1887

Journal of Medical Microbiology logo

Volume 69, Issue 2

The longitudinal health economic impact of viral encephalitis in the United States Free

Abstract

Previous studies of viral encephalitis have focused on acute costs, estimating incidence at 7.3 per 100 000 and total US annual charges at $2 billion in 2010.

We aim to quantify the most updated longitudinal health economic impact of viral encephalitis in the USA from 2008 to 2015.

Data on patients diagnosed with viral encephalitis were obtained from the Truven Health Analytics MarketScan database. Patients with a primary diagnosis of viral encephalitis, from herpetic viruses and other viral aetiologies (e.g. West Nile fever) were included in the analysis. Data concerning healthcare resource utilization, inpatient mortality, length of stay and accrued healthcare costs were collected for up to 5 years.

Among 3985 patients with continuous enrolment for 13 months prior to the encephalitis diagnosis, more non-herpes simplex encephalitis (61.7 %) than herpes simplex encephalitis (HSE; 38.3 %) cases were recorded, with the majority concentrated in the southern USA (29.2 %). One-year inpatient mortality was 6.2 %, which over a 5-year period rose to 8.9 % for HSE and 5.8 % for all other viral encephalitides. HSE resulted in longer cumulative stays in the hospital (11 days vs. 4 days; =0.0025), and accrued 37 % higher first-year costs, after adjusting for known confounders [<0.001, cost ratio=1.37, 95 % confidence interval (1.20, 1.57)]. Additionally, HSE was associated with greater 5-year cumulative median charges ($125 338 vs. $82 317, =0.0015).

The health economic impact and long-term morbidity of viral encephalitis in the USA are substantial.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): encephalitis , healthcare resource utilization , infectious disease , prevalence , viral encephalitis and viral infections
Funding
This study was supported by the:
  • National Institutes of Health (Award UL1TR001117)
    • Principle Award Recipient: Shivanand P. Lad
© 2020 The Authors
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001153
2020-02-10
2024-04-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/69/2/270.html?itemId=/content/journal/jmm/10.1099/jmm.0.001153&mimeType=html&fmt=ahah

