• Friday May 29,2020

Japanese encephalitis

Japanese Encephalitis is an infectious disease caused by viruses. It is most prevalent in Southeast Asia, China and India and can be fatal if left untreated. However, there is a vaccine against this tropical disease, which is recommended to every traveler to Asia by the Tropical Institute. Especially small children and the elderly are at risk of having severe complications from Japanese Encephalitis.

What is Japanese Encephalitis?

Of concern are the cases in which the symptoms are severe and start with high fever, headache and muscle pains. Within a few hours and days after the first symptoms of the disease appear disturbances of consciousness, which indicate the involvement of the meninges.
© Kaspars Grinvalds - stock.adobe.com

Japanese encephalitis is a tropical disease that occurs mainly in eastern and southern Asia. Among other things, the majority of India and the southern part of the People's Republic of China are severely affected. It is a viral disease that in many cases causes very mild symptoms or can remain symptom-free because it does not break out.

However, one in 250 people suffers from it seriously and develops encephalitis, an inflammation of the meninges. It is associated with symptoms such as dysregulation, high fever, muscle pain and severe headache. Diarrhea and vomiting are also characteristic of children. If Japanese Encephalitis does not kill, it often leaves permanent damage.


The cause of Japanese encephalitis are viruses that live in livestock. Wild birds and pigs are particularly in question, they carry most viruses. Occasionally they are also found in horses or bats. Finally, they are transmitted by mosquitoes, which pick up the virus from the farm animal and use it through their sting in humans.

The incubation period of the Japanese Encephalitis virus is 5-15 days, after which the outbreak of Japanese Encephalitis may occur. The risk of infection for tourists is very low, the rural population in the most vulnerable areas is the most affected. The rate of new infections with Japanese Encephalitis is also related to the life cycle of the mosquitoes and the rainy seasons that are crucial in this zone of the earth for the survival and death of carriers.

Symptoms, complaints & signs

Japanese encephalitis is usually mild or causes little or no discomfort. In two out of 250 cases, however, the infected develop severe health problems that are fatal in almost 30 percent of the cases. Many survivors suffer from permanent neurological damage after recovery.

In general, Japanese encephalitis causes flu-like symptoms with fever, chills and headache. In a severe case, a meningitis sets in, which causes not only fever but also head, muscle and neck pain, neck stiffness and fatigue. Also typical are gastrointestinal complaints and an increased sensitivity to light and noise.

If it comes in addition to a brain inflammation, follow the initially high fever deficit symptoms of the nervous system. Many patients suffer from confusion, loss of consciousness and behavioral changes. Physically manifests a brain inflammation by seizures, paralysis, reflex disorders and muscle tremors.

In the further course the patient falls into a coma. The symptoms of severe Japanese Encephalitis occur within a short time and become stronger in the space of a few days. The fever usually decreases after seven to ten sick days. In a severe case, the individual symptoms can lead to the death of the patient.


Following infection, Japanese Encephalitis virus is in most cases killed by the body's immune system. It does not contribute to the development of the disease and the person does not suffer any lasting damage. After the incubation period of 5-15 days, it can only come to very mild symptoms that would hardly differ from a severe flu. They disappear after a few days and weeks by themselves and also leave no damage.

Of concern are the cases in which the symptoms are severe and start with high fever, headache and muscle pains. Within a few hours and days after the first symptoms of the disease appear disturbances of consciousness, which indicate the involvement of the meninges. It can also lead to the expression of other neurological symptoms.

If Japanese Encephalitis is not treated, it can be fatal. Even with a treatment this can sometimes be the case. At best, the patient survives Japanese encephalitis and only sustains some permanent damage.


This encephalitis is a very serious disease. If it does not come to a treatment, then the patient can die of this disease in the worst case. Likewise, irreversible consequential damage is possible. In order to avoid possible complaints and complications, a vaccination should always be performed before traveling.

Those affected suffer from a strong fever and headaches. These can also spread to other regions of the body and cause pain there. Furthermore, it comes without treatment to severe paralysis of the whole body and a stiff neck. It can also be a complete loss of consciousness and the person suffering from a stiff neck.

The quality of life is significantly reduced by Japanese encephalitis and everyday life is restricted. Also, the resilience of the affected drops significantly from this disease. Japanese encephalitis can not be treated directly. Only the complaints are restricted.

There are no special complications. However, the duration of this infection can not be predicted. It is also possible that the affected person is infected again after a successful treatment. If treatment is initiated early, life expectancy will generally not decrease.

When should you go to the doctor?

