
| 700 | 1 | |a Buzele, Rodolphe |e investigator |4 oth | |
| 700 | 1 | |a Canouï, Etienne |e investigator |4 oth | |
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| 700 | 1 | |a Chirouze, Catherine |e investigator |4 oth | |
| 700 | 1 | |a Chroboczek, Tomasz |e investigator |4 oth | |
| 700 | 1 | |a Courjon, Johan |e investigator |4 oth | |
| 700 | 1 | |a De Broucker, Thomas |e investigator |4 oth | |
| 700 | 1 | |a De La Blanchardière, Arnaud |e investigator |4 oth | |
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| 700 | 1 | |a Gravier, Simon |e investigator |4 oth | |
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| 700 | 1 | |a Gueit, Isabelle |e investigator |4 oth | |
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| 700 | 1 | |a Henry, Carole |e investigator |4 oth | |
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| 700 | 1 | |a Katchatourian, Lydie |e investigator |4 oth | |
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