澳大利亚1990–2007年脑炎的病因

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Etiology of Encephalitis in Australia, 1990–2007
美国Emerging Infectious Diseases2009年第9期
Abstract
Encephalitis is a clinical syndrome commonly caused by emerging pathogens, which are not under surveillance in Australia. We reviewed rates of hospitalization for patients with encephalitis in Australia's most populous state, New South Wales, from January 1990 through December 2007. Encephalitis was the primary discharge diagnosis for 5,926 hospital admissions; average annual hospitalization rate was 5.2/100,000 population. The most commonly identified pathogen was herpes simplex virus (n = 763, 12.9%). Toxoplasma encephalitis and subacute sclerosing panencephalitis showed notable declines. The average annual encephalitis case-fatality rate (4.6%) and the proportion of patients hospitalized with encephalitis with no identified pathogen (69.8%, range 61.5%–78.7%) were stable during the study period. The nonnotifiable status of encephalitis in Australia and the high proportion of this disease with no known etiology may conceal emergence of novel pathogens. Unexplained encephalitis should be investigated, and encephalitis hospitalizations should be subject to statutory notification in Australia.
脑炎是一种临床常见的综合症，由新兴的病原体引起，在澳大利亚这些病原体不在监测范围。从1990年1月到2007年12月，我们回顾了澳大利亚人口最多的新南威尔士州脑炎病人的住院率。调查了以脑炎为主要出院诊断的5,926例入院病人，其年平均住院率为5.2/100,000，最常见的病原体是单纯疱疹病毒(n = 763, 12.9%)。弓形虫脑炎及亚急性硬化性全脑炎出现明显地下降。脑炎每年的平均病死率是4.6%，由未知病原体引起的脑炎患者占以脑炎为出院诊断的患者的比例为(69.8%, 范围从61.5%至78.7%)，这些数据在研究期间都很稳定。在澳大利亚脑炎未申报的状况以及由未知病原体引起的脑炎所占比例高的情形显示新病原体的出现。在澳大利亚对未知病因的脑炎应当进行调查，同时对患脑炎住院的患者应当进行法定的申报。

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