The 6-year-old baby boy Nguyen Minh Hoang from Hai Duong was admitted in the National Children’s Hospital on June 17. Doctors at the Intensive Care Unit of Center for Tropical Diseases said that the boy had a headache, high fever (38-42 degree Celsisus), vomitting, decreased consciousness, lethargy and sleep a lot at home 6 days ago. He was transferred to the hospital when he fell into a coma. After examination, lumbar puncutre and tests, the boy was diagnosed with Japanese encephalitis, so he was treated by increased intracranial pressure and ventilation. The patient is currently breathing through oxygen mask, not full awake and increasing muscle strength of the whole body. His family said that the child was vaccinated based on the expanded immunization program, however, it is not clear wether he has been vaccinated against Japanese encephatlitis or not.
(Japanese encephalitis patient is being cared for at the Intensive Care Unit of Center for Tropical Diseases)
Another patient is Tran Thanh Tung (5 years old, from Hai Phong), who has been treated at the Intensive Care Unit of Center of Tropical Diseases for 3 weeks. He is still using ventilator, paralyzed with severe prognosis. It is known that the child had symptoms of high fever, intermittent fever with headache and vomitting. Therefore, he was admitted in Hai Phong Children’s Hospital and diagnosed with Japanese encephalitis. After that, the patient was likely to have decreased consciousness and respiratory failure, then he was treated by intubation and transferred to the National Children’s Hospital. According to the child’s medical history, he was vaccinated with 3 doses of Japanese encephalitis when he wass 2 years old, but since then, he has not been vaccinated again.
PhD.MD Nguyen Van Lam – the director of the Center for Tropical Diseases of the National Children’s Hospital said that Japanesse encephalitis is an acute inflammatory disease of brain tissue caused by Japanesse encephalitis virus, which is the top of encephalitis virus in Asia, including Vietnam. The disease occur over years and reached its peaks from May to August. The disease can appear at any age but the most common is in children between the ages of 2 and 8.
Japanese encephalitis is considered as one of the dangerous diseases with high mortality and severe sequelae in young children (from 25 to 35%). These sequelae make patients lose their ability to communicate, reduce the ability of work, become the burden on the family on society.
“At the moment, although the majority of children have been fully vaccinated, there are still many cases of children suffering from diseases due to poor resistance, not being vaccinated against the disease or not getting enough doses. Most mothers of older children with Japanese encephalitis believe that their children have been fully vaccinated with 3 doses until 2 years old. But this is a misconception that causes an increase in disease in older children. Parents should vaccinate their children fully and re-vaccinate every 3-5 years until the age of 15,” said PhD.MD Nguyen Van Lam.
Symptoms of Japanese Encephalitis
The first symptom of the disease is normally fever, headache, nausea, and vomiting. In addition, there may be manifestations of general viral infection such as fatigue, chills.
Severe cases may have the following manifestations: convulstion, reducing cognitive ability. Children change their behavior, scream, agitated or stupor; do not recognize parents, have delirium and coma. Their movement disorders such as paralysis of arms, legs or hemiplegia, spasticity, torsion.
Causes and routes of transmission of the disease
Japanese encephalitis is a blood-borne infection caused by the Japanese encephalitis virus. Children with Japanese encephalitis is due to Japanese encephalitis virus. Japanese encephalitis virus is present in domestic animals (such as pigs, horses and birds) which are considered as intermediate hosts. When mosquitoes bite animals that carry the virus (intermediate hosts) and then bite humans, they will transmit the Japanese encephalitis virus to humans. The mosquito that transmits Japanese encephalitis is the Culex mosquito that has a habit of being active at dusk. This mosquito has a high density in deltas and midlands, and it is the main vector of Japanese encephalitis in our country.
The most effective way to prevent Japanese encephalitis is through vaccination. Vaccine against Japanese encephalitis has now been included in the expanded immunization program in all provinces and cities throughout the country. The first injection is for 12-month-old child; the second injection is carried out 1-2 week after the first one, and the third one is for 1 year after the second injection. It is needed to repeat every 3-5 years until the chil is 15 years old.
In addition, it is necessary for children to eat hygienically, improve their health, stay under mosquito nets in order to avoid mosquito, and keep the living environment clean and clear.
Dr Nguyen Van Lam suggested that “Japanese encephalitis is a serious disease that can progress very quickly with high mortality and sequelae. If children that have suspicious symptoms such as fever, headache, nausea, especially convulsions, impaired consciousness are necessary to be transferred to the nearest medical facility for early detection and timely treatment, so as to minimize the risk of death or sequelae”.
*Patient’s name has been changed.