Abstract
IntroductionConvulsions associated with fever and acute onset of unknown aetiology with case fatalities have become a long observed medical condition at the Child Health Department of the Korle-Bu Teaching Hospital. Children admitted to the department with seizures of undetermined origin and fever has been a source of diagnostic confusion. Studies from the Asia Pacific region suggest a link with non-polio enteroviruses. The aim of the study was to investigate the association between non-polio enterovirus and acute encephalopathy causing neurological morbidity in children.MethodsOne hundred and fifty cerebrospinal fluid (CSF), throat swab and serum samples were collected from participants at the Child Health Department of the Korle-Bu Teaching Hospital for virus isolation and characterization. Samples were cultured on cells and positive culture assayed by microneutralisation. Direct PCR as well as multiplex PCR were used to detect other viral agents present.ResultsEnterovirus isolation rate was approximately 0.67%. Intratypic differentiation by molecular characterization identified a poliovirus from vaccine origin. Further screening by real-time RT-PCR identified the virus as normal Sabin and not vaccine-derive poliovirus. No arbovirus was however detected.ConclusionNon-polio enteroviruses and chikugunya virus were found not to be the etiologic agent responsible for the convulsion with neurologic morbidity observed in the Ghanaian children. Investigation for other viral agents is recommended.
Highlights
Convulsions associated with fever and acute onset of unknown aetiology with case fatalities have become a long observed medical condition at the Child Health Department of the Korle-Bu Teaching Hospital
Convulsions includes seizures lasting for at least half an hour, or convulsions followed by coma lasting two hours or more or convulsions followed by paralysis or other neurological signs not previously present and lasting 24 hours or more and convulsions that presented as encephalitis [32,33,34]
Patients were managed with anticonvulsants, antibiotics, antimalarial and antivirals which were combined with Paracetamol, intravenous fluid (IVF) and oral rehydration salt (ORS) depending on the clinical presentation
Summary
Convulsions associated with fever and acute onset of unknown aetiology with case fatalities have become a long observed medical condition at the Child Health Department of the Korle-Bu Teaching Hospital. The aim of the study was to investigate the association between non-polio enterovirus and acute encephalopathy causing neurological morbidity in children. Conclusion: Nonpolio enteroviruses and chikugunya virus were found not to be the etiologic agent responsible for the convulsion with neurologic morbidity observed in the Ghanaian children. Epidemiologic investigations have revealed that approximately 150,000 children will sustain a first-time, unprovoked seizure each year, and of those, 30,000 will develop epilepsy with the highest risk being among children with prior condition of neurodevelopmental abnormality and family history of afebrile seizures [6,8]. Some of the viruses implicated in cases of convulsion include Human herpesvirus 6 [15,16], influenza A [17,18], Chikungunya virus [19,20] and Human enterovirus 71 [21,22]
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