Clinical Predictors of Japanese Encephalitis

Abstract

Over a 5-year period, virological investigations for Japanese encephalitis (JE) were conducted in children presenting with acute encephalopathic illness. Clinical features of JE-positive patients (n = 116) were compared with patients in whom the diagnosis could be excluded (n = 57). Multivariate analysis by logistic regression revealed that two clinical signs – central hyperpneic breathing pattern and extrapyramidal signs – were significant predictors of the diagnosis. Application of the model yielded a sensitivity of 41.3% and a specificity of 80.7% with positive and negative predictive values of 81.3 and 40.3%, respectively. This indicates that the model may be helpful in making the diagnosis but not in excluding it. The model should be further validated in different areas where the disease is prevalent.

Neurological Sequelae of Hospitalized Japanese Encephalitis Cases in Gansu Province, China

“…9,[11][12][13][14][15][16] In our study, however, we found that rates with any neurological sequelae and mental disorders among adult ( 15 years old) JE cases was similar to that in the young (2-5 and 6-14 years groups) JE cases. Differences of our results from other studies in disability rates may be due to whether the formal examination has been used or the number of surviving JE cases has been surveyed.…”

“…The survivors' disability rate was similar to survivor disability rates seen in India and Vietnam (45.5-58.0%). 11,12 We found that motor neuron symptoms were paralysis, hemiplegia, and limb movement disorder such as reduced muscle strength, tendon reflexes, involuntary movements, increased muscle tone, and sensory dysfunction were the most common neurological sequelae for JE cases. Rates of neurological sequelae were very high at discharge and showed no apparent improvement with 1-2 years after discharge.…”

Prevention, diagnosis, and management of Japanese encephalitis in children

“…Two clinical signs, namely hyperventilation in the acute stage and extrapyramidal features, were significantly and independently associated with a diagnosis of JE. 68 JE is now also recognized to involve spinal cord anterior horn cells and occasionally present with lower motor neurone polio-like weakness with atrophy. 69,70 The polio-like illness may occur with a normal level of consciousness or with coma.…”

Systems Thinking: Prevention and Control of Japanese Encephalitis - "The Plague of the Orient"

“…Motor paralyses including hemiplegia and tetraplegia may also be present. Signs of extra pyramidal involvement, including tremor, rigidity, and abnormal movements are observed in around 30% of the patients (Kumar et al, 1994). Severe clinical cases are likely to have life-long neurological sequelae.…”