If a few days after receiving a mosquito bite abnormalities and changes in the health sensation are noticed, a doctor should be consulted. Skin lesions, abnormal wound formation, or peculiarities of the lymph are a cause for concern. A doctor should be consulted as soon as malaise, an internal weakness, or a feeling of illness occur. If symptoms similar to those of influenza are perceived, they should be monitored.

If you have a headache, an increased need for sleep, fever or sweating, you should consult a doctor. Fatigue and a lack of concentration and loss of appetite should be examined and treated. If there is a short time later to neurological abnormalities, a medical care must be initiated immediately. In the case of gait uncertainties, memory problems or dysfunctions, the person concerned needs medical help. A visit to a doctor is absolutely necessary as it can lead to permanent impairment and a reduced quality of life.

Trembling limbs, muscle weakness, a stiffness of the body or a general inability to perform are to be examined and treated. Paralysis and convulsions already indicate a strong progression of the disease. To avoid long-term damage, a visit to a doctor is necessary. In severe cases it can come without medical treatment to an early death of the person concerned. In acute cases, an ambulance service must be alerted. Until its arrival first aid measures must be initiated.

Treatment & Therapy

Currently, Japanese Encephalitis can not be treated specifically. Because it is a virus, the research of an active ingredient is difficult because it is not about bacteria and therefore classical methods (eg antibiotics) hardly suggest. In the case of Japanese encephalitis, it is mainly symptomatic that the disease progresses. It is possible, for example, to lower the patient's fever by medication in order to prevent it from causing permanent damage or causing the patient to die from it.

It also supports breathing and circulation, which may be affected by brain involvement. In addition, it may be useful to prevent secondary infection by isolating the patient, as such could be fatal.


To completely cure Japanese encephalitis requires comprehensive care and follow-up. The treatment aims to relieve the symptoms. For the patients, a correct intake of the medicines prescribed by the doctor is very important. So far, there are no drugs for the direct treatment of the disease, yet those affected should consult a doctor.

Self-medication at home carries the risk of complications. However, a specialist can recognize the risk at an early stage and do something about it. As part of a targeted, intensive therapy, the disease can be cured well in timely intervention. Treatment is generally inpatient to ensure accurate monitoring.

After therapy, follow-up focuses on further follow-up examinations. Even after the hospital stay, those affected should still spare. In order to rule out secondary infections, meticulous hygiene must be observed. This includes the use of disinfectants. Certain safety measures are designed to protect patients from contracting in the recovery phase.

Only when the symptoms of illness have diminished due to the regular intake of the medication can those affected give up their illness-related isolation. Depending on the severity of the life-threatening illness, however, the recovery phase may take a little longer.

Outlook & Forecast

Japanese encephalitis can lead to numerous complications and premature death of the person without sufficient medical care. Although the infectious disease usually occurs in Southeast Asia or India, it can still be transferred by tourists or other travelers to the local population. Due to the drastic course of the disease there is the possibility of a vaccination. Since almost 30 percent of those affected are confronted with a deadly course, this should be used in the case of a planned trip. If a vaccination has taken place, an infection and thus an outbreak of the disease is unlikely.

The difficulty of Japanese encephalitis lies in the likelihood of confusion with a flu disease. If this results in the diagnosis and thus the medical treatment in an advanced stage of the disease, the prognosis worsens. It can lead to lifelong consequential damages such as restrictions on movement, paralysis or headache. There is also the possibility of the occurrence of unconsciousness. In case of disturbances of consciousness intensive care is necessary. Lesions of the brain are possible which are irreversible.

With a rapid and comprehensive medical care of the patient there is the possibility of a complete recovery. There is a symptomatic treatment, which is based on the individual complaints of the patient. The administration of medication leads to a regression of the symptoms.

You can do that yourself

While there are still no effective medicines for the treatment of Japanese Encephalitis, sufferers should never try to monitor their own disease history at home. Professional medical treatment and care are essential to adequately respond to potential serious complications. Thus, patients with Japanese encephalitis go to inpatient care and follow the instructions of the doctors and the staff. Due to the lack of suitable medication, the nursing staff only monitors the vital functions of the body such as the circulation, the heart rate and the respiration of the patient.

The person concerned spends most of their inpatient stay in a resting position and, through hygienic and quarantine measures, takes care not to become infected with secondary infections. Contact with other people is only possible if they have undergone a thorough disinfection and appropriate safety measures apply.

During inpatient treatment, the patient must ensure that his diet provides sufficient energy and nutrients. If sufficient nutritional intake is not possible due to physical weakness or other reasons, the patient will be given liquid feed intravenously. The patient must inform the medical staff about any changes in his condition in order to avoid complications of Japanese encephalitis.

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