Recently more than 60 children lost their lives within a span of five days in one of the state run Hospitals at Uttar Pradesh.
These deaths were attributed to various reasons ranging from infections arising out of Encephalitis to disruption of oxygen supply in the medical wards; the hospital authorities, however, have rejected oxygen shortage as the reason. This article is an attempt to understand Encephalitis.
What is Encephalitis?
Encephalitis is a condition that causes inflammation (swelling) of the brain. It is usually associated with fever, headache, delirium (severe confusion), stiffness in the head and neck region and may also be associated with seizures (epilepsy).
Causes of Encephalitis:
Encephalitis is a non-communicable disease ( is not transmitted from one person to another through touch, etc.)
Encephalitis is primarily caused by viruses but may also be caused by bacteria or parasites and rarely by fungus.
The virus may be transmitted through vectors (example – Nest Nile virus carried by an infected mosquito) or through viral infections (example – herpes simplex virus).
Encephalitis may also be caused due to weak immune system and may also be transferred from a mother to the child.
Types of Encephalitis:
Encephalitis may be classified based on
a) Classification based on type of Infection:
Primary Encephalitis—Primary encephalitis is the one that may be sporadic (sporadic) or occur in various people at the same time in the same geographical area (epidemic).
Secondary Encephalitis— This type of Encephalitis is caused by reactivation of a viral infection or due to a complication of viral infection. The reactivation may be caused by suppression of immune system that may be caused by stress/malnutrition/other conditions.
b) Classification based on Cause of Infection:
- Japanese Encephalitis – Caused by Mosquitoes
- Tick borne Encephalitis – Caused by Ticks
- Rabies – Caused by Mammals
Children and older people are more susceptible to this condition.
People with weakened immune systems are also more prone to this condition.
Encephalitis – Symptoms:
The symptoms associated with Encephalitis may be categorized as Mild or severe.
Mild Encephalitis Symptoms:
- High Fever
- Delirium (Confusion)
- Head and neck muscle stiffness
Severe Encephalitis Symptoms:
- Seizures (epileptic attacks)
- Loss of Memory
- Personality Disorders
Diagnosis of Encephalitis:
Encephalitis is usually diagnosed based on the medical history of the person, the doctor may prescribe one or more of the following tests to confirm the same.
- Diagnostic Imaging- Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) Scan may be prescribed by the doctor to check for the inflammation (swelling) or other changes in the brain.
- Spinal Fluid Test- Spinal fluid test/analysis may be done to check for increased White Blood Cells (WBCs) or proteins. The causative agent virus/bacteria/fungus/parasite may also be detected in the cerebrospinal fluid.
- Blood Test – At times blood tests may also be prescribed by the doctor to confirm type of causative virus/bacteria.
- Electroencephalogram (EEG) – EEG measures the electrical signals of the brain, the changes in the brain signals can be indicative of this condition.
Encephalitis Prevention Tips:
- Avoid areas affected with viral encephalitis; if not avoidable prevent mosquito bites.
- Wear full sleeved clothing.
- Sleep under mosquito nets.
- Stay indoors in the evenings.
- Use mosquito repellent cream.
- Keep your surroundings neat and tidy.
- Avoid stagnation of water in containers.
- Use pesticides in around water bodies that breed mosquitoes/larva.
- Protect your children by giving them MMR (Measles, Mumps, Rubella) and Chickenpox vaccinations.
- Get yourself vaccinated against Japanese encephalitis/Mosquito borne encephalitis in case you are traveling in areas affected with these conditions
- Regularly check for ticks in and around elbows, hair line, groin area, arm pits.
Treatment of Encephalitis:
- Encephalitis is a rare but serious condition; the treatment plan is usually determined by the symptoms associated with it.
- Since most of the cases are caused by a Virus, antiviral medications are the first choice of treatment in cases diagnosed to be caused by viruses.
- In cases where the condition is caused by bacteria, antibiotics are the usually administered. The antibiotics may be either given orally or intravenously.
- The treatment may also include palliative or symptomatic care (treatment of the symptoms associated with the condition) for example physiotherapy for stiffness in and around the neck, occupational therapy for delirium/memory loss.
- Taking plenty of rest and fluids is advised during the course of the treatment.
- Headache and body ache may be relieved by Non-Steroidal Anti Inflammatory Drugs (NSAIDs) -It must, however, be noted that these drugs must be taken strictly under the guidance of the doctor as consumption of drugs such as aspirin may lead to certain adverse conditions such as Reye’s syndrome in children/young adults below the age of 20.
Note: This article is an attempt to educate people about encephalitis; we at Medlife do not encourage self-medication. If you or someone you know suffers from the above symptoms it may be advised to visit a physician at the earliest.