Preface

Chapter 7 **Genetic and Biological Properties of Original TBEV Strains Group Circulating in Eastern Siberia 95**

Chapter 8 **The Pathomorphology of Far Eastern Tick-Borne**

Kaminsky and Anna Y. Fisenko

**West Region of Ukraine 145**

Shulgan and R. Morochkovski

**Emerging Pathogen 161**

and Madhavan P. N. Nair

Kaliyaperumal Karunamoorthi

Yongxin Yu

**Far East 231**

**Virus Infection 251**

**Encephalitis 113**

**VI** Contents

I.V. Kozlova, M.M. Verkhozina, T.V. Demina, Yu.P. Dzhioev, S.E. Tkachev, L.S. Karan, E.K. Doroshchenko, O.V. Lisak, O.V. Suntsova, A.I. Paramonov, O.O. Fedulina, A.O. Revizor and V.I. Zlobin

Larisa M. Somova, Galina N. Leonova, Natalia G. Plekhova, Yurii V.

I. Lozynski, H. Biletska, O. Semenyshyn, V. Fedoruk, O. Drul, I. Ben, A.

Shailendra K. Saxena, Sneham Tiwari, Rakhi Saxena, Asha Mathur

Chapter 9 **Active Natural Foci of Tick-Borne Neuroinfection in the North-**

Chapter 11 **Development of Japanese Encephalitis Attenuated Live Vaccine**

Chapter 12 **Yellow Fever Encephalitis: An Emerging and Resurging Global Public Health Threat in a Changing Environment 207**

> Galina N. Leonova, Larisa M. Somova, Sergei I. Belikov, Il'ya G. Kondratov, Natalya G. Plekhova, Natalya V. Krylova, Elena V.

> Tomoyuki Honda, Misako Yoneda, Hiroki Sato and Chieko Kai

Chapter 10 **Japanese Encephalitis Virus: The Complex Biology of an**

**Virus SA14-14-2 and its Charcteristics 181**

Chapter 13 **The Fatal Case of Lyssavirus Encephalitis in the Russian**

Pavlenko, Mikhail P. Tiunov and Sergey E. Tkachev

Chapter 14 **Pathogenesis of Encephalitis Caused by Persistent Measles**

Chapter 15 **Viral Encephalitis with Focus on Human Enteroviruses 263**

Po-Ying Chia and Justin Jang Hann Chu

Encephalitises are a group of inflammatory human and animal diseases of brain caused essentially by different pathogens. In spite of evident success in approaches for prevention, diagnostics and treatment during the last decades, the encephalitises of different etiology still constitute a menace for thousands of people all around the world.

Recently, three-volume book was published by InTech, including the first "Flavivirus Encephalitis" (edited by Daniel Růžek), the second "Non-Flavivirus Encephalitis" (edited by Sergey Tkachev) and the third "Pathogenesis of Encephalitis" (edited by Daisuke Hayasaka) parts, which can be found on InTech site (http://www.intechopen.com). But a lot of different aspects and information were not included in these volumes so we decided to publish the additional book.

The first part of this book is devoted to encephalitis clinical diagnostics and treatment. Proper diagnosis definition is an important step in encephalitis treatment so the 1st chapter considers the questions of clinical management of the patient and includes step-by-step instructions for encephalitis diagnostics.

In some cases the abnormalities in encephalitis clinical course or symptoms similar to encephalitis can be observed so the physicians should pay special attention to such patients. The 2nd and 3rd chapter describe the cerebrospinal fluid abnormalities that could be seen in some cases during the viral encephalitis and the cases of spontaneous intracranial hypotension that could be erroneously taken for encephalitis.

One of the important questions of any pathogen study is the epidemiology and monitoring and prediction of the epidemiological situation. Chapters 4 and 5 give the example of such monitoring of the encephalitis cases caused by viral pathogens in Japan and Nepal.

