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Encephalitis: The Deadly Condition That Killed More Than 100 Children In Bihar

The outbreak of Acute Encephalitis Syndrome (AES) in Bihar has led to the death of 125 children so far. Acute Encephalitis Syndrome is also being referred to as 'Litchi havoc', 'chamki fever', 'killer encephalitis', 'deadly Litchi toxin'.

Read on to know more about what causes encephalitis, its symptoms, diagnosis and treatment methodologies.

What Is Encephalitis?

Encephalitis is an acute inflammation of the brain either caused by a viral infection or when the immune system mistakenly attacks the brain tissue. However, the most common cause is a viral infection [1] .

Encephalitis can be life-threatening and can even cause death due to a number of factors like the severity of disease and age.

Causes Of Encephalitis

Viral and bacterial infections are believed to cause acute encephalitis [2] . The viruses that can cause encephalitis are herpes simplex virus (HSV), mosquito-borne viruses, tick-borne viruses, enteroviruses, rabies virus, and childhood infections like measles, mumps, and German measles.

There are 2 types of encephalitis:

  • Primary encephalitis - It occurs when a virus directly infects the brain cells; it can either affect one area or can be widespread.
  • Secondary encephalitis - It occurs when the immune system mistakenly attacks the healthy cells in the brain instead of attacking the cells causing the infection.

Symptoms Of Encephalitis

People with encephalitis have mild flu-like symptoms, which include the following:

  • Fever
  • Headache
  • Fatigue or weakness
  • Aches in joints and muscles

Severe signs and symptoms of encephalitis include the following:

  • Seizures
  • Muscle weakness
  • Confusion, agitation or hallucinations
  • Hearing or speech problem
  • Loss of sensation or paralysis in certain areas of the face or body
  • Loss of consciousness

The symptoms in infants and children include the following:

  • Body stiffness
  • Nausea and vomiting
  • Bulging in the soft spots (fontanels) of an infant's skull
  • Irritability
  • Poor feeding

Risk Factors Of Encephalitis [3]

  • Age - Young children and older adults are vulnerable to viral encephalitis.
  • Weakened immune system - People with HIV/AIDS and malnourished children have a weak immune system which increases the risk of encephalitis.
  • Geographical regions - In certain regions, mosquito-borne viruses and tick-borne viruses are common.
  • Certain seasons of the year - In many areas of the United States, mosquito-borne viruses and tick-borne viruses increase the risk of acute encephalitis.

Complications Of Encephalitis

The complications of viral encephalitis depend on factors like age, the cause of infection and the severity of your initial illness. The complications are:

  • Epilepsy
  • Loss of memory
  • Speech impairments
  • Paralysis
  • Hearing or vision defects
  • Behavioural and personality changes
  • Persistent fatigue
  • Muscle weakness

Diagnosis Of Encephalitis [4]

The doctor will first conduct a physical examination and go through your medical history. The diagnostic tests include:

  • Brain imaging - A CT scan or an MRI is useful in detecting changes in brain structure.
  • Lumbar puncture - This is done by taking a sample of cerebrospinal fluid (CSF) that surrounds the brain from the spinal cord.
  • Electroencephalogram (EEG) - Electrodes are attached to the scalp to record the brain's activity. Abnormal patterns of the brain are detected through this type of diagnosis.
  • Other lab tests include samples of blood, urine or fluid from the back of the throat is tested for the virus.

Treatment Of Encephalitis [4]

Encephalitis requires urgent treatment, which is usually treated in the hospital in an intensive care unit (ICU).

  • Antiviral medicines - If encephalitis is caused by the herpes simplex virus or chickenpox virus, the antiviral medications are given thrice a day for 2 to 3 weeks.
  • Immunoglobulin therapy - This type of medication aids in controlling the immune system, which may be needed if steroids don't help.
  • Steroid injections - It is used if encephalitis is caused due to a fault in the immune system. The treatment is only for a few days.
  • Antibiotics and antifungal medications - These medications are given if encephalitis is caused due to a bacterial or fungal infection.
  • Plasmapheresis - It is a procedure which removes harmful antibodies that attack the brain from the blood.
  • Surgery to remove abnormal tumour growth in the brain.

Other treatments options to relieve the symptoms are as follows:

  • Fluids are given into the vein to prevent dehydration
  • Medications to control seizures
  • Painkillers are used to reduce fever or discomfort
  • For breathing problems, an oxygen mask is provided to support the lungs for breathing.

Prevention Of Encephalitis

  • Avoid sharing beverages and tableware.
  • Practising good hygiene is important .
  • Children should be given vaccinations to prevent deadly diseases.
  • Apply mosquito repellent creams on children.
  • Get rid of open stored water which are the breeding places of mosquitoes.
View Article References
  1. [1] Narain, J. P., Dhariwal, A. C., & MacIntyre, C. R. (2017). Acute encephalitis in India: An unfolding tragedy.The Indian journal of medical research,145(5), 584–587.
  2. [2] John, T. J., Verghese, V. P., Arunkumar, G., Gupta, N., & Swaminathan, S. (2017). The syndrome of acute encephalitis in children in India: Need for new thinking.The Indian journal of medical research,146(2), 158–161.
  3. [3] Hamid, J. S., Meaney, C., Crowcroft, N. S., Granerod, J., & Beyene, J. (2011). Potential risk factors associated with human encephalitis: application of canonical correlation analysis.BMC medical research methodology,11(1), 120.
  4. [4] Kennedy, P. G. E. (2004). Viral encephalitis: causes, differential diagnosis, and management.Journal of Neurology, Neurosurgery & Psychiatry,75(suppl 1), i10-i15.
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