JAPANESE ENCEPHALITIS IN ENGLISH
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https://www.youtube.com/watch?v=S5T-0cbRi2g
JAPANESE ENCEPHALITIS-
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Japanese
encephalitis (JE) is a mosquito-borne encephalitis caused by a group B
arbovirus (Flavi-virus) and transmitted by culicine (culex) mosquitoes.
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JE is the leading
cause of viral encephalitis in Asia and occurs in almost 24 Asian and Western
Pacific countries. In India JE was first identified in1955 in Tamil Nadu.
Presently it has been reported from different parts of the country. The disease
is endemic in 18 states. Assam, Bihar, Haryana, Uttar Pradesh, Karnataka, West Bengal and Tamil Nadu are most affected states.
SIGN AND SYMPTOMS-
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Mostly cases of JE
are asymptoatic. Based on sign and symptoms JE has three stages-
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Prodromal stage- Onset of prodromal stage is characterized by-
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fever,
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headache,
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gastrointestinal
disturbances,
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lethargy and
malaise.
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This stage lasts
for one to six days
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Acute encephalitic stage- In this stage sign and symptoms related to encephalitis starts such as-
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High fever,
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Nuchal rigidity,
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convulsions
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difficulty of
speech.
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Ocular palsies,
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hemiplegia,
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quadriplegia,
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coarse tremors,
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altered sensorium,
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patient may enter into coma.
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Late stage- This stage begins when active inflammation comes to an end. The
temperature touch to normal. Neurological signs become stationary or tend to
improve.
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Convalescence may
be prolonged and residual neurological deficits may stay for some time.
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The case fatality
rate varies between 20-40 per cent. The average period between the onset of
illness and death is about 9 days
DIAGNOSTIC INVESTIGATIONS-
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diagnosis of JE is
mainly based on serology using IgM-capture-ELISA which detects specific
IgM in the cerebrospinal fluid or in the blood of almost all patients within 7
days of onset of disease.
TREATMENT-
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There is no
specific treatment for JE. Only symptomatic treatment is provided along with
rest and adequate fluid. Antipyretic and pain killers are given to provide
symptomatic relief. Attention is given for preventive measures.
PREVENTION-
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(a) VACCINATION :
Vaccination of population at risk is best method of prevention of JE .
Currently, the two primary doses of JE vaccines are given at 9 and 16 months of
age. Recommended primary dose is 0.5 ml subcutaneously and site is left upper
arm.
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Booster doses are
given after 1 year and subsequently at 3-yearly intervals until the age of
10-15 years. The vaccine is given subcutaneously in doses of 0.5 ml for
children under 3 years and one ml for children more than 3 years of age.
Protective immunity develops in about one month time after the second dose.
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(b) VECTOR CONTROL:
The vector mosquitoes of JE are widely scattered and not easily amenable to
control. An effective way to deal with them is to resort to aerial or ground
fogging with ultra-low-volume (ULV) insecticides (e.g., malathion,
fenitrothion). All the villages reporting cases should be brought under indoor
residual spray.
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The spraying should
cover the vegetation around the houses, breeding sites and animal shelters in
the affected villages. Uninfected villages falling within 2 to 3 km radius of
the infected villages should also receive spraying as a preventive measure.
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Other measures to
prevent JE includes prevention of mosquito bite by using mosquito repellants
sticks, mosquito nets, mosquito
repellant creams and removing breeding places of mosquitoes. Imparting health
education regarding prevention of JE also prevents the disease in general public.
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