Human outbreak of St. Louis encephalitis detected in Argentina, 2005

Abstract 

Background

An outbreak of flavivirus encephalitis occurred in 2005 in Córdoba province, Argentina.

Objectives

To characterize the epidemiologic and clinical features of that outbreak and provide the serologic results that identified St. Louis encephalitis virus (SLEV) as the etiologic agent.

Study design

From January to May 2005, patients with symptoms of encephalitis, meningitis, or fever with severe headache were evaluated and an etiologic diagnosis achieved by detection of flavivirus-specific antibody sera and cerebrospinal fluid.

Results

The epidemic curve of 47 cases showed an explosive outbreak starting in January 2005 with one peak in mid-February and a second peak in mid-March; the epidemic ended in May. Cases occurred predominantly among persons 60 years and older. Nine deaths were reported. SLEV antibodies, when detected in 47 patients studied, had a pattern characteristic of a primary SLEV infection.

Conclusions

Even though isolated cases of St. Louis encephalitis have been reported in Argentina, this is the first description of a large SLEV encephalitis outbreak in Argentina.

Abbreviations: SLEV, St. Louis encephalitis virus, CNS, central nervous system, CSF, cerebrospinal fluid, IgM, immunoglobulin M, MAC-ELISA, IgM-capture enzyme-linked immunosorbent assay, IFA, immunofluorescent assay, IH, hemagglutination inhibition, PRNT, plaque reduction neutralization test, UTMB, University of Texas Medical Branch, YF, yellow fever, DEN-1, DEN-2, DEN-3, dengue 1, 2, 3, ILH, Ilheus, ROC, Rocio, WN, West Nile

Keywords: St. Louis encephalitis virus, Encephalitis outbreak, SLEV antibodies, Argentina