Japanese Encephalitis in Children in Bellary Karnataka: Clinical Profile and Sequelae

Abstract

Objectives:To study the clinical profile and outcome of Japanese Encephalitis(JE) Methods: Prospective study was done in Vijayanagara Institute Medical Sciences hospital, Bellary, Karnataka. 233 patients below 12 years of age presented with acute encephalitic picture during the epidemic period formed the subjects and were worked up according to a predesigned protocol. CSF and serum samples were tested for JE specific IgM antibodies. Patients were followed up for 4 months to over one year. Results: The predominant age group was 5 to 12 years. Fever (94.84%), seizures (73.39%) and altered sensorium(91.84%) were the important presenting symptoms. Onset of illness was acute in 28.32% and subacute in 38.62% .CSF showed lymphocytosis and 45.06% had cell count of 6-50/cmm and in majority it was <200/cmm. 55.36% patients were positive for JE. Mortality was 22.74%. Deeper level of coma , respiratory irregularities and meningeal signs were associated with mortality. 147 patients survived the acute attack. Of that 40.85% completely recovered. Speech disturbance (47.61%), motor deficits (36.73%), behavioural disturbance (14.96%), involuntary movements (12.24%) and seizures (1.36%) were the morbidities. The deficits found to be gradually improving. Motor deficits and speech disturbances were found in 25.68% and 22.01% respectively at one year follow up. Conclusions:The characteristic clinical features of JE include fever, seizure, altered sensorium, aphasia, relative absence of cranial nerve involvement and irregular and rapidly changing motor and tone abnormality. Deeper level of coma, respiratory abnormalities and meningeal signs were associated with mortality. Speech disturbance and motor deficits were frequently encountered sequelae.

Clinical Profile and Outcome of Japanese Encephalitis in Children Admitted with Acute Encephalitis Syndrome

“…In children similar manifestation was also noted in earlier studies [25, 26]. Signs of meningeal irritation were frequently observed in more than half of the study patients as recorded in other studies [1, 27].…”

“…However, in a study by Avabratha et al observed elevated cell count in 45.06% and protein in 74.67% study patients [26]. …”

Acute Encephalitis Syndrome in Children With Special Reference to Japanese Encephalitis: A Retrospective Analysis

“…These findings are comparable to other studies. 13,19,20 However, the study by Roy et al found a higher JE mortality of 54.55% in children aged 1 month to 12 years. 9 71% of JE patients were found to have been discharged from hospital in our study, but the proportion of these patients having intact neurological survival and the presence of sequelae at the time of discharge could not be studied.…”

Cryptic etiopathological conditions of equine nervous system with special emphasis on viral diseases

“…The birds are the main reservoir hosts along with pigs as major amplifying hosts, while human beings and horses are the incidental (dead end) hosts associated with this disease [ 6 ]. In southern part of India, co-infection of cysticercosis and JE in children has been reported, in which pigs were the intermediate as well as amplifying hosts for these diseases [ 50 ].…”