Long-Term Neurological Sequelae and Disease Burden of Japanese Encephalitis in Gansu Province, China

Abstract

Background and objects:The study aimed to evaluate the long-term neurological sequelae and the disease burden of JE in Gansu, China.Methods: JE patients were included as study population from 2005-2011 in Gansu, and a follow-up survey was conducted in 2007-2014. Pair-matched healthy individuals were selected as controls. All subjects underwent a neurological examination and intelligence quotient (IQ) and memory quotient (MQ) assessments. Then, the disability-adjusted life years (DALYs), and direct and indirect medical expenses were systematic assessed.Results: Forty-four point seven percent of the JE patients had objective neurological deficits, compared with 2.4% of controls. Subnormal intelligence was found in 21.2% of JE subjects, compared with 1.2% control who exhibited a mildly reduced IQ. Abnormal MQ scores were noted in 56.3% JE subjects, compared with only 12.7% controls. Prevalence of each sequelae caused by JE were significantly higher in adults than in younger subjects. Furthermore, median DALY lost due to JE was 9.2 per subject. Median economic cost of JE was approximately $2776.6 per subject and significantly higher in adults than in younger subjects.Findings and Conclusions: JE patients suffered from severe neurological sequelae and high disease burden, resulting in a significant downstream burden for both the patients (especially adults) and the healthcare system.

Outcome and Sequelae of Infectious Encephalitis

“…A recent Chinese cohort study including 35 adults among 85 JE patients found that neurological and cognitive sequelae were more frequent in adult patients than children at follow-ups performed 1 to 8 years after discharge. 30 Sensory disorders were seen in 60% of 35 adults, motor disorders in 41%, aphasia in 14%, and epilepsy in 6%. General, verbal, and performance IQ scores were lower than 70 in 37% of adult patients, and 72% had memory disorders.…”

“…The CFR may be significant among these infections, such as 18% for WNV encephalitis 29 and 20% for JE. 30 The CFR following TBE depends on the viral subtype: the Far East subtype is known to be more pathogenic than the Siberian and European subtypes, with the CFR following TBE due to the European subtype reportedly being less than 1%. 31 …”

Economic burden of dengue fever in China: A retrospective research study

“…The results showed that, compared with the economic burden of other infectious diseases in China, the costs from dengue fever is lower. Liao [ 19 ] investigated the economic burden of patients from 21 notified infectious diseases in an infectious disease hospital and found that the average direct economic burden of patients from 2006 to 2015 ranged from 9,892.13 CNY to 12,572.06 CNY, while Wang et al [ 20 ] found that the direct economic burden of Japanese encephalitis patients was 6889.00 CNY in Gansu Province, and it was 7228.00 CNY for scrub typhus patients [ 21 ]. The direct economic burden of all these diseases was higher than that of dengue patients in this study, and the indirect economic burden was similar.…”

3D engineered tissue models for studying human-specific infectious viral diseases

“…The Japanese encephalitis virus (JEV) causes severe neurological infection in the brain [ 154 ]. Most diseases caused by JEV infection appear with mild symptoms, but severe symptoms such as mental disorders appear when the virus spreads to the brain [ 155 ]. Children under the age of 15 years may die or suffer from complex disabilities, including intellectual, behavioral, or neurological problems such as paralysis, recurrent seizures, or the inability to speak [ 156 ].…”