A Study of 32 Adult Patients of Japanese Encephalitis in Jharkhand.

Abstract

Japanese encephalitis (JE) is fatal endemic viral encephalitis and is common in India and other parts of the world. It has a mortality rate of around 20-30%, and most of the survivors are left with neurological deficits. Studies related to JE in India, including Jharkhand, are focused on the pediatric population. This study aims to evaluate the presentation and prognosis of JE among adults. In this observational and prospective study, 116 patients aged 18 years or above with features of encephalitis were investigated. JE was confirmed in 32 adults by detection of immunoglobulin M (IgM) antibody in cerebrospinal fluid (CSF) through the National Institute of Virology (NIV) Pune kit. Detailed demographic profile, clinical picture, fatality rate, and prognosis were evaluated. Out of the 32 patients we enrolled for the study, 75% (24) were male and 75% (24) were between 18 and 40 years of age. The mean age of presentation was 29.81 ± 14.14. Most of the patients (87.5%) belonged to rural areas; also, most of them presented between August and November. In our study, the most common symptom was fever, seen in all patients, followed by altered sensorium in 24 (75%), seizure in 10 (31.25%), and headache in 8 (25%). Around 14 (43.75%) patients succumbed to death, and out of all patients who were discharged, 88.88% had neurological deficits and 11.11% of patients were healthy. The most common neurological deficit among discharged patients was an inability to speak (44.44%). We found high mortality and neurological deficits among adults. Detailed epidemiological surveys, awareness programs, and targeted use of vaccination can be helpful.