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Early mental and neurological sequelae after Japanese B encephalitis.

Japanese B encephalitis is a disease with high mortality and many of those surviving suffer from serious sequelae. During the 1992 epidemic in northern Vietnam 50 patients treated at the Institute for Protection of Children's Health in Hanoi were studied concerning the type of sequelae and the development of the symptoms during the first two months of the disease. The age span was 1 to 15 years. 29 of the patients (58%) did not recover fully during the observation period. Fifteen (30%) showed signs of both neurological and mental disturbances. Nine (18%) only had mental symptoms while 5 (20%) suffered from isolated neurological sequelae. EEG was pathological in 9 out of 30 tested cases (30%); 9 of 23 patients (39%) performed subnormal IQ tests. Deep coma, bronchopneumonia with cyanosis, apnea attacks, prolonged fever and coma were all correlated (without statistical significance) to a higher risk for subsequent sequelae.

Adolescent↗

Behavioural disturbances following Japanese B encephalitis.

Clinically, Japanese B encephalitis (JBE) is often overlooked as its occurrence in Western countries is rare. However, its neurological, cognitive and psychiatric sequelae constitute a major public health problem in the Far East where JBE is endemic. European and American subjects may however experience the JBE when returning from a Far East journey. In such cases, misdiagnosis is frequent because of the unawareness of psychiatrists and physicians. The present review, therefore, documents the behavioural and cognitive sequelae of JBE. This reactivates the debate concerning the vaccination against the virus all the more that the literature enlightens the importance of the vaccination for those who undertake frequent and extensive tourist excursions to the Orient but still discusses it for occasional travellers. Following is a case-report of a young western European post-graduate student who has contracted JBE by experiencing an acute febrile delirium during an unusual short stay in South East Asia. Pyramidal syndrome, Parkinsonism and amnesia were the prominent acute deficits. Whereas these faded in great part during convalescence, emotional and behavioural instability associated with affective involvement, obsessive-compulsive symptoms and cognitive impairments appeared. A partial recovery was however obtained with neuroleptics, lithium and following electro-convulsive therapy. Organic personality syndrome was persistent and thereafter constituted the main sequelae syndrome. Hypersomnia and several enuretic episodes persisted.

Adult↗

[The natural infection rate of mosquitoes by Japanese encephalitis B virus in Yunnan Province].

In July-September 1983-1987, 57,898 adult female mosquitoes belonging to 29 species of 8 genera were collected from Japanese B encephalitis (JE) epidemic areas in Yunnan, China, and were examined by C 6/36 cell method and sucking mouse method. Twenty-eight strains of JE virus were isolated from Culex tritaeniorhychus, C. whitomorei, C. pseudovishnui, C. fuscocephala, C. annulus, C. gelidus, Anopheles sinensis, Mansonia uniformis, Aedes albopictus, Ae. Vexans, Ae. lineatopennis, and Ae. assamensis. The positive isolation rates by the two methods were 6.19% and 3.33% respectively. The highest positive isolation rate 12.3% (per 100 pools), moiquito body virus carrier rate 1:208 or moiquito body virus carrier rate 4.81% (per 1000 mosquitoes) were found in the middle ten days of August, corresponding to epidemic peak of JBE Nine strains of JE virus were isolated from C tritaeniorhychus with an isolation rate of 7.44%, natural isolation ratio was 1.584 and mosquito body virus carrier rate 1.71%. These results indicated that C. tritaeniorhynchus might be the main vector of JE virus in Yunnan, while C. whitmorei, C. pseudovishnui and An. sinensis are also important vectors of JE virus in Yunnan.

Aedes↗

[Immune response and reactions to simultaneous administration of hepatitis B vaccine with routine vaccine in children. II. Immune response and reactions to simultaneous administration of hepatitis B vaccine with Japanese B encephalitis vaccine and measles vaccine].

This paper reports the result of the immune response and reactions to simultaneous administration of Japanese B encephalitis vaccine, measles and hepatitis B vaccine. 215 children (0-9 months of age) were divided into three groups. Group one was vaccinated with hepatitis B vaccine alone, group two was vaccinated with Japanese B encephalitis vaccine, measles vaccine, and group three was Vaccinated with hepatitis B vaccine, Japanese B encephalitis vaccine and measles vaccine simultaneously. The result of the immune response to the combination of hepatitis B vaccine with Japanese B encephalitis vaccine were similar to that observed after immunization with each vaccine alone. But the result of the immune response to the combination of hepatitis B vaccine with measles vaccine were lower than to that observed after immunization with measles vaccine alone. The general reaction of all vaccine were mild, no significant difference between each group was noted. The study demonstrated that children can not be immunized with hepatitis B vaccine and measles vaccine simultaneously but can be immunized with hepatitis B Vaccine and Japanese B encephalitis vaccine.

Encephalitis Virus, Japanese↗