The Role of Human Herpesvirus Type-6 (HHV-6) in Convulsions Seen in Children at Korle-Bu Teaching Hospital, Accra


Background: Since the isolation of HHV-6 in 1986, extensive investigation has revealed it to be ubiquitous and responsible for the majority of cases of a common febrile rash illness of infants known as roseola. Other clinical associations including seizure disorders, encephalitis and meningitis have also been stated in various publications. Objective: The aim of the study is to find out if there is any association between HHV-6 infection and the convulsions prevailing at the Child Health Department of the Korle-Bu Teaching Hospital, Accra-Ghana. Methods and Results: Children admitted into the Department of Child Health with episode of convulsions were recruited after informed consent had been sought from subjects. Cerebrospinal fluid (CSF) and Plasma were obtained from patients. PCR directed at the detection of the large tegument protein (LTP) gene in the SIE strain of the HHV-6 in Plasma and CSF from patients was done. The mean age of study subjects was 37.44 months with 53 (64.6%) being males. There was a significant relationship between the convulsions and fever (P < 0.05). Based on CSF characteristics gathered, viral infections may be the probable cause of the observed convulsions but not malaria or bacterial infections. None of the samples from the patients had evidence of HHV-6. Conclusion: The study was unable to establish HHV-6 infection in the CSF and Plasma of patients. What role if any HHV-6 has in convulsions seen in children or neurological diseases at large merits further studies. Other neurotropic viruses need to be investigated as possible causes for the convulsions.

Share and Cite:

Lennox-Mac, A. , Theophilus, A. , Eben, B. , Sagoe, K. , Kafintu-Kwashie, A. and Seshie, M. (2014) The Role of Human Herpesvirus Type-6 (HHV-6) in Convulsions Seen in Children at Korle-Bu Teaching Hospital, Accra. Open Journal of Medical Microbiology, 4, 77-89. doi: 10.4236/ojmm.2014.41009.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Brown, N.A., Sumaya, C.V., Liu, C.R., Ench, Y., Kovacs, A., Coronesi, M. and Kaplan, M.H. (1988) Fall in Human Herpesvirus-6 Seropositivity with Age. Lancet, 332, 396-397.
[2] Knowles, W.A. and Gardner, S.D. (1988) High Prevalence of Antibody to Human Herpesvirus-6 and Seroconversion Associated with Rash in Two Infants. Lancet, 332, 912-913.
[3] Suga, S., Yoshikawa, T., Asano, Y., Kajita, Y., Ozaki, T., Yazaki, T., Nakashima, T., Yamada, A., Challoner, P.B., Smith, K.T. and Parker, J.D. (1993) Clinical and Virological Analyses of 21 Infants with Exanthema Subitum (Roseola Infantum) and Central Nervous System Complication. Annals of Neurology, 33, 597-603.
[4] Asano, Y., Suga, S., Yoshiekawa, T., Yazaki, T. and Uchikawa, T. (1995) Clinical Features and Viral Excretion in an Infant with Primary Human Herpesvirus-7 Infection. Pediatrics, 95, 187-190.
[5] Pellet, P. and Roizman, B. (2007) Herpesviridae: A Brief Introduction. In: Howley, P., Ed., Fields Virology, 5th Edition, Lippincott, Philadelphia, 2480-2499.
[6] Caserta, M.T., Hall, C.B., Schnabel, K., CIntyre, K., Long, C., Costanzo, M., Dewhurst, S., Insel, R. and Epstein, L.G. (1994) Neuroinvasion and Persistence of Human Herpesvirus 6 in Children. The Journal of Infectious Diseases, 170, 1586-1589.
[7] Leach, C.T., Newton, E.R., McParlin, S. and Jenson, H.B. (1994) Human Herpesvirus-6 Infection of the Female Genital Tract. The Journal of Infectious Diseases, 169, 1281-1283.
[8] Okuno, T., Oishi, H., Hayashi, K., Nonogaki, M., Tanaka, K. and Yamanishi, K. (1995) Human Herpesviruses-6 and 7 in Cervixes of Pregnant Women. Journal of Clinical Microbiology, 33, 1968-1970.
[9] Campadelli-Fiume, G., Mirandola, P. and Menotti, L. (1999) Human Herpes Virus 6: An Emerging Pathogen. Emerging Infectious Diseases, 5.
[10] Barone, S.R., Kaplan, M.H. and Krilov, L.R. (1995) Human Herpesvirus-6 Infection in Children with First Febrile Seizures. Journal of Pediatrics, 127, 95-97.
[11] Osman, H. (2000) Human Herpesvirus 6 and Febrile Convulsions. Herpe, 7, 33-37.