References

  1. Granerod J, Ambrose HE, Davies NWS, Clewley JP, Walsh AL et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010; 10:835–844 [View Article]
     [Google Scholar]
  2. Lee TC, Tsai CP, Yuan CL et al. Encephalitis in Taiwan: a prospective hospital-based study. Jpn J Infect Dis 2003; 56:193–199
     [Google Scholar]
  3. Koskiniemi M, Rantalaiho T, Piiparinen H, von Bonsdorff C-H, Färkkilä M et al. Infections of the central nervous system of suspected viral origin: a collaborative study from Finland. J Neurovirol 2001; 7:400–408 [View Article]
     [Google Scholar]
  4. Davison KL, Crowcroft NS, Ramsay ME, Brown DW, Andrews NJ. Viral encephalitis in England. 1989–1998: what did we miss? Emerg Infect Diseases 2003; 9:234
     [Google Scholar]
  5. Nicolosi A, Hauser WA, Beghi E, Kurland LT. Epidemiology of central nervous system infections in Olmsted County, Minnesota, 1950-1981. Journal of Infectious Diseases 1986; 154:399–408 [View Article]
     [Google Scholar]
  6. Granerod J, Crowcroft NS. The epidemiology of acute encephalitis. Neuropsychol Rehabil 2007; 17:406–428 [View Article]
     [Google Scholar]
  7. Mailles A, Stahl Jean‐Paul, Stahl JP. Infectious encephalitis in France in 2007: a national prospective study. Clin Infect Dis 2009; 49:1838–1847 [View Article]
     [Google Scholar]
  8. Whitley RJ, Kimberlin DW. Herpes simplex: encephalitis children and adolescents. Seminars in Pediatric Infectious Diseases 16 2005 pp 17–23 [View Article]
     [Google Scholar]
  9. Hanley DF, Johnson RT, Whitley RJ, Yes WRJ. Yes, brain biopsy should be a prerequisite for herpes simplex encephalitis treatment. Arch Neurol 1987; 44:1289–1290 [View Article]
     [Google Scholar]
  10. Tyler KL, Tedder DG, Yamamoto LJ, Klapper JA, Ashley R et al. Recurrent brainstem encephalitis associated with herpes simplex virus type 1 DNA in cerebrospinal fluid. Neurology 1995; 45:2246–2250 [View Article]
     [Google Scholar]
  11. Hart RP, Kwentus JA, Frazier RB, Hormel TL. Natural history of Klüver-Bucy syndrome after treated herpes encephalitis. South Med J 1986; 79:1376–1378 [View Article]
     [Google Scholar]
  12. Fisher CM. Hypomanic symptoms caused by herpes simplex encephalitis. Neurology 1996; 47:1374–1378 [View Article]
     [Google Scholar]
  13. George BP, Schneider EB, Venkatesan A. Encephalitis hospitalization rates and inpatient mortality in the United States, 2000-2010. PLoS One 2014; 9:e104169 [View Article]
     [Google Scholar]
  14. Tyler KL. Emerging viral infections of the central nervous system: Part 1. Arch Neurol 2009; 66:939–948
     [Google Scholar]
  15. Peterson AT, Vieglais DA, Andreasen JK. Migratory birds modeled as critical transport agents for West Nile virus in North America. Vector-Borne and Zoonotic Diseases 2003; 3:27–37 [View Article]
     [Google Scholar]
  16. Mostashari F, Bunning ML, Kitsutani PT, Singer DA, Nash D et al. Epidemic West Nile encephalitis, New York, 1999: results of a household-based seroepidemiological survey. The Lancet 2001; 358:261–264 [View Article]
     [Google Scholar]
  17. Armstrong PM, Andreadis TG. Eastern equine encephalitis virus — old enemy, new threat. N Engl J Med 2013; 368:1670–1673 [View Article]
     [Google Scholar]
  18. Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J et al. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis 2013; 57:1114–1128 [View Article]
     [Google Scholar]
  19. Whitley RJ, Soong SJ, Linneman C, Liu C, Pazin G et al. Herpes simplex encephalitis: clinical assessment. JAMA 1982; 247:317–320
     [Google Scholar]
  20. Kupila L, Vuorinen T, Vainionpää R, Hukkanen V, Marttila RJ et al. Etiology of aseptic meningitis and encephalitis in an adult population. Neurology 2006; 66:75–80 [View Article]
     [Google Scholar]
  21. Monath TP, Nystrom RR, Bailey RE, Calisher CH, Muth DJ. Immunoglobulin M antibody capture enzyme-linked immunosorbent assay for diagnosis of St. Louis encephalitis. J Clin Microbiol 1984; 20:784–790 [View Article]
     [Google Scholar]
  22. McCabe K, Tyler K, Tanabe J. Diffusion-Weighted MRI abnormalities as a clue to the diagnosis of herpes simplex encephalitis. Neurology 2003; 61:1015 [View Article]
     [Google Scholar]
  23. Vora NM, Holman RC, Mehal JM, Steiner CA, Blanton J et al. Burden of encephalitis-associated hospitalizations in the United States, 1998-2010. Neurology 2014; 82:443–451 [View Article]
     [Google Scholar]
  24. Raschilas F, Wolff M, Delatour F, Chaffaut C, De Broucker T et al. Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study. Clin Infect Dis 2002; 35:254–260 [View Article]
     [Google Scholar]
  25. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol 1994; 47:1245–1251 [View Article]
     [Google Scholar]
  26. Khetsuriani N, Holman RC, Anderson LJ. Burden of Encephalitis‐Associated hospitalizations in the United States, 1988–1997. Clin Infect Dis 2002; 35:175–182 [View Article]
     [Google Scholar]
  27. Bernard S, Mailles A, Stahl JP. Epidemiology of infectious encephalitis, differences between a prospective study and hospital discharge data. Epidemiol Infect 2013; 141:2256–2268 [View Article]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001153
Loading
The longitudinal health economic impact of viral encephalitis in the United States
J. Med. Microbiol. 69, 270 (2020); https://doi.org/10.1099/jmm.0.001153
/content/journal/jmm/10.1099/jmm.0.001153
/content/journal/jmm/10.1099/jmm.0.001153
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error