Guowei Wang, Lianmei Zhong, Manxia Wang, Juan Zhou, Shuting Liu, Wang Miao, Leilei Li, Yonghong Liu, Shougang Guo, Haining Li, Xiaoming Wang, Liuqing Xie, Min Xie, Shihong Fu, Tingting Xuan, Fan Li, Tingting Yang, Lufei Shao, Mingfang Shi, Xiaocong Li, Xiaoling Li, Li Gao, Shaopeng Zhai, Jia Ding, Tianhong Wang, Dayong Liu, Guosheng Ma, Jiang Wu, Dongjun Wan, Junlin Guo, Xinbo Zhang, Jinxia Wu, Yinxu Wang, Ansong Jin, Lei Ma, Huan Yang, Xuexian He, Xiaona Ma, Huijuan Liu, Boya Ma, Ningai Yang, Xiaolin Hou, Ting Xu, Cheng-feng Qin, Huanyu Wang, Peng Xie, and Zhenhai Wang
ABSTRACTPreviously, we reported a cohort of Japanese encephalitis (JE) patients with Guillain–Barré syndrome. However, the evidence linking Japanese encephalitis virus (JEV) infection and peripheral nerve injury (PNI) remains limited, especially the epidemiology, clinical presentation, diagnosis, treatment, and outcome significantly differ from traditional JE. We performed a retrospective and multicenter study of 1626 patients with JE recorded in the surveillance system of the Chinese Center for Disease Control and Prevention, spanning the years 2016–2020. Cases were classified into type 1 and type 2 JE based on whether the JE was combined with PNI or not. A comparative analysis was conducted on demographic characteristics, clinical manifestations, imaging findings, electromyography data, laboratory results, and treatment outcomes. Among 1626 laboratory confirmed JE patients, 230 (14%) were type 2 mainly located along the Yellow River in northwest China. In addition to fever, headache, and disturbance of consciousness, type 2 patients experienced acute flaccid paralysis of the limbs, as well as severe respiratory muscle paralysis. These patients presented a greater mean length of stay in hospital (children, 22 years [range, 1–34]; adults, 25 years [range, 0–183]) and intensive care unit (children, 16 years [range, 1–30]; adults, 17 years [range, 0–102]). The mortality rate was higher in type 2 patients (36/230 [16%]) compared to type 1 (67/1396 [5%]). The clinical classification of the diagnosis of JE may play a crucial role in developing a rational treatment strategy, thereby mitigating the severity of the disease and potentially reducing disability and mortality rates among patients.