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Japanese Encephalitis. A Mosquito-borne Virus. Non-living structures containing genetic material. (PBS, 2007) First discovered in 1898 by Loeffler and Frosch (UCMO, 1993) Require host cells to reproduce (PBS, 2009)
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Japanese Encephalitis A Mosquito-borne Virus
Non-living structures containing genetic material. (PBS, 2007) • First discovered in 1898 by Loeffler and Frosch (UCMO, 1993) • Require host cells to reproduce (PBS, 2009) • Function by inserting their unique code into the nucleus of the host, taking over the functions and ultimately destroying the cell What are Viruses?
Single strand RNA virus • Related to West Nile • Prevalent in Asian countries • Occurs in wet, rural areas • Transmitted mainly by mosquitoes Japanese Encephalitis
The JE virus (JEV) is mainly transmitted by the mosquito Culextritaeniorrhynchus, which prefers to breed in irrigated rice paddies (CDC, 2009) • Water birds may also carry the disease, and it often infects pigs • Raising pigs is a risk factor! • Spreads through bird and human migration, and internationally through wind-blown mosquitoes Transmission
(NHS, 2010) Symptoms
Occurs in South Asia, Southeast Asia, East Asia and the Pacific • Has been carried by mosquitoes to Australia • Carried most specifically by Culextritaeniorrhynchus, which breeds in rice paddies (CDC, 2009) • Annual deaths (human) 10,000-15,000 • 20%-30% mortality rates • 30%-50% of survivors suffer residual neuropsychiatric problems (CDC, 2009) Prevalence
Basically, • Use nets, repellent, and wear long and loose clothing • Efforts only relevant for visits to endemic areas for > 1 month during the JE season, or in areas with ongoing outbreak (CDC, 2012) • A vaccine is obtainable and advised for those whose situation matches the one described above Prevention
There is NO SPECIFIC TREATMENT • STILL, there are measures taken to control symptoms and prevent complications • Therapy may be necessary, and is supportive. • Patients may require: • Feeding • Airway management • Anticonvulsants • Mannitol (decreases intracranial pressure) [Medscape, 2012] • In ICU cerebral perfusion pressure (mean minus arterial) is maintained thru modulation (Medscape, 2012) Treatment
For patients not covered by health insurance, vaccines for prevention can be $450-$1,100 • For those with insurance, it can be as low as $10-$40 (costhelper, 2010) • Global impact in 2002 was 709,000 disability-adjusted life years (DALYs) [CDC, 2009] • The disease is dynamic, because some cases may be very mild, whereas others cause irreversible neurological damage • Affects mostly tourists and those stationed in rural areas, typically rice farmers, in many Asian countries Personal/Global Effects
Emiliani, C. (1993). Introduction to the Viruses. UCMP. [accessed 12 March 2013]. Retrieved from http://www.ucmp.berkeley.edu/alllife/virus.html • Costhelper. (2010). Japanese Encephalitis Vaccine Cost. [accessed 12 March 2013]. Retrieved from http://health.costhelper.com/japanese-encephalitis-vaccine.html • Jani, A. A. (2012). Japanese Encephalitis Treatment and Management. Medscape. [accessed 12 March 2012]. Retrieved from http://emedicine.medscape.com/article/233802-treatment • Erlanger, T.E., Weiss S., Keiser J., UtzingerJ., Wiedenmayer K. (2012). Past, Present, and Future of Japanese Encephalitis. CDC. [Accessed 12 March 2012]. Retrieved from http://wwwnc.cdc.gov/eid/article/15/1/08-0311.htm • NHS. (2012). Japanese Encephalitis. [accessed 12 March 2012]. Retrieved from http://www.nhs.uk/Conditions/Japanese-encephalitis/Pages/Introduction.aspx • CDC. (2012). Japanese Encephalitis. [accessed 12 March 2012]. Retrieved from http://www.cdc.gov/japaneseencephalitis/prevention/index.html Documentation