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Murray Valley Encephalitis Virus

Australia X Encephalitis Virus


Presentation

  • Clinical presentation is rare but severe, with a case fatality rate of 15 30%. Here we report a case of MVEV from the cerebrospinal fluid (CSF) of a patient in the Northern Territory in Australia.[ncbi.nlm.nih.gov]
  • Diffuse and focal gliosis were present throughout the brain and spinal cord. In the more severely affected areas of midbrain and medulla, swollen, chromatolytic, and necrotic neurons were present, with glial satellitosis ( Fig. 3 ).[oadoi.org]
Fever
  • Amino acid sequence homology between the Murray Valley encephalitis and yellow fever (Rice et al 1985) polyproteins is 42% over the region sequenced.[authors.library.caltech.edu]
  • Some infections (about 1 in 800 cases) may produce mild fever, headache, nausea and vomiting.[sitata.com]
  • Murray Valley Fever Virus Murray Valley Private Hospital Murray Valley rash Murray Valley virus Murray Wetlands Working Group Murray, Albert Lee Murray, Alexander Stuart Murray, Gilbert Murray, Gilbert Murray, Henry A.[medical-dictionary.thefreedictionary.com]
  • […] users and now totalling 15,000… 10 May 2019 Counterfeit medications, believed to be sold as ‘corticosteroids, erectile dysfunction-treating medicine and sleeping pills’ were discovered during a raid on… 10 May 2019 There has been no let-up in new dengue fever[traveldoctor.com.au]
  • In adults and older children, symptoms include: fever drowsiness bad headache and stiff neck nausea muscle tremors dizziness. In young children the symptoms include: fever floppiness irritability drowsiness fits.[ww2.health.wa.gov.au]
High Fever
  • In a small number of cases, the infection may cause inflammation of the brain (encephalitis) with high fever, severe headache, lethargy, drowsiness, altered mental state, tremors and sometimes convulsions.[sitata.com]
  • Symptoms of the disease include severe headache, high fever, drowsiness, tremors and seizures, the department says. It can lead to delirium and coma as well as paralysis and brain damage.[abc.net.au]
  • Dr Carnie said people with symptoms of the virus, which include severe headache, high fever, drowsiness, tremor and seizures, should seek urgent medical attention.[theland.com.au]
  • The symptoms of Murray Valley encephalitis virus include severe headache, high fever, drowsiness, neck stiffness, tremor and seizures. Symptoms for Kunjin virus are similar, though more mild.[heraldsun.com.au]
  • The symptoms of MVE can include severe headache, high fever, drowsiness, tremors, seizures (especially in young children) and in some cases the disease can progress to delirium, coma, permanent brain damage or death.[ntnews.com.au]
Fatigue
  • A previously healthy 19-year-old woman from Alberta, Canada, returned from Australia with increasing fatigue, fever, lethargy, and confusion.[wwwnc.cdc.gov]
  • Dr Lindsay said for most people the diseases’ symptoms were “fairly mild” headache, fever, fatigue, aching, swollen joints and skin rash but in rare cases some could cause inflammation of the brain and lead to long-term disability or death.[thewest.com.au]
  • Other symptoms associated with Murray Valley encephalitis include: fever; headaches; vomiting; photophobia; fatigue; malaise; muscle weakness; aches and pains; unsteady gait; disorientation; seizures; sudden severe dementia; memory loss; as well as distinct[medigest.uk]
  • Murray Valley Encephalitis (MVE) can cause milder symptoms such as swollen joints, sore muscles skin rashes, fever, headaches and fatigue, but can also leave people with permanent impaired neurological function, such as paralysis and loss of verbal function[abc.net.au]
Rigor
  • The data do not support the view that clinical cases of MVE infection in humans are due to a particular strain of virus although this has not been rigorously excluded.[ncbi.nlm.nih.gov]
Chills
  • Then headache and chills. I make you yellow with jaundice. I have two different homes to grow in. My urban life cycle hangs around houses. My sylvatic cycle uses monkeys in the jungle.[adoptamicrobe.blogspot.com]
Tachypnea
  • At examination, she had mild tachypnea. She did not have nuchal rigidity, focal neurologic signs, or a rash. Initial clinical tests results are shown in Table 1 . Test results for malaria were negative.[wwwnc.cdc.gov]
Vomiting
  • The majority of MVEV infections are sub-clinical, i.e. do not produce disease symptoms, although some people may experience a mild form of the disease with symptoms such as fever, headaches, nausea and vomiting and only a very small number of these cases[en.wikipedia.org]
  • "If people do become infected, the vast majority have no symptoms or only mild symptoms, including fever, headache, nausea and vomiting," Prof Phillips said.[news.com.au]
  • Some infections (about 1 in 800 cases) may produce mild fever, headache, nausea and vomiting.[sitata.com]
  • Some people do develop symptoms such as fever, headache, nausea, vomiting, and tiredness. People who get the virus may also develop severe disease.[wwwnc.cdc.gov]
  • Most infections are symptomless, although sometimes a mild form of illness can develop with fever, headache, nausea, and vomiting. Only a small number of people develop encephalitis as such.[viajarseguro.org]
Nausea
  • The majority of MVEV infections are sub-clinical, i.e. do not produce disease symptoms, although some people may experience a mild form of the disease with symptoms such as fever, headaches, nausea and vomiting and only a very small number of these cases[en.wikipedia.org]
  • "If people do become infected, the vast majority have no symptoms or only mild symptoms, including fever, headache, nausea and vomiting," Prof Phillips said.[news.com.au]
  • Some infections (about 1 in 800 cases) may produce mild fever, headache, nausea and vomiting.[sitata.com]
