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Japanese Encephalitis (JE)
DIMAPUR, OCT 22 (NPN):
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Published on 23 Oct. 2010 12:04 AM IST
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Zion Hospital & Research Centre, Dimapur has shared some of its findings on the Japanese Encephalitis (JE). According to the hospital’s Managing Director, Dr Mhonthung Murry, there is no specific treatment once the infection occurs and the only way to protect oneself from the dreadful disease is prevention through vaccination. In the year 2010, out of 10 positive cases, 6 resulted in deaths. The hospital currently is still struggling with 4 patients; three are in a vegetative state while one is recovering but speech affected.
What causes JE?
Japanese Encephalitis (JE) is an illness caused by infection with a Flavivirus that belongs to the family Flaviviridae. This virus is a part of a group of viruses known as Arboviruses that are spread by arthropods (mosquitoes or ticks).
The JE virus is carried by a variety of different mosquitoes, but not all. Mosquitoes spread the virus between humans and animals, and Culex annulirostris (common banded mosquito).
This disease is very dangerous and causes encephalitis, which is inflammation of the brain. This swelling can lead to death or brain damage. There is a 30% mortality rate for people who get sick from JE, and only 10-15% of patients make a full recovery. However, only 1 in every 30-300 people bitten by an infected mosquito becomes sick. JE is a Nationally Notifiable Disease.
In Dimapur, 2007: Patients complained of fever, severe headache, convulsions and neck rigidity with altered sensorium. Over a period number of patients increased with similar complains.
Laboratory analysis for Cerebro Spinal Fluid (CSF) showed
- High proteins
- Low Cell Count
- Sugar level a little low and ADA not so high like Tubercular (TB) meningitis.
OBSERVATION:-
• At the initial stage the JE can mimick TB meningitis.
• Can be differentiated by testing the blood- CSF.
• Patients die due to aspiration pneumonia and cerebral edema.
• Those who recovered showed second peak which seem to have more Sequela.
• Most of those who recovered have long lasting Sequela in the form of paralysis and mental derangement.
• Clinical observations need to be scientifically proven with studies involving larger number of patients.
How do we prevent it from occurring?
• Removing mosquito-breeding sites from around communities. Sites include blocked roof gutters, pot plant drip trays, and any containers that may hold water after rain (tins, tyres or jars).
• Keeping swimming pools full and well maintained and fishponds stocked with fish to stop mosquitoes breeding in them.
• Screening septic tank vents and rainwater tanks, and flushing unused toilets once a week to stop mosquitoes breeding in them.
• Screening living areas, and using mosquito bed-nets to keep out mosquitoes. Mosquito coils and mats can be used to kill adult mosquitoes in the home.
• Avoiding being outside in areas where mosquitoes are present just before sunset or sunrise, and for 2 hours after, because this is when they are most active.
• Wearing loose light-coloured long-sleeved shirts and long trousers, socks and covered footwear to prevent being bitten by mosquitoes. Clothing can be sprayed with mosquito repellents for further protection.
• Using insect repellents in areas where mosquitoes are active. Repellents containing 20-30% diethyl toluaminde (DEET) offer the best protection. However, they should not be used on small children. Repellents containing around 6% DEET are available, which are registered for use on kids. Repellents need to be applied every 4 hours.
• Sleeping under mosquito nets, because repellents do not last all night long.
• Avoiding keeping domestic pigs within 3km of a community.
• Prevention through control of Culex mosquito breeding, proper vaccination of the pigs reared at home and vaccination of the population at large.
JAPANESE ENCEPHALITIS CASES AT ZH&RC, DIMAPUR
Year Suspected Confirmed Male Female Dead
2007 15 7 4 3 1
2008 NIL NIL NIL NIL NIL
2009 20 8 6 2 5
2010 19 10 7 3 6

 
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