[12] Asad, A., Li, S.B., Mark, J.A. and Adriana, W. (2004) Human Herpes Viruses 6 and 7 and Central Nervous System Infectious in Children. Emerging Infectious Diseases, 10.
[13] Cone, R.W., Huang, M.W., Hackman, R.C. and Corey, L. (1996) Coinfection with Human Herpes Virus 6 Variants A and B in Lung Tissue. Journal of Clinical Microbiology, 34, 877-881.
[14] Parsyan, A., AddoYobo, E., Owusu-Ofori, S., Akpene, H., Sarkodie, F. and Allain, J.P. (2006) Effects of Transfusion on Human Erythrovirus B19 Susceptible or Infected Pediatric recipients in a Genotype 3 Endemic Area. Transfusion, 46, 1593-1600.
[15] Bener, A., Al-Suweidi, E.E.K., Bessisso, M., Al-Gazali, L.I. and Al-Khider, A. (2006) Genetics and Environmental Risk Factors Associated with Febrile Seizure. Journal of Pediatric Neurology, 4, 239-243.
[16] Chua, K.B., Lam, S.K., AbuBakar, S., Koh, M.T. and Lee, W.S. (1997) The Incidence of Human Herpesvirus 6 Infection in Children with Febrile Convulsion Admitted to the University Hospital. Kuala Lumpur, Medical Journal of Malaysia, 52, 335-341.
[17] Gururaj, A.K., Bener, A., Al-Suweidi, E.K., Al-Tatari, H.M. and Khadir, A.E. (2001) Predictors of Febrile Seizure: A Matched Case-Control Study. Journal of Tropical Pediatrics, 47, 361-362.
[18] Ling, S.G. (2000) Clinical Characteristics and Risk Factors for a Complex First Febrile Convulsion. Singapore Medical Journal, 40, 264-267.
[19] Mahyar, A., Ayazi, P., Fallahi, M. and Javadi, A. (2010) Risk Factors of the First Febrile Seizures in Iranian Children. International Journal of Peadiatrics, Article ID: 862897.
[20] Pavlidou, E., Tzitiridou, M., Kontopoulos, E. and Panteliadis, C.P. (2008) Which Factors Determine Febrile Seizure Recurrence? A Prospective Study. Brain & Development, 30, 7-13.
[21] Bessiso, M.S., Cindro, L. and Neubauer, D. (1990) Prognosis and Risk Factors in Febrile Convulsions: A Prospective Study of 150 Children in Kuwait. Neuroepidemiology, 9, 78-87.
[22] Forsgren, L., Sidenvall, R., Blomquist, H.K., Heijbel, J. and Nystrom, L. (1990) An Incidence Case-Referent Study of Febrile Convulsions in Children: Genetical and Social Aspects. Neuropaediatrics, 21, 153-159.
[23] Kjeldsen, M.J., Corey, L.A., Solaas, M.H., Friss, M.L., Harris, J.R., Kyvic, K.O., et al. (2005) Genetic Factors in Seizures: A Population-Based Study of 47,626 US, Norwegian and Danish Twin Pairs. Twin Research and Human Genetics, 8, 138-147.
[24] Farwell, J.K., Blackner, G., Sulzbacher, S., Adelman, L. and Voeller, M. (1994) First Febrile Seizures, Characteristics of the Child, the Seizure and the Illness. Clinical Pediatrics, 33, 263-267.
[25] Moller, K.L. (2008) Exanthema Subitum and Febrile Convulsions. Acta Paediatrica, 45, 534-540.
[26] Van Zeijl, J.H., Mullart, R.A. and Galama, J.M.D. (2002) The Pathogenesis of Febrile Seizures: Is There a Role for Specific Infections? Reviews in Medical Virology, 12, 93-106.
[27] Berg, A.T. and Shinnar, S. (1996) Complex Febrile Seizures. Epilepsia, 37, 126-33.
[28] Verity, C.M., Butler, N.R. and Golding, J. (1985) Febrile Convulsions in a National Cohort Followed up from Birth. I. Prevalence and Recurrence in the First Years of Life. British Medical Journal, 290, 1307-1310.
[29] Chung, B., Wat, L.C. and Wong, V. (2006) Febrile Seizures in Southern Chinese Children: Incidence and Recurrence. Pediatric Neurology, 34, 121-126.
[30] Kwong, K.L., Tong, K.S. and So, K.T. (2003) Management of Febrile Convulsion: Scene in a Regional Hospital. Hong Kong Medical Journal, 9, 319-322.
[31] Kong, C.K. and Ko, C.H. (2000) Local Data on Febrile Convulsion. HKCNDP Education Bulletin, 1, 6-8.
