Japanese Encephalitis: A Brief Review on Indian Perspectives

Kulkarni, Reshma; Sapkal, Gajanan; Kaushal, Himanshu; Mourya, Devendra T.

doi:10.2174/1874357901812010121

Cited by 63 publications

(53 citation statements)

References 52 publications

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“…Finally, there has been some preliminary work on the use of intravenous immunoglobulin in Nepal [28], again without proof yet of survival benefit. The finding that JE cases were more frequent in the wet season and in delta and lowland regions (with paddy fields and areas prone to flooding) aligns with current knowledge about transmission of JE in Asian countries [29,30]. There are seasonal correlations in rural areas between mosquito abundance, JE virus seroconversion in pigs, and concurrent human JE outbreaks [29].…”

Section: Discussionsupporting

confidence: 64%

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

et al. 2020

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Background: Myanmar is endemic for Japanese encephalitis (JE) and has experienced several outbreaks in recent years. The vector-borne disease control (VBDC) program has collected hospital-based surveillance data since 1974. There is an urgent need to collate, analyze, and interpret the most recent information. The study aimed to describe (i) hospital-based JE cases and deaths between 2012 and 2017, (ii) a catch-up vaccination campaign in children in 2017, and (iii) health service provider perceptions about JE in one township in 2018. Methods: This was a cross-sectional study of cases, deaths, and catch-up childhood vaccinations using secondary data from program records and a survey database of health service provider perceptions. Results: Between 2012 and 2017, there were 872 JE cases and 79 deaths with a case fatality rate of 91 per 1000; 2016 was the year with most cases and deaths. Most cases (n = 324) and deaths (n = 37) occurred in children aged 5-9 years. Large case numbers were reported in delta and lowland regions (n = 550) and during the wet season (n = 580). The highest case fatality rates were observed in the hills and coastal regions (120 and 112 per 1000, respectively). Nationwide coverage of the catch-up JE vaccination campaign among 13.7 million eligible children was 92%, with coverage lower in the hills and coastal regions (84%) compared with delta and lowland regions and plains (94%). More vaccinations (65%) occurred through school-based campaigns with the remainder (35%) vaccinated through community-based campaigns. Structured interviews in one township showed that service providers (n = 47) had good perceptions about various aspects of JE, although perceived benefits of specific vector control measures were poor: spraying/fumigation (38%), garbage removal (36%), larvicide use (36%), and drainage of standing/stagnant water (32%).

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Section: Discussionsupporting

confidence: 64%

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

et al. 2020

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“…The optimal method for laboratory confirmation is by testing JEV-specific IgM antibodies in the cerebrospinal fluid or serum. [ 1 ] However, IgM titers are 100% detectable after 7 days of infection. [ 6 ] Therefore, there might be a delay of 7 days at least before JE confirmation.…”

Section: Discussionmentioning

confidence: 99%

“…The initial manifestations might be diverse, ranging from behavioral abnormalities, seizures, disorientation, coma, to spastic paralysis with high grade fever. [ 1 ] Hemiplegia is a rare manifestation seen during the initial stage of JE. [ 2 ] We herein present a case report of an individual with left-sided limb weakness but with no fever.…”

Section: Introductionmentioning

confidence: 99%

Japanese encephalitis (JE) mimicking acute ischemic stroke

et al. 2020

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Introduction: Japanese encephalitis (JE) is one of the most serious viral infectious diseases of the central nervous system in Asia. The clinical manifestations of it might be non-specific. We herein report a case of JE mimicking acute ischemic stroke. Patient concerns: A 52-year-old man presented with acute onset of left-sided limb weakness for 2 hours and a 5-year history of hypertension but with no fever or cold before the onset. Immediate cranial computed tomography scan showed small ischemic foci. Diagnosis: Initial diagnosis revealed acute cerebral infarction as the symptoms mimicked stroke at onset. Furthermore, his symptoms progressed and magnetic resonance scan after 6 days of onset appeared negative on diffusion weighted imaging. Other etiologies were also then considered. Japanese encephalitis virus immunoglobulin M in the serum supported positive diagnosis of JE. Interventions: The patient was given Ribavirin, and then his symptoms slowly improved. Outcomes: Brain MRI on day 29 after the onset revealed high-intensity lesions in bilateral thalamus on diffusion weighted imaging. During the follow-up (at about 2 months after the onset), the patient's consciousness was clear but could not walk. At about 6 months after the onset, he could walk with parkinsonian features. Conclusion: Diagnosis of JE that mimicked acute stroke at onset and with no fever can be challenging. Recognition of disease development, MRI and Japanese encephalitis virus immunoglobulinM findings are helpful in early definitive diagnosis.

