Emerging epidemic viral encephalitides with a special focus on henipaviruses |
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Authors: | Kum Thong Wong |
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Institution: | (1) Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia |
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Abstract: | In the last few decades, there is an increasing emergence and re-emergence of viruses, such as West Nile virus, Enterovirus
71 and henipaviruses that cause epidemic viral encephalitis and other central nervous system (CNS) manifestations. The mortality
and morbidity associated with these outbreaks are significant and frequently severe. While aspects of epidemiology, basic
virology, etc., may be known, the pathology and pathogenesis are often less so, partly due to a lack of interest among pathologists
or because many of these infections are considered “third world” diseases. In the study of epidemic viral encephalitis, the
pathologist’s role in unravelling the pathology and pathogenesis is critical. The novel henipavirus infection is a good example.
The newly created genus Henipavirus within the family Paramyxoviridae consists of two viruses, viz., Hendra virus and Nipah virus. These two viruses emerged in Australia and Asia, respectively,
to cause severe encephalitides in humans and animals. Studies show that the pathological features of the acute encephalitis
caused by henipaviruses are similar and a unique dual pathogenetic mechanism of vasculitis-induced microinfarction and parenchymal
cell infection in the CNS (mainly neurons) and other organs causes severe tissue damage. Both viruses can cause relapsing
encephalitis months and years after the acute infection due to a true recurrent infection as evidenced by the presence of
virus in infected cells. Future emerging viral encephalitides will no doubt continue to pose considerable challenges to the
neuropathologist, and as the West Nile virus outbreak demonstrates, even economically advanced nations are not spared. |
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