Dumaguing: Japanese Encephalitis

PARENTS, especially mothers have been texting and calling; frantic and nervous about the increasing deaths from Japanese encephalitis, especially among children, even at the heel of reassurance of the Department of Health (DOH) that there is no case of human avian flu in the country.

Indeed, as of this writing, it appears that the scary bird flu has been contained, thanks to the aggressive and concerted efforts of government agencies as well as local officials, so much so that even our President Rody was seen enjoying a boodle fight with chicken and eggs as main gustatory delights. But then, here comes Japanese encephalitis.

Fact is, the brain and the spinal cord are remarkably resistant to infection but when they do get infected, the consequences as well as complications can be serious and even deadly. For example, meningitis is inflammation of the coverings of the brain-dura mater, arachnoid and pia mater- and the spinal cord. Encephalitis is a term which should be reserved for those pathologic states diseases of the brain in which inflammation and especially infection is the predominant.

In both meningitis and encephalitis, the causative organisms may be viruses, bacteria, fungus and even protozoa. However, although both are diseases of the central nervous system, in encephalitis, the affected part of the brain is the parenchyma or the brain tissue itself. If the infection extends to the spinal cord, then it is called encephalomyelitis.

Historically, Japanese encephalitis attracted worldwide attention and concern when large numbers of military personnel stationed in the Far East suffered from the disease.

That was 1924, it affected thousands of locals as well as foreigners and killed many of them. There seems to be seasonal pattern, spiking in incidence during the summer months. Admittedly, it continues to be a public health hazard.

The Japanese encephalitis is caused by a virus transmitted by the bite of the Culex mosquito. Like most encephalitis, the acute stage is associated with fever, severe headache, nausea and vomiting, with signs and symptoms of menigeal irritation like stiff neck. Encephalitis disrupts normal brain functions causing personality changes, some form of muscle weakness or paresis, confusion or delirium states, seizures, sleepiness that could deteriorate into coma.

Doctors and even specialists in neurology admit that during the acute stage of the disease, it is not easy to diagnose the illness, much less differentiate encephalitis from meningitis. A spinal tap - kinunan ng tubig sa likod - also called lumbar puncture is routine diagnostic procedure. Immunologic tests would show rise of antibodies to a particular virus. Problematic cases may require CATScan and even an MRI.

Anti-viral medicines are part and parcel of management of encephalitis on top of supportive and symptomatic treatment. Recovery would greatly depend on how early medical treatment is instituted before coma occurs.

Let's put our hands together and pray that a vaccine be available soon. Meanwhile, let's clean our surroundings let's, deprive that pesky Culex its breeding place and protect ourselves from its bite.
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