Clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndrome.

Jagadish Mahanta,Prafulla Dutta,Gitali Kakoti,Bishnu Ram Das,Jani Borah

doi:10.1155/2013/152656

Abstract

Japanese encephalitis (JE) is an arthropod borne viral disease. Children are most commonly affected in Southeast Asian region showing symptoms of central nervous system with several complications and death. The clinical characteristics and outcomes in pediatric JE patients hospitalized with acute encephalitis syndrome (AES) are still poorly understood. A prospective study was conducted in pediatric ward of Assam Medical College Hospital to evaluate the clinical profile and outcome of JE in children. A total of 223 hospitalized AES cases were enrolled during March to December 2012. Serum and cerebro spinal fluids were tested for presence of JE specific IgM antibody. 67 (30%) were found to be JE positive. The most common presenting symptoms in JE patients were fever (100%), altered sensorium (83.58%), seizure (82.08%), headache (41.79%), and vomiting (29.85%). Signs of meningeal irritation were present in 55.22% of cases. Around 40.29%, JE patients had GCS ≤ 8. Among the JE patients, 14.7% died before discharge. The complete recoveries were observed in 63.9% of cases, while 21.3% had some sort of disability at the time of discharge. JE is still a major cause of AES in children in this part of India. These significant findings thus seek attentions of the global community to combat JE in children.

Highlights

Japanese encephalitis (JE) is the most prevalent and significant mosquito borne viral encephalitis of man, occurring with an estimated 30,000 to 50,000 of cases and 15,000 deaths annually [1,2,3]
In 45 acute encephalitis syndrome (AES) patients both serum and CSF were positive for Japanese encephalitis virus (JEV) specific IgM antibody
The present study demonstrates that JE is one of the leading forms of viral encephalitis of children in this part of the country

Summary

Introduction

Japanese encephalitis (JE) is the most prevalent and significant mosquito borne viral encephalitis of man, occurring with an estimated 30,000 to 50,000 of cases and 15,000 deaths annually [1,2,3]. About 20% to 30% of JE cases are fatal, and 30–50% result in permanent neuropsychiatric sequelae [3, 4]. In India, most states have reported JE cases except that of Jammu & Kashmir, Himachal Pradesh, and Uttaranchal [7]. The Northeastern region (NE region) of India, the upper part of the state of Assam, has been experiencing recurrent episodes of JE with different magnitudes from July to October every year [8]. Treatment of JE is essentially symptomatic and intensive supportive care is important to avoid neurological sequelae [12]. This study was undertaken for a better understanding and to determine the clinical profile and outcome of JE in children hospitalized with AES cases which may help in early diagnosis and initiating prompt supportive care

Materials and Methods

Results

Discussion