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“…Pigs act as an amplifier host of JEV, thus can be a key suspect of spreading infection to human living in close proximity [4]. The detection of JEV in pigs was reported earlier from Cambodia, Singapore, Vietnam, Australia, Japan, China, Thailand, Laos, Indonesia, India etc (Fig 6) [22, 34-42], however the studies on pigs for the presence of JE virus and its genotypes in circulation among pigs in India are limited [19].…”

Section: Discussionmentioning

confidence: 99%

“…The genome is divided into a structural region containing capsid (C), pre-membrane (prM) and envelope (E) genes and a non-structural region consisting of NS1, NS2a, NS2b, NS3, NS4a, NS4b and NS5 genes [3]. The NS3 and NS5 genes encode for viral helicase and polymerase enzymes respectively whereas the functions of NS4a and NS4b are not clearly understood [4]. Culex tritaeniorhyncus is the dominant transmitting vector [5] whereas other species of mosquitoes namely Culex modestus [6], Culex pipiens [7], Culex bitaeniorhyncus [7] and Anopheles sinensis [8] have also been reported.…”

Section: Introductionmentioning

confidence: 99%

Molecular epidemiology of Japanese Encephalitis Virus in pig population of Odisha, Assam and Manipur states of India

Datey

Singh²,

Rajkhowa

et al. 2019

Preprint

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AbstractJapanese encephalitis virus (JEV) comes under the family Flaviviridae and genus flavivirus. It predominantly infects the children under the age of 10 years and the case fatality rate can stretch out as high as 30%. Pigs act as reservoir and amplifying intermediate host for JEV. Recent report suggested longer persistence of JEV in tonsil than in circulation of experimentally infected pigs. The current investigation was conducted to understand the prevalence and molecular epidemiology of JEV infection in pigs in three different geographical sites in India (Odisha, Assam and Manipur). Serum samples were tested by ELISA and RT-PCR for detection of JEV, while only RT-PCR was done in case of tonsils tissues collected from pigs slaughtered in abattoir. Prevalence of JEV was highest in Manipur (25.45% in serum and 10.08% in tonsil) but lower in Assam (3.75% in serum and 0% in tonsils) and Odisha (1.49% in serum and 3.7% in tonsils). The percentage of sero-positivity was found to be 3.75% of IgM and 9.9% of IgG in Assam and Odisha respectively. Genotype III (GIII) of JEV was the dominant genotype and sporadic mutations of S83G, H76P, E78Q, C55S, and S64W along with two consistent mutations V46S and V51I were observed in all the GIII strains. Analysis of the E gene sequence revealed a single mutation, S118N in the GI strain. Older pigs (above 7 months) were found to be infected relatively more (8.6%) than younger pigs (age group 3-7 months). In conclusion, the high JE virus infection rate of pig in the current locations suggests the need for continuous surveillance of this virus in pigs which will ultimately help to adopt an effective control strategy to prevent the spread of JE infection to human.Author summaryJapanese encephalitis is one of the contributing factors in acute encephalitis syndrome cases reported across India as well as Asia. Primarily young naive human population are affected with JEV. The death rate can be as high as 30% and in about 30%-50% surviving population paralysis, brain damage or other serious permanent sequelae may be observed. The viral load gets amplified in pigs and thus plays a crucial role in transmitting the infection in human communities living in close proximity to pig dwelling. The current study was conducted to demonstrate prevalence of JEV in pig population of three geographical regions of India viz. the States of Odisha, Assam and Manipur that have reported JE outbreaks in human population. The current study demonstrates that the rate of infection is 3.28% among pigs in Manipur followed by Assam and Odisha. GIII was found to be the most predominant JEV genotype, while only one GI genotype strain was detected from Odisha region. These findings suggested the need of continuous surveillance of this virus in pigs and proper implementation of human and animal vaccination programme to control the infection.

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Japanese Encephalitis: A Brief Review on Indian Perspectives

Cited by 63 publications

References 52 publications

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

Japanese encephalitis (JE) mimicking acute ischemic stroke

Molecular epidemiology of Japanese Encephalitis Virus in pig population of Odisha, Assam and Manipur states of India

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