Japanese Encephalitis

Japanese encephalitis is a viral illness affecting most regions in Asia. It is caused by a virus that considers pigs and birds as prime reservoir and comes from the family Flaviviridae. It is carried by a mosquito vector known as Culex tritaeniorhynchus which resides in marshes, rice fields, still waters and wetlands, therefore rural areas are the ones mostly affected.  Once it infects humans, it can be tremendous as it affects the central nervous system, develop complications and can eventually lead to death.

Manifestations

  • Fever
  • Fatigue
  • Chills
  • Nausea
  • Headache
  • Vomiting
  • Rigidity
  • Convulsions
  • Confusion
  • Seizures
  • Paralysis
  • Coma
  • Brain damage

Pathophysiology

The mosquito vector usually resides in rice fields and wetlands, once infected by the virus and attacks human, the bite injects the virus into the human system and causes infection. Once inside the body, it affects the central nervous system which includes the brain and the spinal cord. Since there is no specific treatment, complications and mortality is highly possible.

Diagnosis

Japanese Encephalitis is diagnosed by the following:

  • Blood tests
  • Serum tests (detects antibodies)
  • CSF (cerebrospinal fluid) exams

Prevention

Since mosquitoes are never fun to be with, it is recommended that individuals should use clothing that could protect their skin, the use of long pants and long sleeved shirts can be very helpful. Applying mosquito repellent lotion and putting up screened rooms and mosquito nets can prevent mosquito attacks. Promoting sanitation in the surroundings will be of great help. For travellers, a vaccine against this virus can prevent infection. It should also be known that this type of mosquitoes attack during cooler periods of the day, therefore activities during sunset and sunrise should be limited.

Management

There is no specific treatment for Japanese encephalitis, therefore, preventive and supportive therapies are the only available regimens that can aid individuals affected with this malady. For prevention, vaccines used are JE-Vax, Green Cross and IXIARO (mostly used in US and in Europe). As of today, research and development of more vaccines are being done. Supportive therapy involves care and treatment of symptoms and complications. Since Japanese encephalitis affects the central nervous system, nursing and medical management focuses more on oxygenation (breathing especially), mobility, self care, feeding, seizure management and passive ROMs. Medications are indicated so as to treat manifested symptoms like seizures, increased intra cranial pressures and other possible complications.

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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