Japanese Encephalitis and Other Acute Encephalitis Syndrome in the Khurda, Odisha, India

Abstract

Background: Japanese Encephalitis (JE) is caused by Japanese encephalitis virus (JEV), a mosquito-borne flavivirus (family Flaviviridae, genus Flavivirus). In India a large number (10-15%) of cases of Acute Encephalitis Syndrome (AES) is due to Japanese encephalitis with a case fatality rate of 18%. In Odisha, sporadic cases of JE/AES cases have been reported since 2011. A case-control study was conducted in Khurda district of Odisha to assess the burden of Japanese encephalitis and the associated risk factors. Methods: A probable case of AES/JE is defined as any child of 0-15 year age with onset of illness between September 1-December 31, 2017, residing in the Khurda district of Odisha, presenting with an “acute onset of fever, change in mental status (such as confusion, disorientation, delirium or coma) and/ or new onset of seizures”.. A 1to 2 age matched case-control study was conducted. Data was analysed using SPSS version 15.0.Results: We enrolled 13 cases and 26 controls between September 1-December 31, 2017. People living in close proximity to the agricultural fields(OR:15.63) rearing livestock at their house and having animal shed at proximity (OR:3.02 and 6.57 respectively) are at higher risk of getting the disease. Presence of waterbodies within 200-meter distance of the household (OR: 9.05) and stagnant water in the surrounding of the houses (OR: 12.38) were at higher risk of getting AES/JE.People using peri-domestic space for toilet (OR: 3.6) and having Practice of open air defecation (OR: 12.38) were are at higher risk of getting the disease.Conclusion: Improvement of water and sanitation practices among the community by empowering the village water hygiene and sanitation committee and village gram panchayat. That will also involve building of toilets in the houses. Vector control activities like insecticide fogging, IRS spraying and distribution of long lasting insecticide treated nets are to be taken into consideration, especially in the rural parts of the district where it is not done regularly. Vaccination coverage of Japanese Encephalitis vaccine is to be increased.