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The shocking death of over 60 children within a week in Uttar Pradesh’s Gorakhpur district has raised alarms reflecting the failed apathy of the medical condition of the state.

What makes the deaths more controversial is the fact that UP Chief Minister Yogi Aditynath visited Baba Raghav Das Medical College on Wednesday to take a note of the facilities.

Besides inaugurating ten-bed ICU, a six-bed Critical Care Unit facility, the CM also inspected the ward meant for children infected with Japanese Encephalitis — disease responsible for the maximum deaths.

Refuting the charges of lack of oxygen the hospital authorities and the District Magistrate have maintained that the deaths occurred due to Japanese encephalitis virus, and cases of Acute Encephalitis Syndrome (AES).

While the grieving parents are left to a state of shock and grief there seems to be no resolute in sight against the disease.

Let us take a look at the deadly Japanese encephalitis virus and Acute Encephalitis Syndrome; cases doctors seem to have no answer to.

Japanese encephalitis

Japanese encephalitis virus (JEV) is an infection of the brain. The flavivirus caused by mosquito bite is related to dengue, yellow fever and West Nile viruses.

The virus appears to have originated from its ancestral virus in the mid-1500s in the Indonesia-Malaysia region and evolved there into different genotypes later.

Alone in Asia, there is an estimate of 68 000 clinical cases discovered every year.

What is the cause of JE

Caused by a flavivirus, the disease can affect both humans and animals. The virus is passed from animals to humans through the bite of an infected mosquito. Pigs and wading birds are the main carriers of the Japanese encephalitis virus.

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Geographic Distribution of Japanese Encephalitis Virus. (Source: cdc.gov)

 

Symptoms

The incubation period of JEV is 2 to 15 days. A vast majority of infections are asymptomatic, while only 1 in 250 infections develops into encephalitis.

Initial symptoms often include fever, headache, and vomiting.

Mental status changes, neurologic symptoms, weakness, and movement disorders might develop over the next few days.

Seizures are common, especially among children.

Can it be cured?

There’s currently no particular cure for Japanese encephalitis. Treatment involves supporting the functions of the body as it tries to fight off the infection.

No specific treatments have been found to benefit patients with JE, but hospitalization for supportive care and close observation is generally required.

Rest, fluids, and use of pain relievers and medication to reduce fever may relieve some symptoms. 

***

Complex case of Encephalitis Syndrome

Acute Encephalitis Syndrome

Acute Encephalitis Syndrome (AES) is a group of Clinical neurologic issues caused by an array of different viruses, bacteria, fungus, parasites, spirochetes, chemical and toxins.

While Japanese encephalitis virus continues to be one of the most common causes of acute viral encephalitis, Eastern equine encephalitis virus (EEEV), Hendra virus (HeV), enteroviruses (ENV), Chandipura virus (CHPV), Nipah (NiV), Kyasanur forest disease (KFD), Herpes simplex, poliovirus and measles virus are among the various other diseases related to it.

At least 80% of the cases of Acute Encephalitis Syndrome in India have mostly been identified in Uttar Pradesh, Assam, Bihar, Karnataka, Uttar Pradesh and Tamil Nadu.

The core challenge with the doctor treating such patients is to first ascertain the disease as the infection is almost indistinguishable from each other, with the patient reflecting similar symptoms. It happens so as the virus infecting the patient varies from one geographical location to another.

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Acute Encephalitis Syndrome in India. (Source: ncbi.gov)

Notably, monsoon being the breeding season for the mosquitoes, the cases of AES and JE usually increase during the rainy period.

There is no specific drug available to counter the AES including Japanese Encephalitis.

As per the report obtained from BRD hospital, there has been a sudden spike of deaths of patients since August 7 listed under NICU (neonatal intensive care unit), AES, non-AES, reports English daily The Indian Express.

August 7: 9 (4 NICU, 2 AES, 3 non-AES)

August 8: 12 (7 NICU, 3 AES, 2 non-AES)

August 9: 9 (6 NICU, 2 AES, 1 non-AES)

August 10: 23 (14 NICU, 3 AES, 6 non-AES)

August 11: 7 (3 NICU, 2 AES, 2 non-AES)

August 12: 3 more children die due to Encephalitis.

First Published | 12 August 2017 11:09 AM
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Web Title: Clueless doctors, dying children: Complex case of encephalitis virus in Gorakhpur hospital

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