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JAPANESE ENCEPHALITIS
Its a viral disease,transmitted by infective bites of female mosquitoes mainly belonging to Culex tritaeniorhynchus,Culex vishnui and Culex pseudovishnui group. However,some other mosquito species also play a role in transmission under specific conditions. JE virus is primarily zoonotic in its natural cycle and man is an accidental host. The virus is neurotorpic and arbovirus and it primarily affects central nervous system.
Cases: 1,896 cases reported so far,with Uttar Pradesh reporting the maximum of 1,065.
Deaths: 251,of these 172 from Uttar Pradesh.
Signs and symptoms
Symptoms similar to any other virus causing encephalitis
Infection may result in febrile illness of variable severity associated with neurological symptoms ranging from headache to meningitis or encephalitis. Symptoms can include headache,fever,meningeal signs,stupor,disorientation,coma,tremors,paralysis generalised,hypertonia,loss of coordination
Prodromal stage may be abrupt 1-6 hours,acute 6-24 hours or more commonly subacute 2-5 days
In acute stage,symptoms noted in prodromal phase convulsions,alteration of sensorium,behavioural changes,motor paralysis and involuntary movement supervene and focal neurological deficit is common. Usually lasts for a week but may prolong due to complications
Amongst patients who survive,some lead to full recovery through steady improvement and some suffer with stabilisation of neurological deficit. Convalescent phase is prolonged and vary from weeks to several months
Clinically it is difficult to differentiate between JE and other viral encephalitis
Treatment: There is no specific anti-viral medicine available. The cases are managed symptomatologically. Clinical management of JE is supportive and in the acute phase is directed at maintaining fluid and electrolyte balance and control of convulsions,if present. Maintenance of airway is crucial.
Vaccine: Central Research Institute,Kasuali,has developed Japanese encephalitis vaccine; it is a mouse brain-derived vaccine and three doses are required to produce primary immunisation. Two doses are administered sub-cutaneously within a gap of 7-14 days followed by third dose any time after one month and before one year of the second dose. A booster is required after three years.
Mouse brain technology has limitations in huge production beyond a few million. Tissue culture vaccines with feasibility of mass production are under various phases of development,standardisation and/ or commercialisation.
DENGUE
A viral disease transmitted by the infective bite of Aedes Aegypti mosquito. A man develops disease after five-six days of being bitten by an infective mosquito. It occurs in two forms: Dengue Fever and Dengue Haemorrhagic Fever DHF. While Dengue Fever is a severe,flu-like illness,DHF is a more severe form of disease,which may cause death.
Cases: As on August 31,7,262 cases,with Kerala reporting maximum 2,167,followed by Karnataka 1,338 and Delhi 937.
Deaths: 25,of these 13 from Kerala.
Signs and symptoms
Abrupt onset of high fever
Severe frontal headache
Pain behind the eyes which worsens with eye movement
Muscle and joint pains
Loss of sense of taste and appetite
Measles-like rash over chest and upper limbs
Nausea and vomiting
Vector
Aedes Aegypti is the vector
It is a small,black mosquito with white stripes and approximately 5 mm in size
It takes about seven to eight days to develop the virus in its body and transmit the disease.
Its a day-biter
Feeds on humans in domestic and peridomestic situations
Bites repeatedly
Rests in dark corners of houses,on hanging objects like clothes,umbrella,or under furniture
It breeds in any type of man-made containers or storage containers having even a small quantity of water
Eggs can live without water for more then one year
Breeding places: Desert coolers,drums,jars,pots,buckets,flower vases,plant saucers,tanks,cisterns,bottles,tins,tyres,roof gutters,refrigerator drip pans,cement blocks,cemetery urns,bamboo stumps,coconut shells,tree holes and places where rainwater gets collected or is stored.
Precautions
Clean coolers regularly
Remove water from containers once a week
Use aerosol during day time to prevent bites of mosquitoes
Do not wear clothes that expose arms and legs
Children should not be allowed to play outside wearing shorts,half sleeve clothes
Use mosquito nets or mosquito repellents while sleeping
H1N1
Swine influenza also called swine flu is an infection by any one of several types of swine influenza virus. Swine influenza virus SIV is any strain of the influenza family of viruses that is endemic in pigs. As of 2009,the known SIV strains include influenza C and the subtypes of influenza A known as H1N1,H1N2,H3N1,H3N2,and H2N3.
Cases: 41,234 cases so far
Deaths: 2,241
Signs amp; symptoms: Symptoms similar to most influenza infections: fever 100F or more,cough,nasal secretions,fatigue,and headache. Some patients also get nausea,start vomiting,and complain of diarrhoea. Swine flu is presumptively diagnosed clinically by the patients history of association with people known to have the disease and their symptoms listed above. Usually,a quick test for example,nasopharyngeal swab sample is done to see if the patient is infected with influenza A or B virus. Most of these tests can distinguish between A and B types.
Infectious period: Persons with swine influenza A H1N1 virus infection should be considered potentially contagious for up to seven days following illness onset. Persons who continue to be ill longer than seven days after illness onset should be considered potentially contagious until symptoms have resolved. Children,especially younger ones,might potentially be contagious for longer periods. The duration of infectiousness might vary by swine influenza A H1N1 virus strain. Sick persons who have not been hospitalised and are confirmed or suspected case of swine influenza A H1N1 virus infection are recommended to stay at home voluntary isolation for at least the first seven days after illness onset,except to seek medical care.
Precautions
Keep a distance of at least 6 feet from the sick person
Personal protective equipment: fit-tested N95 respirator if unavailable,wear a surgical mask
For collecting respiratory specimens from an ill,confirmed or suspected swine influenza A virus case,the following are usually recommended:
Personal protective equipment: fit-tested disposable N95 respirator,disposable gloves,gown,and goggles. Place all PPE in a biohazard bag for appropriate disposal
Wash hands thoroughly and regularly with soap and water or alcohol-based hand gel
