Japanese encephalitis virus (JEV) is an important cause of encephalitis among children in Cuddalore district, Tamil Nadu, India (original) (raw)
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Journal of Clinical Virology, 2005
Background: Japanese encephalitis (JE) is endemic in Cuddalore district, Tamil Nadu (TN), Southern India. The reports of JE cases from the local hospitals did not reflect the actual disease burden. It is likely that these cases were attending the nearby referral hospitals, for want of better treatment facilities. Objectives: Between July 2002 and February 2003, a pilot study was undertaken to examine whether JE was a component of paediatric acute encephalitis syndrome (AES) reported to two major referral hospitals adjacent to Cuddalore, and to map the distribution of the JE cases. Study design: A total of 58 hospitalized children [0-15 years] with AES were investigated. Other than the routine laboratory investigations, either CSF or sera or both [depending on the availability] collected from these children were analyzed at Center for Research in Medical Entomology, Madurai (TN) for JEV-antigen, antibody detection, virus isolation and virus genome detection by indirect immunofluorescence, MAC enzyme linked immunosorbent assay (ELISA), insect bioassay and by reverse transcriptase polymerase chain reaction (RT-PCR), respectively. Results: JE was established in 17 (29%) of 58 AES cases; half of the AES cases [31/58, 53%] and 59% [10/17] of JE cases were confined to JE-endemic areas in Cuddalore district. The JE confirmation scored by different assays varied according to the clinical phase of the illness. The attack rate was high among the children aged 3-8 years. The monthly distribution of acute encephalitic syndrome cases followed the distribution of JE cases [coinciding with the rainy season in this region] suggesting encephalitis of JE origin. Conclusion: In JE-endemic areas, the actual JE burden can be estimated by the collection of JE case reports from the local hospitals and from the referral hospitals. Building of diagnostic facilities in hospitals for JE is necessary to achieve this goal.
Serosurveillance for Japanese encephalitis in children in several districts of West Bengal, India
Aim: To evaluate the prevalence of antibodies to flaviviruses, particularly Japanese encephalitis (JE) in children. Methods: Virological and serological investigations were conducted into JE, along with dengue 2 (Den2) and West Nile viruses, in the Flavivirus group. The paediatric age group (up to 10 y), in the districts of Burdwan, Bankura, Midnapore and Purulia of West Bengal, India, was assessed for recent activity of these viruses, for 4 consecutive years from 1996 to 1999. In total, 2260 sera samples were collected, of which 204 were from acute fever cases; only 72 paired sera were available. There was a significantly higher incidence of fever cases in children belonging to the schedule caste and schedule tribes. These communities occupy the lowest level in the society and are closely associated with pigs. Results: No virus could be isolated from the sera collected from fever cases. The results of the serological survey showed the presence of antibodies to JE virus in only 13.3% of the contact sera, 33.3% of acute sera and 22.1% of convalescent sera investigated. Only 3.1% of the contact sera had antibodies to Den2 and no antibodies were found against West Nile virus. This indicates that the JE virus is in recent circulation in the population of these four districts, and as the majority of children lack substantial immunity to JE virus, they may be affected by an epidemic.
Clinical Infectious Diseases, 2006
Background. Japanese encephalitis is a disease that affects the rural poor in Asia. In August-September 2005, a severe epidemic of Japanese encephalitis occurred in Uttar Pradesh, one of India's poorest states. Methods. Children admitted to the King George Medical University hospital (Lucknow, Uttar Pradesh, India) with acute febrile encephalopathy (defined as fever plus encephalopathy of р2 weeks' duration) from July to October 2005 underwent ELISA for Japanese encephalitis virus immunoglobulin M in cerebrospinal fluid or serum on hospital admission. Clinicolaboratory features of patients with positive test results were recorded. Results. Of the 223 children tested, 77 had positive results for Japanese encephalitis immunoglobulin M. Patients were from 18 districts of Uttar Pradesh. All but 1 were from rural areas, and none were !2 years of age. The prodromal period was very short (, days). Convulsions were present mean ע standard deviation 2.61 ע 2.23 in 76 patients (98.7%). The mean ע( standard deviation) Glasgow Coma Scale score was. Generalized 7.4 ע 2.7 hypertonia was found in 39 patients (50.6%), and focal deficits were found in 35 patients (45.4%), including 19 cases of monoparesis and 16 cases of hemiparesis. Gastric hemorrhage was found in 42 patients (54.5%). Extrapyramidal features were found in 24 (31.1%), a hyperepneic breathing pattern was found in 20 (26%), and thrombocytopenia was found in 5 (15.6%) of 32 patients. The mean cerebrospinal fluid cell count was 48.3 cells/ mm 3. The serum bilirubin level was normal in all patients, but the aspartate aminotransferase level was elevated in all 21 patients (100%) tested and the alanine aminotranferase level was elevated in 25 (47.2%) of 53 patients. In-hospital mortality was 34%. Conclusions. Clinical features of Japanese encephalitis were severe. Derangements in liver function and thrombocytopenia were found in a significant proportion of patients. These findings were not highlighted during earlier epidemics of the illness and could suggest a possible mutation of the virus towards other flaviviruses.
