Refractory status epilepticus with fever due to mumps vaccine-induced encephalitis caused secondary encephalopathy mimicking acute encephalopathy with biphasic seizures and late reduced diffusion.

BACKGROUND: Encephalitis due to vaccination for mumps is a rare complication that occurs in 0.00004% of recipients, and there has been no report of serious neurological sequelae. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) has been reported as the most frequent type among acute encephalopathy syndromes in the pediatric population in Japan. There has been no report of AESD caused by vaccinations. Case presentation We present the clinical course of a 1-year and 10-month-old boy who had no preexisting condition, and developed mumps vaccine-induced severe primary encephalitis. Refractory status epilepticus due to encephalitis persisted for 16 h and resulted in secondary encephalopathy as a form of AESD mimic. He had serious neurological sequelae, such as West syndrome, transient spastic tetraplegia, and intellectual disability, despite intensive treatments. DISCUSSION: The presented boy is the first patient to develop mumps vaccine-induced primary encephalitis with severe central nervous system (CNS) damage. Screening of the immunological background in the presented patient revealed no abnormalities; therefore, it is unclear why he developed such severe adverse events. In patients with acute encephalitis caused by the herpes simplex virus 1, inborn immune errors in CNS based on mutations in single genes are involved in its pathophysiology. Consequently, some immunogenetic alterations could be found by further analysis in the presented patient.

A novel WD40-repeat protein involved in formation of epidermal bladder cells in the halophyte quinoa.

Halophytes are plants that grow in high-salt environments and form characteristic epidermal bladder cells (EBCs) that are important for saline tolerance. To date, however, little has been revealed about the formation of these structures. To determine the genetic basis for their formation, we applied ethylmethanesulfonate mutagenesis and obtained two mutants with reduced levels of EBCs (rebc) and abnormal chloroplasts. In silico subtraction experiments revealed that the rebc phenotype was caused by mutation of REBC, which encodes a WD40 protein that localizes to the nucleus and chloroplasts. Phylogenetic and transformant analyses revealed that the REBC protein differs from TTG1, a WD40 protein involved in trichome formation. Furthermore, rebc mutants displayed damage to their shoot apices under abiotic stress, suggesting that EBCs may protect the shoot apex from such stress. These findings will help clarify the mechanisms underlying EBC formation and function.

A Cluster of Hepatitis A Infections Presumed to be Related to Asari Clams and Investigation of the Spread of Viral Contamination from Asari Clams.

In a cluster of hepatitis A infections that occurred in Nagano Prefecture in 2017, hepatitis A virus (HAV) was detected in asari clams (reference food) and the patients' fecal samples. Initially, the asari clams were suspected to be the infection source. However, the exact infection route remained unknown because a patient who had not consumed an asari clam dish also developed the disease. Suspecting a secondary infection originating from the asari clams, we investigated the presence of HAV genomes in water used for washing and soaking the frozen asari clams and detected HAV in the soaking water. These results suggest that soaking water is a risk factor for secondary contamination because of the leakage of HAV accumulated in midgut gland of the asari clam. During the asari clam sand removal process, the water used to clean asari clams spread across a wide area in a concentric fashion, raising concerns that this process may aggravate contamination. In addition to HAV, diarrhea viruses, such as norovirus, have often been detected in bivalves, including asari clams. Thus, handling these foodstuffs requires adequate care.