JAPANESE ENCEPHALITIS IN CHILDREN IN BELLARY KARNATAKA: CLINICAL PROFILE AND SEQUELAE

Abstract

Objectives: To study the clinical profile and outcome of Japanese Encephalitis(JE) Methods: Prospective study was done in Vijayanagara Institute Medical Sciences hospital, Bellary, Karnataka. 233 patients below 12 years of age presented with acute encephalitic picture during the epidemic period formed the subjects and were worked up according to a predesigned protocol. CSF and serum samples were tested for JE specific IgM antibodies. Patients were followed up for 4 months to over one year. Results: The predominant age group was 5 to 12 years. Fever (94.84%), seizures (73.39%) and altered sensorium(91.84%) were the important presenting symptoms. Onset of illness was acute in 28.32% and subacute in 38.62% .CSF showed lymphocytosis and 45.06% had cell count of 6-50/cmm and in majority it was <200/cmm. 55.36% patients were positive for JE. Mortality was 22.74%. Deeper level of coma , respiratory irregularities and meningeal signs were associated with mortality. 147 patients survived the acute attack. Of that 40.85% completely recovered. Speech disturbance (47.61%), motor deficits (36.73%), behavioural disturbance (14.96%), involuntary movements (12.24%) and seizures (1.36%) were the morbidities. The deficits found to be gradually improving. Motor deficits and speech disturbances were found in 25.68% and 22.01% respectively at one year follow up. Conclusions: The characteristic clinical features of JE include fever, seizure, altered sensorium, aphasia, relative absence of cranial nerve involvement and irregular and rapidly changing motor and tone abnormality. Deeper level of coma, respiratory abnormalities and meningeal signs were associated with mortality. Speech disturbance and motor deficits were frequently encountered sequelae.