What is Acute Encephalitis Syndrome?

Acute Encephalitis Syndrome (AES) is a sort of brain inflammation, spreading endemically and in clusters in various parts of India, especially UP, Bihar, and West Bengal. It is not a single disease but a cluster of them presenting with similar symptoms. There are many different types of Encephalitis, of which, the three most common, in the Indian context are:

Herpes Encephalitis is one of the most common forms of encephalitis in the world. Sporadic episodes of this condition are observed throughout the year in India. However, JE and CF are more commonly seen in summers and monsoon.

  1. Acute Encephalitis Syndrome (Chamki Fever) symptoms
  2. Acute Encephalitis Syndrome causes and spread
  3. Acute Encephalitis Syndrome (Chamki Fever) treatment
  4. Ways to prevent Acute Encephalitis Syndrome

Acute Encephalitis Syndrome initially appears as a set of flu-like symptoms including:

However, headache and light sensitivity are two of the identifying features of this condition.

Further symptoms include dizzinessdelirium, disorientation, and bedwetting. In severe cases, it may lead to seizurescoma and even death if left untreated

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Japanese Encephalitis 

Japanese Encephalitis is a mosquito-borne disease, spread by the Culex vishnui mosquito.

Pigs and migratory birds like herons who live in waterlogged areas are the primary reservoirs for JE virus.

Once the virus enters into the bloodstream, it takes about 5-15 days to manifest apparent symptoms. This is also known as the incubation period of the disease.

Chamki Fever (Muzzafarpur Encephalitis)

No exact reason has yet been found for Chamki Fever. Studies conducted by the Center for disease control (CDC), US and National Center for Disease Control (NCDC), India suggest that lychee season may have a link with this condition. Most of the children suffering from this condition have been found to be malnourished and have had consumed lychee on an empty stomach. They were also found to have low blood sugar levels, which may be due to two compounds known as hypoglycin and MCPG present in lychee. Both these compounds have a significant hypoglycemic action, especially when taken empty stomach. Though the fruit may not be directly associated with the onset of Acute Encephalitis Syndrome, it may have some role in increasing the manifestations of this condition.

(Read more: Malnourishment symptoms)

Though no curative treatment is available for Chamki Fever and Japanese Encephalitis, the disease can be managed well by adequate and timely supportive management including treatment of fever, seizures, hypoglycemia (low blood glucose), treatment for brain inflammation and ventilator support in some cases.

Prompt and early treatment is important. By starting treatment early, up to 70% to 80% of patients can be saved and complications and sequelae are minimised too.

The longer the delay in seeking medical attention, the greater the chances of brain damage.

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Japanese Encephalitis

Since JE is a mosquito-borne disease, the best way to prevent it is by maintaining a clean environment so as to reduce the mosquito population in your immediate surroundings. Co-habitation of humans and animals, especially pigs, should also be avoided.

Wear full clothes, mosquito repellents, and mosquito nets to avoid mosquito bites.

A vaccine is also available for prevention of Japanese Encephalitis and people living in endemic areas are urged to get themselves vaccinated as per government policy, well before the endemic season.

(Read more: Ways to prevent mosquito bites)

Chamki Fever

Chamki Fever most commonly affects malnourished children, so the best way to prevent it is by giving a healthy and balanced diet to your children. Also, make sure that they take dinner and do not eat lychee on an empty stomach. Staying indoors in hot summers would greatly reduce the risk of Chamki Fever.

References

  1. Sourish Ghosh and Anirban Basu. Acute Encephalitis Syndrome in India: The Changing Scenario. Ann Neurosci. 2016 Sep; 23(3): 131–133. Published online 2016 Sep 9. doi: 10.1159/000449177
  2. D. O. Gray and L. Fowden. α-(Methylenecyclopropyl)glycine from Litchi seeds. Biochem J. 1962 Mar; 82(3): 385–389. doi: 10.1042/bj0820385
  3. Jai Prakash Narain, A. C. Dhariwal, and C. Raina MacIntyre. Acute encephalitis in India: An unfolding tragedy. Indian J Med Res. 2017 May; 145(5): 584–587. doi: 10.4103/ijmr.IJMR_409_17
  4. Arun Venkatesan and Romergryko G. Geocadin. Diagnosis and management of acute encephalitis: A practical approach. Neurol Clin Pract. 2014 Jun; 4(3): 206–215. doi: 10.1212/CPJ.0000000000000036
  5. T. Jacob John, Valsan Philip Verghese, Govindakarnavar Arunkumar, Nivedita Gupta, and Soumya Swaminathan. The syndrome of acute encephalitis in children in India: Need for new thinking. Indian J Med Res. 2017 Aug; 146(2): 158–161. doi: 10.4103/ijmr.IJMR_1497_16
  6. National Centre for Disease Control, India; Outbreak of Acute Encephalitis Syndrome in Bihar. 2012.
  7. Shrivastava A et al. Outbreaks of unexplained neurologic illness - Muzaffarpur, India, 2013-2014.. MMWR Morb Mortal Wkly Rep. 2015 Jan 30;64(3):49-53.
  8. Spencer PS, Palmer VS, Mazumder R. Probable Toxic Cause for Suspected Lychee-Linked Viral Encephalitis. Emerging Infectious Diseases. 2015;21(5):904-905. doi:10.3201/eid2105.141650.
  9. Dr. Kaushalendra Kumar Singh, Dr Binod Kumar Singh. Study of AES (Acute Encephalitis Syndrome) with respect to clinical profile and outcome in Patna medical college and hospital. International Journal of Medical and Health Research ISSN: 2454-9142. Volume 4; Issue 2; February 2018; Page No. 158-161
  10. National Centre for Disease Control, India; Acute Encephalitis Syndrome (AES) p 37. Annual Report 2014 -15, Directorate General of Health Services (Ministry of Health & Family Welfare , Government of India)
  11. Melde K, Buettner H, Boschert W, Wolf HP, Ghisla S. Mechanism of hypoglycaemic action of methylenecyclopropylglycine.. Biochem J. 1989 May 1;259(3):921-4.
  12. Peter S Spencer and Valerie S Palmer. The enigma of litchi toxicity: an emerging health concern in southern Asia. The Lancet. VOLUME 5, ISSUE 4, PE383-E384, APRIL 01, 2017. Published:January 30, 2017DOI:https://doi.org/10.1016/S2214-109X(17)30046-3
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