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Acute Encephalitis Syndrome

This topic provides information about Causes, target group, Signs & symptoms of Acute Encephalitis Syndrome.

Introduction

Acute Encephalitis Syndrome (AES) including Japanese Encephalitis (JE) is a group of clinically similar neurologic manifestation caused by several different viruses, bacteria, fungus, parasites, spirochetes, chemical/ toxins etc. The outbreak of JE usually coincides with the monsoon and post monsoon period when the density of mosquitoes increases while encephalitis due to other viruses specially entero-viruses occurs throughout the year as it is a water borne disease.

Who is affected?

  • It predominantly affects population below 15 years.
  • There is seasonal and geographical variation in the causative organism.
  • JEV has its endemic zones running along the Gangetic plane including states of UP (east), Bihar, West Bengal and Assam, and parts of Tamil Nadu.

In India, AES outbreaks in north and eastern India have been linked to children eating unripe litchi fruit on empty stomachs. Unripe fruit contain the toxins hypoglycin A and methylenecyclopropylglycine (MCPG), which cause vomiting if ingested in large quantities.Hypoglycin A is a naturally occurring amino acid found in the unripened litchi that causes severe vomiting (Jamaican vomiting sickness), while MCPG is a poisonous compound found in litchi seeds that causes a sudden drop in blood sugar, vomiting, altered mental states leading to lethargy, unconsciousness, coma and death. These toxins cause sudden high fever and seizures serious enough to require hospitalisation in young, severely malnourished children.

Signs and Symptoms

Acute encephalitis syndrome (AES) is characterized by an acute onset of fever and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma. Apart from viral encephalitis, severe form of leptospirosis and toxoplasmosis can cause AES. Keeping in mind the wide range of causal agents and the rapid rate of neurological impairment due to pathogenesis, clinicians face the challenge of a small window period between diagnosis and treatment. Several government initiatives have been undertaken to educate and improve the hygiene of people living in the JE endemic zones. Government and non-government organizations have been instrumental in providing proper nutrition to the AES-affected population as most of the affected people belong to the lower economic strata of the society.

Sources :

  1. http://nvbdcp.gov.in/Doc/Revised%20guidelines%20on%20AES_JE.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5043220/
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