Outlook – July 06, 2019

the litchis of wrath

he origins of the dreaded acute encephalitis syndrome remain shrouded in mystery.

the sPectrum of symPtoms

raPiD onset & ProGress

DiaGnosis & treatment

Wading birds are the natural maintenance

hosts of many of the AES viruses.

From around this

year, a range of

new viruses have

been causing AES,

leading to massive

outbreaks.

6 years and below.

Children in this age group

are most vulnerable to

AES fatalities, although

the syndrome can

afflict anyone.

2000

Seizures, sudden-

onset fever, intense

headache, sensitivity

to light, stiff neck

and back

Respiratory

problems, lack of

muscle coordination,

change in speech and

eye movements

Delirium, tremors,

disorientation,

convulsions,

partial paralysis

Child goes to bed fine in

the evening

Altered mental state;

vomiting and diarrhoea

may follow

Found seriously ill early

in the morning

Loss of consciousness

and muscle rigidity and

eventual coma

Sudden onset of seizures,

with or without fever

Death within 6-12 hours

of hospital admission in

severe cases

Drop in blood sugar, blood

platelets and leucocytes

Vomiting, diarrhoea,

elevated liver enzymes,

renal dysfunction

in most of the severe cases, death strikes during the first four days

with multifarious causes, aes is difficult to diagnose

and requires a lot of laboratory tests, which are time-

consuming, laborious and expensive. the basic clinical

guidelines at the district level are:

Blood glucose is assessed

Intravenous dextrose therapy

Blood and urine specimens are

collected

Lumbar puncture for Cerebrospinal

Fluid (CSF) Analysis, the primary

diagnostic tool for infections of

the central nervous system

Cytological (white blood cell

count) and biochemical

examination of CSF specimens

Blood serologic tests for antibodies,

the most common being lgM ELISA

Detailed neurological examination

within 12 hours of admission

Brain MRI to look for signs of

inflammation or abnormalities

EEG diagnostic testing (usually not

available at district hospitals)

Virus isolation by apex labs

8 July 2019 OutlOOk 37