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Murray Valley encephalitis in an adult traveller complicated by long-term flaccid paralysis: case report and review of the literature

Douglas, M. W., Stephens, D. P., Burrow, James N. C., Anstey, Nicholas M., Talbot, K. and Currie, Bart J. (2007). Murray Valley encephalitis in an adult traveller complicated by long-term flaccid paralysis: case report and review of the literature. Transactions of the Royal Society of Tropical Medicine and Hygiene,101(3):284-288.

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Title Murray Valley encephalitis in an adult traveller complicated by long-term flaccid paralysis: case report and review of the literature
Author Douglas, M. W.
Stephens, D. P.
Burrow, James N. C.
Anstey, Nicholas M.
Talbot, K.
Currie, Bart J.
Journal Name Transactions of the Royal Society of Tropical Medicine and Hygiene
Publication Date 2007
Volume Number 101
Issue Number 3
ISSN 0035-9203   (check CDU catalogue open catalogue search in new window)
Start Page 284
End Page 288
Place of Publication Oxford
Publisher Elsevier
HERDC Category C1 - Journal Article (DEST)
Abstract Murray Valley encephalitis (MVE) virus, a mosquito-borne flavivirus, is the most common cause of viral encephalitis in the tropical 'Top End' of northern Australia. Clinical encephalitis due to MVE virus has a mortality rate of approximately 30%, with a similar proportion of patients being left with significant neurological deficits. We report the case of a 25-year-old man from the UK who acquired MVE while travelling through northern Australia. He required prolonged admission to the Intensive Care Unit and several years later remains partly ventilator-dependent, with flaccid quadriparesis. To our knowledge, this is the first reported case of MVE virus-induced flaccid paralysis in an adult in northern Australia, although it is well described in children. Paralysis was thought to be due to anterior horn cell involvement in the spinal cord and extensive bilateral thalamic destruction, both of which are well recognised complications of infection with MVE virus. Cases of flaccid paralysis with similar pathology have been described following infection with the related flavivirus Japanese encephalitis virus as well as more recently with West Nile virus. Our case highlights the potential severity of flavivirus-induced encephalitis and the importance of avoiding mosquito bites while travelling through endemic areas. (c) 2006 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
Keywords viral encephalitis
encephalitis virus
Murray Valley
quadriplegia
paralysis
flavivirus infections
Australia
WEST-NILE-VIRUS
JAPANESE ENCEPHALITIS
AUSTRALIAN ENCEPHALITIS
POLIOMYELITIS
INFECTION
FEATURES
DOI http://dx.doi.org/10.1016/j.trstmh.2006.09.005   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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