Japanese encephalitis

The Japanese encephalitis is an infectious disease caused by viruses. It is most common in Southeast Asia, China, and India and can be fatal if left untreated. However, there is a vaccination against this tropical disease that is recommended by the Tropical Institute for every traveler to Asia. Young children and the elderly in particular are at risk of severe complications from Japanese encephalitis.

What is Japanese encephalitis?

Of concern are cases in which the symptoms are severe and begin with a high fever, headache and muscle pain. Within a few hours and days after the first symptoms of the disease, disorders of consciousness appear, which indicate the involvement of the meninges.
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The Japanese encephalitis is a tropical disease that occurs mainly in East and South Asia. Most of India and the southern part of the People's Republic of China are hardest hit. It is a viral disease that in many cases causes very mild symptoms or can remain symptom-free because it does not break out at all.

One in 250 people becomes seriously ill and develops encephalitis, i.e. inflammation of the meninges. It is associated with symptoms such as impaired consciousness, high fever, muscle pain and severe headache. Diarrhea and vomiting are also characteristic of children. If Japanese encephalitis does not prove fatal, it often leaves permanent damage.

causes

Trigger the Japanese encephalitis are viruses that live in farm animals. Wild birds and pigs are particularly suitable, they carry most of the viruses. They are also occasionally found in horses or bats. They are finally transmitted by mosquitoes, which ingest the virus from farm animals and insert it into humans through their bites.

The incubation period of the Japanese encephalitis virus is 5-15 days, after which Japanese encephalitis may break out. The risk of infection for tourists is very low; the rural population in the endangered areas is primarily affected. The rate of new infections with Japanese encephalitis is also related to the life cycle of the mosquitoes and the rainy seasons, which are crucial for the survival and death of vector animals in this zone of the earth.

Symptoms, ailments & signs

Japanese encephalitis is usually mild or causes few or no symptoms. In two out of 250 cases, however, the infected develop severe health problems that are fatal in almost 30 percent of the cases. Many survivors suffer from permanent neurological damage after recovery.

In general, Japanese encephalitis produces flu-like symptoms with fever, chills, and headache. If the course is severe, meningitis sets in, which, in addition to fever, also causes headache, muscle and neck pain, neck stiffness and fatigue. Gastrointestinal complaints and an increased sensitivity to light and noise are also typical.

If there is also an inflammation of the brain, the initially high fever is followed by failure symptoms of the nervous system. Many patients suffer from confusion, clouding of consciousness and changes in behavior. Physically, encephalitis manifests itself in the form of seizures, paralysis, reflex disorders and muscle tremors.

In the further course the patient falls into a coma. Symptoms of severe Japanese encephalitis appear quickly and get worse over a period of a few days. The fever usually only subsides after seven to ten days of illness. If the course is severe, the individual symptoms can lead to the death of the patient.

Course of disease

Following an infection, this will Japanese encephalitis virus in most cases killed by the body's immune system. The disease does not develop and humans do not suffer any permanent damage. After the incubation period of 5-15 days, only very mild symptoms can occur that would hardly differ from severe flu. They disappear on their own after a few days and weeks and also leave no damage behind.

Of concern are cases in which the symptoms are severe and begin with a high fever, headache and muscle pain. Within a few hours and days after the first symptoms of the disease, disorders of consciousness appear, which indicate the involvement of the meninges. Other neurological symptoms can also develop.

If left untreated, Japanese encephalitis can be fatal. This can sometimes also be the case with treatment. At best, the patient will survive Japanese encephalitis and only suffer some permanent damage.

Complications

This encephalitis is a very serious disease. If there is no treatment, the patient can die from this disease in the worst case. Irreversible consequential damage is also possible. In order to avoid possible discomfort and complications, a vaccination should always be carried out before traveling.

Those affected suffer from a severe fever and headache. These can spread to other regions of the body and lead to pain there. Furthermore, without treatment, severe paralysis of the whole body and a stiff neck occur. Complete loss of consciousness can also occur and the person has a stiff neck.

The quality of life is significantly reduced by Japanese encephalitis and everyday life is restricted. The resilience of the person affected also decreases considerably as a result of this disease. Japanese encephalitis cannot be treated directly. Only the complaints are restricted.

There are no particular complications. However, the duration of this infection cannot be predicted. It is also possible that the person affected will be infected again even after successful treatment. If treatment is started early, there is usually no decrease in life expectancy.

When should you go to the doctor?

