DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20194744

Study on acute encephalitis syndrome in children and their correlation with clinical parameters and etiological factors

Maram Nagarjuna Reddy, Gangadhar Belavadi, Vaka Hari Priyanka

Abstract


 

Background: Acute encephalitis is the clinical diagnosis of children with acute onset of symptoms and signs of inflammatory lesions in the brain. It must be diagnosed promptly for saving life and preserving brain functions.

Authors objectives was to determine the profile and outcome of children admitted with Acute Encephalitis Syndrome (AES) and to identify etiological factors.

Methods: Study consist of a retrospective analysis of hospital records of children up to 15 years of age admitted with a diagnosis of AES in the pediatric ward, Narayana medical college, Nellore from January 2018 to June 2019.

Results: In a total of 30 patients of AES, clinical features like fever (100%), altered sensorium (100%), convulsion (40%), headache (45%) and neuro deficit (40%) and vomiting (50%). The average Glasgow coma scale at admission was 8. There are 55% of cases in the 5 to15 yr age group (p>0.05). Both Encephalitis (56.6%) and meningitis (43.3%) were documented significantly more in males as compared to females (p<0.01). Twenty-one cases are discharged, eight expired, and 1 case was referred (p<0.001). JE IgM positive cases contributed to 36.6%, of which eight males and three females recorded between 5-15 years. Male children are more likely to play outdoors where the mosquito vector of the disease is abundant.

Conclusions: JE has significant morbidity and mortality, can be prevented by immunization, and reduced if supportive interventions are provided in time. Preventive measures must be taken for 5-15 years of age group those playing outdoors, going to school or agriculture fields predisposing them to vector mosquito bite.


Keywords


Acute encephalitis syndrome, Meningitis, Mortality, Glasgow coma scale

Full Text:

PDF

References


Narain JP, Lal S. Responding to the challenge of acute encephalitis syndrome/JE in India. J Comm Dis. 2014;46:1-3.

Kumari R, Joshi PL. A review of Japanese encephalitis in Uttar Pradesh, India. WHO South-East Asia J Public Health. 2012 Oct 1;1(4):374-95.

Sen TK, Dhariwal AC, Jaiswal RK, Lal S, Raina VK, Rastogi A. Epidemiology of acute encephalitis syndrome in India: changing paradigm and implication for control. J Comm Dis. 2014 Oct 7;46(1):4-11.

Ghosh S, Basu A. Acute encephalitis syndrome in India: the changing scenario. Annals Neurosci. 2016 Sep;23(3):131.

Kumar R, Tripathi P, Singh S, Bannerji G. Clinical features in children hospitalized during the 2005 epidemic of Japanese encephalitis in Uttar Pradesh, India. Clini Infect Dis. 2006 Jul 15;43(2):123-31.

Solomon T, Thao TT, Lewthwaite P, Ooi MH, Kneen R, Dung NM, et al. A cohort study to assess the new WHO Japanese encephalitis surveillance standards. Bulletin World Health Org. 2008;86:178-86.

Narain JP, Bhatia R. The challenge of communicable diseases in the WHO South-East Asia Region. Bull World Health Organ. 2010;88:162.

Fidan J, Emsley H, Fischer M et al. The incidence of acute encephalitic syndrome in western industrialized and tropical countries. Virology J. 2008;5.

WHO-recommended standards for surveillance of selected vaccine preventable diseases. Available at: http:// www.who.int/vaccine-documents/DocsPDF/843.pdf. Assessed 10 Feb 2010).

Burke DS, Nisalak A, Ussery MA, Laorakpongse T, Chantavibul S. Kinetics of IgM and IgG responses to Japanese encephalitis virus in human serum and cerebrospinal fluid. J Infect Dis. 1985 Jun 1;151(6):1093-9.

Gupta N, Chatterjee K, Karmakar S, Jain SK, Venkatesh S, Lal S. Bellary, India achieves negligible case fatality due to Japanese encephalitis despite no vaccination: an outbreak investigation in 2004. Ind J Pediatr. 2008 Jan 1;75(1):31-7.

Rayamajhi A, Singh R, Prasad R, Khanal B, Singhi S. Clinico-laboratory profile and outcome of Japanese encephalitis in Nepali children. Annals of tropical paediatrics. 2006 Dec 1;26(4):293-301.

Solomon T. Flavivirus Encephalitis. N Eng J Med 2004; 351:370-8.

Shresta SR, Awale P, Neupane S, Adhikari N, Yadav BK. Japanese encephalitis in children admitted at Patan hospital. J Nepal Paediatr Society. 2009;29(1):17-21.

Mishra MK, Basu A. Minocycline neuroprotects, reduces microglial activation, inhibits caspase 3 induction, and viral replication following Japanese encephalitis. J Neurochem. 2008 Jun;105(5):1582-95.

Kumar R, Basu A, Sinha S, Das M, Tripathi P, Jain A, et al. Role of oral Minocycline in acute encephalitis syndrome in India–a randomized controlled trial. BMC Infect Dis. 2015 Dec;16(1):67.