  • In adults and older children, symptoms include: fever drowsiness bad headache and stiff neck nausea muscle tremors dizziness. In young children the symptoms include: fever floppiness irritability drowsiness fits.[ww2.health.wa.gov.au]
  • Some people do develop symptoms such as fever, headache, nausea, vomiting, and tiredness. People who get the virus may also develop severe disease.[wwwnc.cdc.gov]
Hypertension
  • An emergent external ventricular drain was placed, and standard measures were taken to treat intracranial hypertension. Despite intervention, refractory intracranial hypertension developed (intracerebral pressure 70 mm H 2 O).[wwwnc.cdc.gov]
Photophobia
  • Other symptoms associated with Murray Valley encephalitis include: fever; headaches; vomiting; photophobia; fatigue; malaise; muscle weakness; aches and pains; unsteady gait; disorientation; seizures; sudden severe dementia; memory loss; as well as distinct[medigest.uk]
  • The danger signs of MVE encephalitis include the following symptoms: severe headache neck stiffness sensitivity to bright lights (photophobia) drowsiness and confusion.[health.nsw.gov.au]
Headache
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures.[news.com.au]
  • Some infections (about 1 in 800 cases) may produce mild fever, headache, nausea and vomiting.[sitata.com]
  • In adults and older children, symptoms include: fever drowsiness bad headache and stiff neck nausea muscle tremors dizziness. In young children the symptoms include: fever floppiness irritability drowsiness fits.[ww2.health.wa.gov.au]
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures," he said. The disease has no specific treatment or vaccine.[adelaidenow.com.au]
  • The majority of MVEV infections are sub-clinical, i.e. do not produce disease symptoms, although some people may experience a mild form of the disease with symptoms such as fever, headaches, nausea and vomiting and only a very small number of these cases[en.wikipedia.org]
Confusion
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures," he said. The disease has no specific treatment or vaccine.[adelaidenow.com.au]
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures.[news.com.au]
  • A previously healthy 19-year-old woman from Alberta, Canada, returned from Australia with increasing fatigue, fever, lethargy, and confusion.[wwwnc.cdc.gov]
  • Patients with the severe form of MVE get worse very quickly with confusion and worsening headaches, increasing drowsiness and possible fits. People with suspected Murray Valley encephalitis should be taken to the nearest hospital without delay.[ww2.health.wa.gov.au]
Seizure
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures," he said. The disease has no specific treatment or vaccine.[adelaidenow.com.au]
  • "In about one in 1000 cases, symptoms can worsen with increasing confusion, headaches, drowsiness, neck stiffness, tremors and seizures.[news.com.au]
  • Symptoms of the disease include severe headache, high fever, drowsiness, tremors and seizures, the department says. It can lead to delirium and coma as well as paralysis and brain damage.[abc.net.au]
  • […] not fully attributable to a pre-existing seizure disorder New onset of focal neurologic findings CSF WBC count 5 / mm3 Abnormality of brain parenchyma on neuroimaging suggestive of encephalitis that is either new from prior studies or appears acute in[lifeinthefastlane.com]
Rabies
  • These diseases range from polio and measles, to rabies, Varicella-zoster, Herpes, West Nile, Japanese encephalitis, and AIDS.[books.google.com]
  • Almost half of all suspected chikungunya cases reported since early January have been from the coastal health department of Kouilou (others are Bouenza, Pointe… 09 May 2019 A Norwegian woman, who had been travelling in SE Asia two months ago, has died of rabies[traveldoctor.com.au]
  • A large number of viruses have only occasional and minor ocular localizations ; among these are the viruses of psittacosis, dengue fever, foot and mouth disease, rabies, lymphocytic choriomeningitis and canine distemper.[jamanetwork.com]
  • PubMed Speers DJ , Flexman J , Blyth CC , Rooban N , Raby E , Ramaseshan G , et al. Clinical and radiological predictors of outcome for Murray Valley encephalitis. Am J Trop Med Hyg . 2013 ; 88 : 481 – 9 .[wwwnc.cdc.gov]
  • We also keep track of environmental risks (i.e. beach closures due to sewage) and animal diseases (i.e. foxes found with rabies) to provide you a broader picture of diseases in your area.[healthmap.org]
Meningism
  • B 27 - Investigation of Cerebrospinal Fluid and G 4 - Viral Encephalitis and Meningitis should be referred to for... West Nile virus Resources Key Messages West Nile virus (WNV) is transmitted to animals, birds and humans by mosquitoes.[evidence.nhs.uk]
  • […] especially in Australia Encephalitis is commonly fatal or results in significant morbidity PATHOPHYSIOLOGY inflammation of the brain parenchyma results in diffuse and/or focal neuropsychological dysfunction there may be coexistent involvement of the meninges[lifeinthefastlane.com]
  • Murray Valley Encephalitis Murray Valley Encephalitis is a viral infection of the brain, spinal cord or the meningeal lining caused by a member of the flavivirus family called Murray Valley Encephalitis virus.[travelhealthadvisor.com]
  • Encephalitis virus can commonly cause : Subclinical infection ; Relatively mild disease with features such as fever, headache, nausea and vomiting ; In some infected patients, mild disease may further progress to involve the central nervous system, causing meningitis[histopathology-india.net]
  • In about 1 in 1000 infected people symptoms worsen, with: increasing confusion headaches drowsiness possible seizures indicating progression to meningitis (inflammation of the lining of the brain and spinal cord) or encephalitis (infection or inflammation[sahealth.sa.gov.au]

