Patient care at the Infectious Disease Intensive Care Unit. (Illustration photo)
In June 2024, the Department of Infectious Resuscitation, Institute of Clinical Infectious Diseases, 108 Central Military Hospital received a 16-year-old male patient, living in Son La, admitted to the hospital with an infection and acute brain damage, specifically: high fever, coma, quadriplegia, autonomic nervous system disorder.
Brain magnetic resonance imaging showed inflammatory lesions in the thalamus, hippocampus, bilateral cerebral peduncles, and multifocal lesions in the left temporal and parietal regions. Serological results were positive for Japanese encephalitis virus B.
Doctor Nguyen Sy Thau, Department of Infectious Resuscitation, Institute of Clinical Infectious Diseases, 108 Central Military Hospital said that the patient was actively resuscitated and has passed the acute stage. Currently, the patient is conscious and breathing on his own, but still has sequelae of weakness in all four limbs, especially the right side, and is unable to take care of himself.
Japanese encephalitis virus is the leading cause of viral encephalitis in Asia, including Vietnam. The virus was first isolated during a viral encephalitis outbreak in Japan in 1935, hence the name 'Japanese encephalitis virus'.
Most cases of Japanese encephalitis virus infection are asymptomatic or have fever, which resolves spontaneously. Less than 1% develop encephalitis, but the disease is usually severe and has a high mortality rate; among survivors, neurological sequelae are common.
The virus is transmitted through mosquito bites, in Vietnam it is identified as Culex mosquitoes. This is a species of mosquito that often resides in rice fields, especially in seedling fields and spreads widely in the fields, so it is also called field mosquito.
Mosquitoes breed a lot in the hot summer, when there is a lot of rain (May, June, July in the North); mosquitoes often fly out to suck blood from people and animals at dusk. The main hosts of the virus are animals, most importantly birds (moving from the forest to the plains during the fruit season, carrying pathogens from the wild, then infecting domestic pigs), and pigs (about 80% of the pig herd in the epidemic area is infected with the virus).
Humans are the random host and also the final host of the infection chain, because in the human body the virus cannot develop in sufficient numbers to infect mosquitoes, so there is no direct infection from person to person.
In Vietnam, the virus circulates throughout the country, mostly in the northern delta and midland provinces, and can infect all ages, but is most common in children under 15 years old. Preventive measures for Japanese encephalitis virus include avoiding mosquito bites, especially in areas near pig farms, rice fields, at dusk, etc. However, vaccination is the most effective method.
The vaccine has been included in the expanded immunization program in Vietnam since 1977, and by 2014 it had been deployed in all provinces and cities nationwide. After 3 basic injections (completed in about 2 years), booster shots should be given every 3-4 years, recommended until the child is over 15 years old. Parents should take note to have their children fully vaccinated to prevent Japanese encephalitis.
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