The members of different virus species are known to be the causative agents of encephalitis, so the second part of the book is devoted to viral pathogens, their epidemiology, pathology and diagnostics. Probably, the arboviruses (and especially members of the genus Flavivirus) are known to be one of the most known and frequent causative agents of encephalitis, so the following chapters are about arboviruses-induced encephalitises. The short review on causative agents of arboviral encephalitis is presented in Chapter 6. Chapters 7-12 are devoted to flaviviruses, their epidemiology, pathology and vaccine design. The attention should be paid to chapter seven which presents new tick-borne encephalitis virus group that was demonstrated to cause focal forms of tick-borne encephalitis with lethal outcome and has high pathogenic potential.

Other virus species are also known to be the causative agents of encephalitis, so the last chapters are devoted to non-arbovirus pathogens. Chapter 13 describes the fatal case of Lissavirus encephalitis on the Russian Far-East. The detailed characteristics of the genetic, biological and pathological properties of isolated virus strain were determined. Chapter 14 is devoted to issues of pathogenesis of encephalitis caused by measles virus. The last chapter of the book focuses on encephalitis caused by enteroviruses which (especially Enterovirus71 (EV71)) have been documented to cause epidemics.

The authors and editors of the book hope that this work might increase the interest in this field of research and that the readers will find it useful for their investigations and clinical usage. Also I would like to thank my family, parents and colleagues who gave me a lot of support during the work on this book.

> **Sergey Tkachev** Laboratory of Molecular Microbiology, Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk, Russia

**Section 1**

**Encephalitis Clinical Diagnostics and Treatment**

**Encephalitis Clinical Diagnostics and Treatment**

Lissavirus encephalitis on the Russian Far-East. The detailed characteristics of the genetic, biological and pathological properties of isolated virus strain were determined. Chapter 14 is devoted to issues of pathogenesis of encephalitis caused by measles virus. The last chapter of the book focuses on encephalitis caused by enteroviruses which (especially Enterovirus71

The authors and editors of the book hope that this work might increase the interest in this field of research and that the readers will find it useful for their investigations and clinical usage. Also I would like to thank my family, parents and colleagues who gave me a lot of

**Sergey Tkachev**

Novosibirsk, Russia

Laboratory of Molecular Microbiology,

Institute of Chemical Biology and Fundamental Medicine SB RAS,

(EV71)) have been documented to cause epidemics.

support during the work on this book.

VIII Preface

**Chapter 1**

**The Clinical Management of**

**the Patient with Encephalitis**

Mohammed M. Hassoon

http://dx.doi.org/10.5772/55171

**1. Introduction**

**1.1. Initial approach**

approach is employed.

Almas Khawar Ahmed, Zakareya Gamie and

Additional information is available at the end of the chapter

It is important to follow a structured systematic approach to ensure good clinical care of the patient and to aid diagnosis. In an acute situation, the patient's airway, breathing and circu‐ lation must be assessed. Therefore, a Primary survey is undertaken and for this an ABCD

Determining the patency of the airway is crucial for the survival of the patient. In the general assessment of airway patency a clinician must observe the face and the neck. Abnormalities in the jaw mouth and neck must be noted as these could lead to airway compromise and future complications. Speaking to the patient for example by asking their name and observing their response, such as able to communicate in full sentences is a good indicator of unobstructed airways. Changes in vocalisation can be due to Asthma, COPD, emboli, oedema or even pneumonia. If any of these conditions are suspected a definitive diagnosis must be obtained

The second stage of the primary survey is the assessment of breathing. We begin with observation of the patient. Looking for signs of respiratory distress is important and failure to recognise this can lead to fatal consequences. Signs of respiratory distress can be the use of

Observation of the chest for any deformity is important but systemic observation is crucially important as well because it can show signs of cyanosis. At this point the respiratory rate needs to me measured. Then proceed to auscultate the chest and then end in percussion. Oximetry

and reproduction in any medium, provided the original work is properly cited.

© 2013 Ahmed et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

accessory muscles or changes in chest movement and in some cases even both.

as any of these could lead to further deterioration of the patient.

is also undertaken to determine the patient's oxygen saturations.

**Chapter 1**