Workup

  • Should there be a standardised approach to the diagnostic workup of suspected adult encephalitis? A case series from Australia. BMC Infect Dis. 2010 Dec 15;10:353. doi: 10.1186/1471-2334-10-353.[lifeinthefastlane.com]
Hyponatremia
  • Her admission was complicated by elevated intracranial pressure and obstructive hydrocephalus, requiring the insertion of an external ventricular drain, hyponatremia due to inappropriate antidiuretic hormone secretion, and respiratory failure due to respiratory[ajnr.org]
Gliosis
  • Satellitosis of a chromatolytic neuron with pyknotic nucleus (arrow); diffuse gliosis. Hematoxylin and eosin. Bar 50 µm.[oadoi.org]

Treatment

  • 22432670 Authors Knox J, Cowan RU, Doyle JS, Ligtermoet MK, Archer JS, Burrow JN, Tong SY, Currie BJ, Mackenzie JS, Smith DW, Catton M, Moran RJ, Aboltins CA, Richards JS Title Murray Valley encephalitis: a review of clinical features, diagnosis and treatment[genome.jp]
  • The disease has no specific treatment or vaccine.[adelaidenow.com.au]
  • Detection, treatment and prevention are also discussed. Included is coverage of novel and beneficial uses of neurotropic viruses for gene therapy and tumor lysis.[books.google.com]
  • Professor Phillips said MVE was a serious illness with no specific treatment or vaccine. The virus is spread through mosquito bites and was recently detected in birds in South Australia's lower Murray region.[news.com.au]

