Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 8—August 2018
Research

Hypoglycemic Toxins and Enteroviruses as Causes of Outbreaks of Acute Encephalitis-Like Syndrome in Children, Bac Giang Province, Northern Vietnam

Nga Thi Phan1, Meriadeg Ar Gouilh1, Juliette Paireau, Loan Phuong, Justine Cheval, Nghia Duy Ngu, Charles Hébert, Tuan Hai Nguyen, Olivier Lortholary, Laura Tondeur, Jean-Claude Manuguerra, Robert Barouki, Johannes Sander, Nils Janzen, Hien Tran Nguyen, Paul T. Brey, Arnaud Fontanet2, and Marc Eloit2Comments to Author 
Author affiliations: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam (N.T. Phan, L.P. Do, N.D. Ngu, T.H. Nguyen, H.T. Nguyen); Institut Pasteur, Paris, France (M. Ar Gouilh, J. Paireau, L. Tondeur, J.-C. Manuguerra, A. Fontanet, M. Eloit); Centre National de la Recherche Scientifique, Paris (J. Paireau); Pathoquest, Paris (J. Cheval, C. Hébert, M. Eloit); Hôpital Necker-Enfants Malades, Paris (O. Lortholary, R. Barouki); Université Paris Descartes, Paris (O. Lortholary, R. Barouki); Institut National de la Santé et de la Recherche Médicale, Paris (R. Barouki); Screening Laboratory Hannover, Hannover, Germany (J. Sander, N. Janzen); Hannover Medical School, Hannover (N. Janzen); Institut Pasteur du Laos, Vientiane, Laos (P.T. Brey); Conservatoire National des Arts et Métiers, Paris (A. Fontanet)

Main Article

Table

Characteristics of 27 children hospitalized with acute encephalitis syndrome who were positive for enteroviruses or toxins, northern Vietnam, 2008–2011*

Characteristic Enterovirus positive and toxin negative (n = 4) or not tested (n = 15)
 Toxin positive and enterovirus negative (n = 7) or not tested (n = 1)
 p value
No. with data No. (%) or median (IQR) No. with data No. (%) or median (IQR)
Sex 19 8 0.80
F NA 6 (32) NA 3 (38) NA
M
 NA
 13 (68)
NA
 5 (62)
 NA
Age, y 19 8 0.47
<2 NA 4 (21) NA 3 (38) NA
2–4 NA 5 (26) NA 3 (38) NA
5–9 NA 7 (37) NA 1 (12) NA
10–15
 NA
 3 (16)
NA
 1 (12)
 NA
Symptoms/signs before and at admission
Temperature at admission, °C 18 38.0 (37.6–38.5) 7 37.5 (37.4–37.8) 0.14
Fever before admission 18 18 (100) 7 5 (71) 0.07
Headache 19 11 (58) 6 3 (50) 1.0
Seizures 18 5 (28) 8 7 (88) 0.009
Coma 14 4 (29) 7 4 (57) 0.35
Meningeal symptoms 18 12 (67) 7 4 (57) 0.67
Limb paralysis 18 1 (6) 5 0 1.0
Vomiting 18 14 (78) 7 6 (86) 1.0
Diarrhea 14 3 (21) 6 0 0.52
Days from disease onset to admission
 19
 2.0 (0.5–2.5)
8
 0.0 (0.0–0.2)
 0.008
Blood sample
Leukocytes, × 109 cells/L 18 10.5 (7.5–15.8) 8 19.5 (18.4–29.9) 0.004
Platelets/μL 12 254 (197–306) 7 340 (274–487) 0.20
Hemoglobin, g/L 7 114 (108–118) 6 116 (92–122) 0.77
Glucose, mmol/L 14 4.5 (3.9–5.0) 7 2.0 (1.6–3.8) 0.67
Glucose <3 mmol/L
 14
 0
7
 5 (71)
 0.001
Cerebrospinal fluid sample
Leukocytes/mm3 12 50 (6–100) 6 3 (1–3) 0.001
Lymphocytes/mm3 8 80 (73–80) 1 45 (45–45) 0.31
Protein level >0.5 g/L 15 4 (27) 6 0 0.28
Transparent appearance of CSF
 15
 15 (100)
7
 7 (100)
 1.0
Liver enzymes at or after admission, IU/L
Alanine aminotransferase 8 24 (12–33) 8 48 (37–56) 0.04
Aspartate aminotransferase 8 28 (20–46) 8 68 (62–79) 0.01

*CSF, cerebrospinal fluid; IQR, interquartile range; NA, not applicable.

Main Article

1These authors contributed equally to this article.

2These senior authors contributed equally to this article.

Page created: July 17, 2018
Page updated: July 17, 2018
Page reviewed: July 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external