Isolation of influenza virus A(H3) from an encephalopathy child, November 1999 - Hokkaido
(IASR 2000; 21: 8-8)

A case report

A five years old male had frequent history of febrile convulsion since he was one and half year old. Since June 1998, he was given by valproic acid, and convulsion was well controlled. On November 29, 1999, he developed fever at noon, and he returned home from kindergarten to receive an antipyretic suppository (acetaminophen). Then, he visited the Department of Pediatric, Hokkaido Syakai-hoken Chuo Hospital. At the waiting room of the outpatient department, he presented generalized tonic convulsion, which lasted 1-2 minutes, and he became drowsy. After admission, he developed the same convulsion once again. Computed Tomography (CT) at that time revealed cerebral edema. Rapid diagnostic kit (Derectigen Flu A) detected influenza A from gargled water, so that influenza encephalopathy was suspected. Amantadine, glyceol, and decadron were given immediately. Following morning, consciousness level improved, he remained drowsy, however. Electroencephalogram showed slow waves, therefore, ulinastatin was added. Consciouness resumed clear on December 5, and he recovered afterward. He had not had history of influenza immunization.

Blood chemistry upon arrival; WBC 7,300/mm3, RBC 4.15mil/mm3, Hb 11.5g/dL, Ht 35.1%, Plat 242thou/mm3, CRP (-), NH3 64 ug/dL, GOT 19 IU, GPT 9 IU, LDH 377 U/L, CK 71 U/L, urine; normal, throat swab; Alfa Streptococcus (+), CSF; normal.

Gargled water at admission was inoculated onto the MDCK cell and the CaCo-2 cell. Virus was isolated from the MDCK cell. Hemagglutinin Inhibition (HI) test, using the ferret anti-sera supplied by the Influenza Center NIID, was carried out. Antibody titer against influenza A/Sydney/5/97 (H3N2) increased 1:320.

Reported by Shigeo Iki and Masahiro Miyoshi, The Hokkaido Institute of Public Health; Keiko Tatsuno and Hiroyuki Sawada, Dept. of Pediatrics, Hokkaido Syakai-hoken Chuo Hospital; and Takehiro Togashi, The Sapporo City General Hospital.

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