Prognosis

  • Treatment and prognosis There is no specific antiviral treatment available for MVE, and thus supportive management (e.g. antiepileptics, corticosteroids) is encouraged 1.[radiopaedia.org]
  • Worse prognosis if: extremes of age ( 55y) comorbidities immunodeficiency virulent organism References and links Lifeinthefastlane.com Anti-NMDA Receptor Encephalitis (CCC) HSV encephalitis (CCC) Journal articles Armangue T, Leypoldt F, Dalmau J.[lifeinthefastlane.com]

Etiology

  • This case serves as a cautionary reminder of other viral etiologies of encephalitis that should be considered for returning travelers, although many of these etiologies might be outside the diagnostic capability of many clinical laboratories.[wwwnc.cdc.gov]
  • The etiologic agent was West Nile (WN) virus (2,3), a member of the Japanese encephalitis virus complex (genus Flavivirus, family Flaviviridae), which includes other mosquito-transmitted human pathogens such as Japanese encephalitis virus, SLE virus,[medical-dictionary.thefreedictionary.com]
  • Japanese Encephalitis Viruses Japanese encephalitis virus group Viruses, Japanese Encephalitis Tree Number: B04.820.230.475 B04.820.250.350.300 Definition English : A subgroup of the genus FLAVIVIRUS which comprises a number of viral species that are the etiologic[decs.bvs.br]
  • Of the large number of ocular diseases whose etiologic basis has not yet been determined, some may well prove to be caused by viruses. As indicated graphically in figure 1, the viruses localizing in[jamanetwork.com]
  • […] methyl-4-isoxazolepropionic acid receptor (AMP A-R), anti-glycine receptor (GlyR), anti-dipeptidyl-peptidase-like protein-6 (DPPX), anti- metabotropic glutamate receptor 5 (mGlu-R5) post-viral (e.g. zoster cerebellitis in children) Unique infectious etiologies[lifeinthefastlane.com]

Epidemiology

  • Natalie Prow, The Changing Epidemiology of Kunjin Virus in Australia, International Journal of Environmental Research and Public Health, 10, 12, (6255), (2013).[doi.org]
  • As such, this case has significant implications for public health surveillance, epidemiology, and the understanding of MVEV evolution.[ncbi.nlm.nih.gov]
  • Hall, RA, Broom, AK, Smith, DW, Mackenzie, JS: 2002, The ecology and epidemiology of Kunjin virus. Curr Top Microbiol Immunol 267: 253 – 269. Google Scholar Medline 10.[oadoi.org]
  • The changing epidemiology of Murray Valley encephalitis in Australia: the 2011 outbreak and a review of the literature. PLoS Negl Trop Dis . 2014 ; 8 : e2656 .[wwwnc.cdc.gov]
Sex distribution
Age distribution

Pathophysiology

  • […] soon as the diagnosis is suspected Always consider epidemiological factors that may indicate an unusual cause of encephalitis (e.g. arboviruses and zoonoses), especially in Australia Encephalitis is commonly fatal or results in significant morbidity PATHOPHYSIOLOGY[lifeinthefastlane.com]

Prevention

  • What can travelers do to prevent Murray Valley encephalitis? There is no vaccine or medicine that prevents MVE. Travelers can protect themselves from MVE by preventing mosquito bites.[wwwnc.cdc.gov]
  • Preventative Measures Avoiding mosquito bites is the best way to prevent this infection.[sitata.com]
  • Thus, the enhanced affinity of the attenuated variants for GAGs ubiquitously present on cells and extracellular matrices most likely prevented viremia of sufficient magnitude and/or duration required for virus entry into the brain parenchyma.[ncbi.nlm.nih.gov]
  • Detection, treatment and prevention are also discussed. Included is coverage of novel and beneficial uses of neurotropic viruses for gene therapy and tumor lysis.[books.google.com]

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