Japanese encephalitis is a mosquito - Transmissible virus neuroinfection with a primary lesion of the brain substance. It is characterized by endemic outbreaks in the period from August to the end of September. It has obscheinfektsionnoe beginning, during the height of characteristic disorders of consciousness, meningeal syndrome, hyperkinesia, myoclonus, paresis, bulbar disorders. Diagnosis involves the study of cerebrospinal fluid, carrying RIF, ELISA and PCR analysis. The therapy is carried out specific immunoglobulin or serum, anti, detoxication, vascular, anticonvulsant, corticosteroids pharmaceuticals.
Japanese encephalitis is a mosquito
Encephalitis is a severe neuroinfections, affecting the medulla and cerebral membranes, prone to generalized spread throughout the body. Description of the disease outbreaks in Japan is found in historical materials of the XVIII century. In 1924 in Japan, there was a great epidemic of Japanese encephalitis with mortality at the level of 70-80%. During this period, there were the first detailed description of the disease, and it has been identified as an independent nosology. In connection with the events in Japan encephalitis called "Japanese." However, natural foci of the disease are found not only in Japan but also in the Far East, Primorye Territory, India, Vietnam, China, Korea, the Philippines.
In the 1933-36 biennium. It was isolated the virus causing Japanese encephalitis. It turned out that it susceptible goats, horses, sheep, cows, monkeys, rodents and some wild birds. Most susceptible to disease children under 10 years of age. Pregnant women with the disease in 1-2 trimester is often a spontaneous abortion (miscarriage). A high percentage of mortality and sequelae do Japanese encephalitis urgent task of modern neurology, infectology and epidemiology.
speech disorders, decreased vision, diplopia, dizuricheskie disorder. After a couple of days all of a sudden debut and quickly compounded obscheinfektsionnye symptoms: high temperature, reaching up to 41 ° C, stunning chills, intense headache, myalgia, back pain and abdominal pain, severe weakness, staggering, sweating, nausea and vomiting. There is facial flushing. Characterized by bradycardia, which is then transformed into a tachycardia. On the 3-4th day of encephalitis on the background of infectious-toxic syndrome show signs of CNS.
Disorders of consciousness that accompany Japanese encephalitis in the crisis period, include confusion, amentia, with agitated delirium and delirium, stupor, coma. Develops meningeal syndrome with typical posture of the patient, hyperesthesia, meningeal signs. There may be seizures, hyperkinesis, oculomotor disturbances, paralysis and paresis of the limbs (mainly on gemitipu), central facial nerve paresis, bulbar disorders. Often marked myoclonic jerking of different muscles, limb tremor when growing movements. Possible pathological sleepiness (hypersomnia), resembling symptoms of lethargic encephalitis.
Japanese encephalitis has an acute course. Fever persists the first 7-10 days. The peak of clinical manifestations observed usually for 3-5 day encephalitis. During this period, Japanese encephalitis can be complicated by infection, toxic shock, brain edema, bacterial pneumonia, pyelonephritis, pulmonary edema, sepsis. Then there is a gradual regression of the symptoms, but convalescence is fairly slow (up to 1.5-2 months.), Long-term fatigue persists, many recover residual effects observed.
Lumbar puncture is performed to take on the analysis of cerebrospinal fluid. Recent research finds characteristic of serous meningitis lymphocytic pleocytosis and a slight increase in protein concentration. Ophthalmoscopy reveals hyperemia of the optic nerve, swelling and sometimes petechial hemorrhages. neuroimaging techniques (CT, MRI) are used to exclude other cerebral pathology (intracerebral tumors, hematoma, stroke).
Japanese encephalitis confirmed by virus isolation from blood and cerebrospinal fluid. However, in clinical practice, the definition of antibodies to the virus by means of ELISA or IFA, as well as the identification of viral RNA by PCR-study. Serological response to the study of paired sera are predominantly retrospective significance, since the second serum is taken on the 3-4th week encephalitis. In the initial period of Japanese encephalitis is difficult to differentiate from other acute infections: flu, measles and other acute respiratory viral infections. When unfolding picture of meningoencephalitis require differentiation from other viral encephalitis - tick-borne encephalitis, lethargic encephalitis economy, secondary encephalitis, a two-wave viral meningoencephalitis.
hearing loss, reduced vision, speech disturbances, ataxia) and psychiatric disorders (hebephrenia, dementia, manic-depression), require further ongoing monitoring by a neurologist or psychiatrist.
Prevention of Japanese Encephalitis
Measures that reduce the incidence of Japanese encephalitis in endemic foci, concerns the use of mosquito nets and protective clothing, treatment of skin exposed areas repellents. Specific preventive maintenance is carried out by vaccination. It is carried out in endemic areas and traveling to parties. Children can be vaccinated from 1 years of age. Adult urban population of endemic areas vaccination is usually not required.
Standard vaccination regimen consists of administration of the vaccine three times at intervals of 721 and then day. There is also an accelerated schedule, wherein administration of the third vaccine made after 7 days from the second. It is believed that the first two doses of vaccine given sufficient protection in 80% of cases. The last administration of the vaccine should be administered within 10 days before moving in endemic area. Revaccination is carried out with an interval of 2-3 years.