Abstract:Japanese encephalitis (JE) is an important cause of morbidity, mortality, and disability in the countries of Asia. Prospective, hospital-based study for AES/JE in all the age group was undertaken for 5 years (January 2008– October 2012) in lakhimpur district of Assam. A total of 217 (Two hundred and Seventeen) nos of AES suspected cases were found from different areas of North Lakhimpur District of Assam out of which 54 (fifty four) nos of patients expired. Serological diagnostic test revealed that 66 (Sixty six) nos of cases were found to be positive for JE IgM antibodies. 12 (Twelve) no of JE positive patients expired during last five years. Most of the AES cases were observed between the age ranges of 6-30 years. Males were highly affected with AES as compared to females. A positive correlation was found between the nos of occurrence of AES/JE cases and monthly rainfall. The prevalence trends of AES/JE cases were found to an unsteady pattern. Keywords:Acute encephalitis syndrome, Japanese Encephalitis, Rainfall, Assam etc.
2018
Introduction: Japanese Encephalitis (JE) commonly affects children and is a major cause of acute childhood encephalopathy. Growth of population, intensified rice farming, pig rearing and lack of surveillance are the key factor for transmission of the disease. Methods: The present study aimed at determining the Case Fatality Rate, Sample Positivity Rate (SPR) and distribution (Time, Place, and Person) of Acute Encephalitis Syndrome (AES) and JE cases in Sonitpur District of Assam, India. This descriptive study was conducted over 8 years’ period (2009-2016), based on surveillance data corresponding to each year. Confirmation of JE was done by IgM ELISA method. Results: In the present study the CFR was highest for AES in the year 2015 being 11.1% and for JE it was 28% in the year 2015. Overall Sample Positivity Rate for JE was 18.35%. In this 8 years’ study (from2009 to 2016), an almost equal sex distribution was observed in case of JE in Sonitpur District. Epi curve of AES cases of So...
Journal of evolution of medical and dental sciences, 2019
BACKGROUND Japanese Encephalitis (JE) over the years has emerged as one of the major public health problems in the country due to its complex eco-epidemiology. JE virus is a leading cause of encephalitis in Asia, causing an estimated 67, 900 JE cases annually. JE/AES has been reported from 171 districts of 19 States in the country. The present study was undertaken to study the trend of AES/JE cases in Cachar District of South Assam. METHODS This is a retrospective descriptive study. IDSP surveillance data was examined for the period January 2014 to December 2016. Results were analysed, and appropriate statistical methods was applied. RESULTS Among 300 clinically diagnosed cases of AES, 189 were males (63%) and rest 111 (37%) were females. The overall SPR for JE was 16.33%. Significant association was found between age groups and sample positivity rate and in distribution of cases in different block PHCs; with highest SPR observed in 31 to 60 years age group. The CFR in AES and JE Cases was found to be 12.34% and 12.24% respectively. The monthly JE cases show seasonal peaks during June to October, coinciding with rainy and post-rainy seasons. Significant correlation of rainfall with prevalence of JE was noticed. CONCLUSIONS JE is endemic in south Assam districts and affects all age groups specially adults. Hence, JE vaccination, integrated vector control management, information, behaviour change communication to be initiated for control of JE.
JAPANESE ENCEPHALITIS IN CHILDREN IN BELLARY KARNATAKA: CLINICAL PROFILE AND SEQUELAE
Objectives: To study the clinical profile and outcome of Japanese Encephalitis(JE) Methods: Prospective study was done in Vijayanagara Institute Medical Sciences hospital, Bellary, Karnataka. 233 patients below 12 years of age presented with acute encephalitic picture during the epidemic period formed the subjects and were worked up according to a predesigned protocol. CSF and serum samples were tested for JE specific IgM antibodies. Patients were followed up for 4 months to over one year. Results: The predominant age group was 5 to 12 years. Fever (94.84%), seizures (73.39%) and altered sensorium(91.84%) were the important presenting symptoms. Onset of illness was acute in 28.32% and subacute in 38.62% .CSF showed lymphocytosis and 45.06% had cell count of 6-50/cmm and in majority it was <200/cmm. 55.36% patients were positive for JE. Mortality was 22.74%. Deeper level of coma , respiratory irregularities and meningeal signs were associated with mortality. 147 patients survived the acute attack. Of that 40.85% completely recovered. Speech disturbance (47.61%), motor deficits (36.73%), behavioural disturbance (14.96%), involuntary movements (12.24%) and seizures (1.36%) were the morbidities. The deficits found to be gradually improving. Motor deficits and speech disturbances were found in 25.68% and 22.01% respectively at one year follow up. Conclusions: The characteristic clinical features of JE include fever, seizure, altered sensorium, aphasia, relative absence of cranial nerve involvement and irregular and rapidly changing motor and tone abnormality. Deeper level of coma, respiratory abnormalities and meningeal signs were associated with mortality. Speech disturbance and motor deficits were frequently encountered sequelae.
BioMed Research International, 2013
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.