If you notice abnormalities and changes in your health perception a few days after receiving a mosquito bite, you should consult a doctor. Skin changes, unusual wound formation or peculiarities of the lymph are cause for concern. A doctor should be consulted as soon as you feel unwell, internal weakness or a feeling of illness. If you experience symptoms similar to those of the flu, they should be monitored.

If you have a headache, an increased need for sleep, a fever or sweating, a doctor should be consulted. Fatigue and poor concentration as well as loss of appetite should be examined and treated. If neurological abnormalities occur a short time later, medical care must be initiated immediately. In the event of unsteadiness, memory problems or functional disorders, the person concerned needs medical help. A visit to the doctor is imperative as this can lead to permanent impairments and a reduced quality of life.

Trembling limbs, muscle weakness, stiffness of the body or general poor performance should be examined and treated. Paralysis and cramps already indicate that the disease has progressed significantly. A doctor's visit is necessary to avoid long-term damage. In severe cases, the affected person may die prematurely without medical treatment. In acute cases, an ambulance service must be alerted. Until it arrives, first aid measures must be initiated.

Treatment & Therapy

Currently the Japanese encephalitis not specifically treated. Since it is a virus, research into an active ingredient is also made more difficult, as it is not a question of bacteria and classic methods (e.g. antibiotics) therefore hardly work. In the case of Japanese encephalitis, the course of the disease is intervened primarily symptomatically. For example, it is possible to use drugs to lower the patient's fever to prevent permanent damage or death from the patient.

It also supports breathing and circulation, which can be impaired by the involvement of the brain. It can also be useful to isolate the patient to prevent secondary infection, as this could be fatal.

Aftercare

Comprehensive care and aftercare are required to fully cure Japanese encephalitis. Treatment is aimed at relieving symptoms. Correct intake of the medication prescribed by the doctor is very important for patients. To date, there are no drugs for the direct treatment of the disease, but those affected should see a doctor.

Self-medication at home carries the risk of complications. A specialist, on the other hand, can identify the risk at an early stage and do something about it. As part of a targeted, intensive therapy, the disease can be cured well with timely intervention. Treatment is generally inpatient to ensure close monitoring.

After therapy, follow-up care focuses on further check-ups. Even after the hospital stay, those affected should take it easy. In order to rule out secondary infections, strict hygiene must be observed. This includes the use of disinfectants. Certain safety measures are designed to protect patients from infection during the recovery phase.

Only when the symptoms of the disease have regressed through regular use of the medication can those affected give up their illness-related isolation. However, depending on the severity of the life-threatening illness, the recovery phase may take a little longer.

Outlook & forecast

Japanese encephalitis can lead to numerous complications and premature death in the absence of adequate medical care. Although the infectious disease mostly occurs in Southeast Asia or India, it can still be transmitted to the local population by holidaymakers or other travelers. Due to the drastic course of the disease, there is the possibility of vaccination. Since almost 30 percent of the sick are confronted with a fatal outcome, this should be used in the event of a planned trip. If a vaccination has taken place, an infection and thus an outbreak of the disease is unlikely.

The difficulty of Japanese encephalitis lies in the likelihood of confusion with flu. If the diagnosis and thus the medical treatment are made at an advanced stage of the disease, the prognosis worsens. This can lead to lifelong consequential damage such as restricted mobility, paralysis or headaches. There is also the possibility of unconsciousness. Intensive medical care is necessary in the case of disorders of consciousness. Lesions of the brain are possible which are irreversible.

With rapid and comprehensive medical care for the patient, there is a possibility of full recovery. Symptomatic treatment takes place, which is created according to the individual complaints of the patient. The administration of medication reduces the symptoms.

You can do that yourself

While there are still no effective medicines to treat Japanese encephalitis, it is important not to try to monitor the progress of the disease at home. Professional medical therapy and care are essential to adequately respond to potentially serious complications. Patients with Japanese encephalitis go to inpatient care and follow the instructions of the doctors and staff. In the absence of suitable medication, the nursing staff only monitor the vital functions of the body such as the patient's circulation, heart rate and breathing.

The person concerned spends most of the inpatient stay in a resting position and uses hygienic and quarantine measures to ensure that they do not become infected with secondary infections. Contact with other people is only possible if they have undergone thorough disinfection and appropriate safety measures are in place.

During inpatient treatment, the patient must ensure that he is getting enough energy and nutrients through his diet. If sufficient food intake is not possible due to physical weakness or other reasons, the patient is given intravenous liquid food. The sick person must inform the medical staff of any change in his or her state of health in order to avoid complications of Japanese encephalitis.