Neurological sequelae of Japanese encephalitis B

Japanese encephalitis virus is the leading cause of viral encephalitis in Asia, including Vietnam. The disease can leave severe neurological sequelae if not detected and treated promptly.

Neurological sequelae of Japanese encephalitis B

Japanese encephalitis virus is the leading cause of viral encephalitis in Asia, including Vietnam. The disease can leave severe neurological sequelae if not detected and treated promptly.

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 injury.

Specifically, high fever, coma, quadriplegia, autonomic nervous system disorder. Brain MRI showed inflammatory lesions in the thalamus, hippocampus, bilateral cerebral peduncles, and multifocal lesions in the left temporal and parietal regions.

The serological results were positive for Japanese encephalitis virus B. The patient was actively resuscitated and has passed the acute phase. 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 an epidemic of viral encephalitis 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 course is usually severe, with 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 the blood of people and animals at dusk.

The main hosts of the virus are animals, most importantly birds (which migrate 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 accidental 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. It can cause infection in all ages, but is most common in children under 15 years old.

Preventive measures against 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 the 3 basic doses (completed within about 2 years), booster doses should be given every 3-4 years, recommended until the child is over 15 years old. Parents should take note to fully vaccinate their children to prevent Japanese encephalitis.

Angina and myocardial infarction due to 30 years of smoking

Mr. Thong, living in Go Vap, Ho Chi Minh City, had no underlying medical conditions but smoked one pack of cigarettes a day for over 30 years. The day before he had chest pain, he lifted weights for over two hours, so he thought the pain was related to muscle strain.

Long-term smokers need to have regular check-ups and cardiovascular screening to prevent risks and have timely treatment to avoid dangerous complications.

He rested for 15 minutes and the pain subsided, but half a day later the pain returned with more severity. Within 3 hours, the patient took medicine and rested but the chest pain was still there, so he was taken to Tam Anh General Hospital for emergency treatment. The electrocardiogram results suggested coronary artery obstruction.

The patient was ordered an urgent coronary angiogram, which determined that the right coronary artery was completely blocked, with many blood clots in the lumen of the vessel.

In addition, the patient also had large blood vessels (diameter 7-8 mm compared to 3-4 mm, maximum 5-6 mm in normal blood vessels). Doctor Huynh Ngoc Long, Director of the Vascular Intervention Center, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, said that this was a case of smoking causing inflammation and coronary atherosclerosis.

Smoking can cause atherosclerosis by several mechanisms. First, the concentration of carbon monoxide (a substance abundant in cigarettes) increases, damaging the flexibility of the blood vessels, leading to the formation of atherosclerotic plaques.

Next, smoking reduces HDL-cholesterol (a beneficial cholesterol) and increases LDL-cholesterol (a harmful cholesterol) levels, increasing triglycerides (also known as blood fat) causing atherosclerosis.

If the atherosclerotic plaque in the blood vessel suddenly ruptures or is eroded, the blood clotting process starts, creating blood clots that block the coronary artery, causing acute myocardial infarction. If not treated promptly and intervened, the patient is likely to suffer from sequelae such as arrhythmia, heart failure, and cardiac arrest.

Dr. Long warns that regular smoking can cause more angina and heart attacks than non-smoking.

In addition, the age of onset of myocardial infarction is also earlier, with more dangerous complications than in non-smokers. Therefore, in addition to a scientific diet and exercise regimen, quitting smoking is the most important thing to do to keep the heart healthy.

Long-term smokers need to have regular check-ups and cardiovascular screening to prevent risks and have timely treatment to avoid dangerous complications.

Source: https://baodautu.vn/tin-moi-y-te-ngay-306-di-chung-than-kinh-do-viem-nao-nhat-ban-b-d218929.html