Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  The BRD Medical College in Gorakhpur, Eastern Uttar Pradesh is in the news for wrong reasons due to deaths of many children due to Japanese Encephalitis. This area is hyperendemic for encephalitis for many decades. Over 26000 cases have been reported since 2010. The Japanese B Encephalitis generally presents in young children from a few months to 15 years old and carries about 40% death rate in those who have brain involvement.

 

What is encephalitis?

1. This an inflammation of the brain due to virus, bacteria, or fungus. It can occur at any age group more commonly in youngsters though. The symptoms occur due to swelling of the brain and increased intracranial pressure.

What are the major symptoms of encephalitis?

1. Fever, headache, vomiting, drowsy state, convulsions and unconscious state are the major symptoms. The prognosis is not always good and many young patients succumb to this deadly disease.

What is Japanese B encephalitis?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  This is due to inflammation of the brain due to a virus. The virus is transmitted by Culex type of mosquito. The virus does not spread from patients to other individuals. The reservoir of the virus is usually the pigs and the virus spreads from pigs to children by mosquitoes bite. The incidence is more common in rural India than urban India. The disease is more prevalent in South East Asian countries. It affects children and young adults then the older population. Adults generally get immunity due to subclinical infections.

How is the diagnosis made?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Besides the typical clinical profile, the examination of brain fluid obtained by lumbar puncture helps in diagnosis. MRI of the brain helps in diagnosis and ruling out other possibilities. Demonstration of IgM antibodies against the Japanese B encephalitis virus in the brain fluid is always helpful.

Why is the disease more common in Eastern UP?

1.   Due to severe poverty and poor hygienic conditions, the disease is more common in this area of India. Open defecation, overcrowding, mosquitoes, migratory birds, pigs and poor sanitation are other issues.

Why are so many children dying due to Japanese Encephalitis in UP?

1. Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Besides overcrowding in hospitals and lack of basic medical facilities in many areas of this region, many children reach very late at the medical care facilities. Besides this most of these children have been malnourished due to poverty. Other infections of the brain including scrub typhus have also been responsible for encephalitis.

What is the treatment of this encephalitis?

1. Unfortunately, there is no specific treatment for encephalitis. The treatment of viral encephalitis is supportive. There are no specific antibiotics for this ailment. Control of fever, seizures,  maintenance of adequate respiration is necessary. Few children may require a ventilator to support their breathing

How is this encephalitis prevented?

1.  Maintaining proper hygiene,  prevent mosquito bites, proper garbage disposal and proper nutrition for children to improve their immunity is necessary.  Vaccines play an important role in preventing Japanese B encephalitis.

How is a vaccination against Japanese B encephalitis done?

1.   High-risk individuals visiting area infested with the virus or children residing in the hyperendemic area should receive the vaccine. Two doses at the interval of about 28 days each are given. No major side effects are observed.

Sunflower Hospital Nagpur | Dr Jay Deshmukh:-  Japanese B encephalitis is a serious disease caused by a virus. It enters our body by a mosquito bite. Transmission from people to people does not occur. Preventing mosquito bites, proper garbage disposal and vaccination is important. Survival after it infects the brain is difficult.