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Need to Know: Japanese Encephalitis

Need to Know: Japanese Encephalitis

23 Feb 2018 Hans Lesmana Articles 56
All You Need to Know About Japanese Encephalitis
 
A disease that lately is spreading in Indonesia is Japanese Encephalitis.  Through news and media, it is not that uncommon for children to have Japanese Encephalitis (JE).   It is important to know the signs and symptoms of JE and more importantly to know that JE is preventable.
 
Encephalitis is an infection of the brain tissue.  Japanese Encephalitis is caused by the Japanese Encephalitis virus, and it is the most common cause of encephalitis is South East Asia.  According to Indonesia’s Ministry of Health in 2016 there were 326 reported cases.  226 cases were reported in Bali (69.3 % of cases).
 
The virus infects pigs and birds through mosquito as a vector.  The virus can also infect humans through a species of mosquito called the Culex Triaenjorhynchus.  The virus lives in pigs and birds that live near the water and is transmitted to humans when these mosquitos are infected from the reservoir animals.  The Culex mosquitos live in humid areas like farms, and these mosquitos are more active in the night.
 
Signs and Symptoms
In the majority of cases, JE infection only results in a mild viral infection that gives nonspecific “flu-like symptoms”.  According to studies, severe JE infections happens in every 1 of 200 JE cases.  The virus’s incubation period (the time it takes from when the virus infects you until the appearance of signs and symptoms) ranges from 5-15 days.
 
Signs and symptoms include:
  1. Fever
  2. Nausea and Vomiting
  3. Headache
  4. Shivers
  5. Fatigue
 
A severe JE infection that is related to brain tissue will give:
  1. Sudden fever
  2. Nuchal rigidity (stiff neck, it will be hard to flex your neck forward)
  3. Confused, disoriented, and agitated
  4. Seizures
  5. Paralyzed
  6. Coma
 
The symptoms will usually subside after the acute phase of the disease however according to reports 20-30% of will continue to have cognitive and psychiatric problems.  As much as 85% of JE cases are reported to infect children under the age of 15 years old. However, people of all ages may be infected by this virus especially individuals that do not have the immune system to fight off the JE virus.
 
How do you treat JE?
There is no specific therapy for JE infection.  Generally, patients are instructed for bed-rest, adequate hydration, and symptomatic management with medications (medications that manage symptoms for example pain killers and anti-fever meds).
 
Prevention
There are 2 approaches to prevent the spread of JE virus.  The first approach deals with eliminating the vector, the Culex mosquito or its bite.  This includes wearing proper attire (long sleeves and pants), using bug repellents, proper hygiene such as not letting still water be the nests of the mosquitos, or using bug sprays and other means of anti-mosquito procedures. 
 
The second approach is to have yourself vaccinated against the JE virus which shows it to be efficient.  In September 2017, the Indonesian Health Ministry has instructed the vaccination of JE virus in certain endemic areas, including Bali.  Vaccinations are given to individuals aged 9-15 years old.
 
By taking care of our environmental hygiene we are also decreasing the risk of getting bitten by JE vectors.  We should also maintain proper nutrition so our body’s immune system is working optimally.  If you would like to prevent JE virus infection, it is recommended to have yourself vaccinated.  If  you have questions regarding the JE virus vaccination, Surya Husadha Hospital Denpasar has pediatricians and physicians you can consult with.
 
(picture: pediatric consultant dr. I Made Gede Dwi Lingga Utama, Sp.A (K) )