[32] Chan, K.K., Cherk, S.W.W., Chan, C.H., Ng, D.K.K. and Ho, J.C.S. (2007) A Retrospective Review of First Febrile Convulsion and Its Risk Factors for Recurrence in Hong Kong Children. HK Journal of Paediatrics, (New Series), 12, 181-187.
[33] Tosun, A., Koturoglu, G., Serdaroglu, G., Polat, M., Kurugol, Z., Gokben, S. and Tekgul, H. (2010) Ratios of Nine Risk Factors in Children with Recurrent Febrile Seizures. Pediatric Neurology, 43, 177-182.
[34] Obi, J.O., Ejeheri, A. and Alakija, W. (1994) Childhood Febrile Seizures (Benin City Experience). Annals of Tropical Paediatrics, 14, 211-214.
[35] Al-Ajlouni, S.F. and Kodah, I.H. (2000) Febrile Convulsions in Children. Neurosciences, 5, 151-155.
[36] Saidulhaque (1981) Febrile Convulsions. Pakistan Pediatric Journal, 5, 15-55.
[37] Johnson, E.W., Dubovsky, J. and Rich, S.S. (1998) Evidence for a Novel Gene for Familial Febrile Convulsions, FEB2, Linked to Chromosome 19P in an Extended Family from the Midwest. Human Molecular Genetics, 7, 63-68.
[38] Al-Eissa, Y.A. (1995) Lumbar Puncture in the Clinical Evaluation of Children with Seizures Associated with Fever. Pediatric Emergency Care, 11, 347-350.
[39] Green, S.M., Rothrock, S.G., Clem, K.J., Zurcher, R.F. and Mellick, L. (1993) Can Seizures Be the Sole Manifestation of Meningitis in Febrile Children? Pediatrics, 92, 527-534.
[40] Rosenberg, N.M., Meert, K., Marino, D. and De Baker, K. (1992) Seizures Associated with Meningitis. Pediatric Emergency Care, 8, 67-69.
[41] Wong, M., Schlaggar, B.L., Buller, R.S., Storch, G. A. and Landt, M. (2000) Cerebrospinal Fluid Protein in Pediatric Patients: Defining Clinically-Relevant Reference Values. Archives of Pediatrics and Adolescent Medicine, 154, 827-831.
[42] Devinsky, O., Nadi, S., Theodore, W.H. and Porter, R.J. (1988) Cerebrospinal Fluid Pleocytosis Following Simple, Complex Partial, and Generalized Tonic-Clonic Seizures. Annals of Neurology, 23, 402-403.
[43] Rider, L.G., Thapa, P.B., Del Beccaro, M.A., Gale, J.L., Foy, H.M. and Farwell, J.R. (1995) Cerebrospinal Fluid Analysis in Children with Seizures. Pediatric Emergency Care, 11, 226-229.
[44] Mohammad, M., Mohebbi, M.R. and Naderi, F. (2003) CSF Glucose Concentrations in Infants with Febrile Convulsions and the Possible Effects of Acetaminophen. Indian Pediatrics, 40, 1183-1185.
[45] Rutter, N. and Smales, O.R.C. (1976) Calcium, Magnesium and Glucose Levels in Blood and CSF of Children with Febrile Convulsions. Archives of Disease in Childhood, 51, 141-143.
[46] Hall, C., Caserta, M. and Schnabel, K. (2008) Chromosomal Integration of Human Herpesvirus 6 Is the Major Mode of Congenital Human Herpesvirus 6 Infection. Pediatrics, 122, 513-520.
[47] Jaworska, J., Gravel, A. and Flamand, L. (2010) Divergent Susceptibilities of Human Herpesvirus 6 Variants to Type I Interferons. Proceedings of the National Academy of Sciences of the United States of America, 107, 8369-8374.
[48] Hall, C.B., Long, C.E., Schnabel, K.C., Caserta, M.T., Mclntyre, M.K., Costanzo, M.A., Knott, A., Dewhurst, S., Insel, R.A. and Epstein, G.L. (1994) Human Herpesvirus-6 Infection in Children: A Prospective Study of Complications and Reactivation. New England Journal of Medicine, 331, 432-438.
[49] Teach, S.J., Wallace, H.L., Evans, M.J., Duffner, P.K., Hay, J. and Faden, H.S. (1999) Human Herpesviruses 6 &7 and Febrile Seizures. Pediatric Neurology, 21, 699-703.
[50] Hukin, J., Farrell, K., MacWilliam, L.M., Calbourne, M., Waida, E., Tan, R., Mroz, L. and Thomas, E. (1998) Case-Control Study of Primary Human Herpesvirus-6 Infection in Children with Febrile Seizures. Pediatrics, 101, e3.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.