Clinical Profile of Acute Encephalitis Syndrome in Children with Special Reference to Japanese Encephalitis in a Tertiary Care Teaching Hospital of Upper Assam

Title: Clinical Profile of Acute Encephalitis Syndrome in Children with Special Reference to Japanese Encephalitis in a Tertiary Care Teaching Hospital of Upper Assam

Authors: Pankaj P Panyang, Manab Narayan Baruah, Pranabjit Biswanath

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.61

Abstract

Background: The north eastern region of India is an endemic area for viral encephalitis that clinically presents as acute encephalitis syndrome (AES). The Japanese Encephalitis (JE) is an acute mosquito-borne viral disease and the most important causative agent of AES in this region, resulting in considerable morbidity and mortality every year. JE is endemic in Assam with outbreaks every year during the monsoons.

Aims: This study was conducted to study the clinical profile of pediatric Acute Encephalitic Syndrome with special reference to Japanese Encephalitis admitted to the department of Pediatrics, Jorhat Medical College and Hospital.

Study Design: Retrospective record-based hospital study in the Department of Pediatrics, Jorhat Medical College and Hospital, Jorhat for 2 years (1^st January 2014 to 31^st December 2015).

Methods And Materials: All admitted cases age between 2months to 12 years fulfilling WHO clinical criteria of AES admitted in Pediatric Ward during study period were included in the study. Other cause of fever, altered sensorium with or without seizure and febrile seizure cases were excluded from the study. Clinical & pathological profile, outcome were analyzed from patient bed head tickets.

Results: The mean age at presentation of AES in children was 6.5 years (range 2 month-12 years) with a male: female ratio of 1:1.2. The maximum number of cases presented during the monsoon months of July and August. JE virus was the commonest causative agent accounting for 34.56% of all cases. Case fatality rate for JE was 51.78% and the majority of deaths were observed in the age group of 5 to 12 years.

Conclusion: Acute Encephalitic Syndrome is a major public health problem in Assam. The yearly seasonal occurrence of both Japanese and Non – JE encephalitic diseases is associated with significant mortality and morbidity in terms of long term neurological sequeale. Japanese Encephalitis accounts for a majority of cases of AES in this region. Though JE vaccine has been introduced in the National Immunization Schedule (NIS), effective vaccination combined with improved vector control strategies and public awareness will be helpful in reducing the disease burden of Japanese Encephalitis.

Keywords: Encephalitis, Japanese; Encephalitis, Viral; Japanese Encephalitis Vaccines.

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Corresponding Author

Dr Pankaj P Panyang

Department of Pediatrics, Jorhat Medical College & Hospital

Jorhat, Assam, India, Pin 785001

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