Guest Blog 870

Japanese Encephalitis: Definition, cause and prevention

Dr Vijay ShindeThe death of over 70 children in just five days at BRD Medical College Hospital in Gorakhpur, Uttar Pradesh, has made national headlines and the government believes encephalitis has been one of the reasons behind the toll. WHO reports Japanese Encephalitis as the main cause for viral encephalitis — an inflammation of the brain tissue. Dr Vijay Shinde, Co-founder, HealthGraph Limited, gives Elets News Network (ENN) a better insight into the disease and its prevention.

What is Japanese Encephalitis?
Japanese Encephalitis (JE) is a viral disease that infects humans through the bite of an infected Culex mosquito. Clinically, a case of JE is described as a case of fever of variable severity associated with neurological symptoms. Mild infections may present with only fever and headache, or without any apparent symptoms. Around 1 in 200 infections result in serious disease which is marked by sudden onset of high fever, headache, neck stiffness, disorientation, coma, tremors, paralysis, stiffness, or loss of coordination. Even among survivors, the nervous system can suffer lasting damage.

What is its cause and how is it spread?
The virus primarily infects animals (especially pigs) and birds, and can be spilled over into humans. Rice fields (also shallow ditches and pools) where mosquitoes breed and accompanied by pig rearing are very common places for transmitting the infections. The virus gets amplified in the blood systems of pigs and birds, but there is no human to human transmission.

What is the diagnosis and management of JE?
A clinical diagnosis is made by a doctor based on the history and clinical presentation. A definite
diagnosis is through laboratory test for JE antigen or antibody in blood (serum) or cerebrospinal
fluid. Only a few of the infected people develop the disease, but there is no definite treatment for JE. Intensive supportive treatment and good nursing can reduce deaths significantly.

How do we prevent JE?
There is a vaccine for JE. However, immunisation is not included in the routine immunisation, and is carried out in select areas as per sero-epidemiological data. The best way to prevent JE is through control of mosquito vectors. Stagnant water bodies should be drained or filled up, and surroundings kept clean and dry. Personal protection through use of repellents and mosquito nets are effective control measures. Bed nets treated with insecticides are being distributed. Indoor Residual Spray, and fogging in outbreak areas are chemical control measures to reduce vector population. Introduce larvivorous fishes in the paddy fields and other stagnant bodies to eat up the mosquito larva. Spread of awareness is important for prevention and also to detect and treat patients early to increase chance of survival and reduce long term mental deficits after recovery.

In case of any illness which resembles the symptoms of JE, visit your nearest health centre/district hospital for sample collection/transportation and treatment of cases.

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