Research Priorities in Acute Encephalitis Syndrome (AES)

Acute encephalitis syndrome (AES) is a constellation of clinical signs and/ or symptoms, i.e. acute fever, with an acute change in mental status and/ or new onset of seizures that signifies acute inflammation of brain cells. Although viruses have been identified as the major etiological agents for this syndrome, a range of pathogens including acute bacterial or parasitic infection have also been attributed. In Asia, the major identified cause of acute encephalitis is Japanese Encephalitis (JE) virus. JE affects over 50,000 people annually, leading to 8- 30% mortality and 50- 60% disability, with children bearing the brunt of the disease. These outbreaks affect over 5,000 people annually in India, most of them being children. Many are left permanently disabled and as many as 700 people die each year. The Eastern region of Uttar Pradesh has been especially hard hit with a recurring outbreak in the rainy season each year, the primary cause of which remains uncertain. Although ICMR research institutions like National Institute of Virology (NIV), Enterovirus Research Centre, Mumbai, Vector Control Research Centre (VCRC), National Institute of Epidemiology (NIE), Centre for Research in Medical Entomology (CRME) etc are engaged in research activities dealing with various aspects of the disease, but have achieved limited success in identifying the aetiological agents. Therefore, there is a need to define research priorities in India to conduct focussed research that identifies the etiological agents for better management and treatment of AES cases to help reduce the morbidity as well as mortality associated with AES