A study on epidemiology, demographic and clinical presentation of acute encephalitis syndrome in children admitted to a tertiary care hospital in Central Gujarat

Rinki H. Shah; Riddhi Dangar

doi:10.18203/2349-3291.ijcp20260825

Authors

Rinki H. Shah Department of Paediatrics, Medical College Baroda, Gujarat, India
Riddhi Dangar Department of Paediatrics, Medical College Baroda, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260825

Keywords:

Acute encephalitis syndrome, Altered sensorium, Status epilepticus, Refractory shock

Abstract

Background: Acute Encephalitis Syndrome is a major public health problem in major parts of the world especially in South and South East Asia. Globally, viral infections remain the most common cause of encephalitis in children. Present study was done to identify epidemiology, demographic and clinical presentation of Acute Encephalitis Syndrome in Children.

Methods: This was tertiary care hospital based retrospective study. Data were collected form case record forms from month of July 2024 till December 2024. 57 patients fulfilling the criteria of AES in the age group of 1-12 years were enrolled in the study. Detailed history and investigations were sent including molecular testing of viral titre.

Results: Total 57 children were enrolled. Mean age of presentation was 3.8 years. Majority of cases occur were seen in children less than 6 years of age. Slight male predominance (30 males=52.6% and 27 female 47.4%) was observed. Most patients were referred from rural area. Case fatality rate was observed to be 54.39%. 22 children were discharged while 4 patients went LAMA. CHPV was detected in 7 patients (12.28%) and Japanese encephalitis in one patient (1.75%). Fever was the major presenting complaint (85.96%) while vomiting was presenting complaints in 36 patients (63.16%). Altered sensorium was present in 23 patients (40.35%).

Conclusions: AES remains a life-threatening neurological emergency in children. Young age, rural residence and severe clinical presentation contribute to poor outcome. Strengthening surveillance, early diagnosis and critical care management are essential to reduce mortality and long-term neurological sequelae.

Author Biography

Riddhi Dangar, Department of Paediatrics, Medical College Baroda, Gujarat, India

Third year Resident , Department Of Pediatrics

References

Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT. Japanese encephalitis. Lancet. 2000;355(9206):869-80.

World Health Organization. Japanese encephalitis surveillance standards. Geneva: World Health Organization. 2008. Available at: https://www.who.int/newsroom/factsheets/detail/japanese-encephalitis. Accessed on 11 February 2026.

Ministry of Health and Family Welfare, Government of India. Guidelines for surveillance of Acute Encephalitis Syndrome (AES). New Delhi: Directorate of National Vector Borne Disease Control Programme. 2014. Available at: https://nvbdcp.gov.in/index1.php?lang=1&level=2&sublinkid=459&lid=317. Accessed on 11 February 2026.

Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis. 2010;10(12):835-44.

Misra UK, Kalita J. Overview: Japanese encephalitis. Prog Neurobiol. 2010;91(2):108-20.

Murhekar MV, Wesley J, Candasamy VT, Sadananda, Mittal M, Gupta N, et al. Investigations of seasonal outbreaks of acute encephalitis syndrome due to Orientia tsutsugamushi in Gorakhpur region, India: A One Health case study. Indian J Med Res. 2021;153:375-81.

Singh G, Mani C, Ranjan A, Agrawal N, Pandey S, Kumar P, et al. Determinants of Acute Viral Encephalitis in Muzaffar Nagar District of Bihar, India. Clin epidemiol glob health. 2016;4:181-7.

Tripathy SK, Mishra P, Bhagirathi D, Lipsa P, Ranjan RD. Clinico-epidemiological Study of Viral Acute Encephalitis Syndrome Cases and Comparison to Nonviral Cases in Children from Eastern India. J Glob Infect Dis. 2019;11(1):7-12.

Sushmitha M, Chetty S, Rao VSR. A study on etiological profile of children admitted with acute encephalitis syndrome. Int J Contemp Pediatr. 2025;12:779-83.

Ravi V, Mani R, Govekar S, Deasai A, Lakshman L, Ravikumar BVl. Aetiology and laboratory diagnosis of Acute Encephalitis Syndrome with special reference to India. J Communicable Dis. 2024;46:12-23.

Sambasivan K, Iyer R, Thomas T. Hyponatremia in acute encephalitis syndrome; prevalence and clinical implications. Int J Contemp Pediatr. 2020;7(6):1284-8.

Sharma P, Parmar K, Datta A, Ghosh B, Sarmah D, Borah A, et al. Recent Progress and Challenges of acute encephalitis syndrome; an update on pathogenesis and interventional approaches. Brain Disord. 2025;19:100267.

Rathore SK, Dwibedi B, Kar SK, Dixit S, Sabat J, Panda M. Viral aetiology and clinico-epidemiological features of acute encephalitis syndrome in eastern India. Epidemiol Infect. 2014; 142(12):2514-21.

Misra UK, Mani VE, Kalita J. A Cost-Effective Approach to the Diagnosis and Management of Acute Infectious Encephalitis. Eur Neurol. 2017;77(2):66-74.

Rebecca B, Thomas M, Abraham AM, Yoganathan S, Jacob E, Kumar S, et al. Acute Encephalitis Syndrome in children and Adolescents; A Five-Year Descriptive Study from South India. Indian Pediatr. 2024;61:413-8.