Neurological sequelae due to 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 due to 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 Infectious Disease Intensive Care Unit of the Clinical Institute of Infectious Diseases, Military Central Hospital 108, admitted a 16-year-old male patient from Son La province with acute infection and brain damage.

Specifically, the patient presented with high fever, coma, quadriplegia, and autonomic nervous system dysfunction. A cranial MRI revealed inflammatory lesions in the thalamus, hippocampus, bilateral cerebral peduncles, and multiple foci in the left temporal and parietal regions.

Serological tests were positive for Japanese encephalitis virus B. The patient received intensive care and has passed the acute phase. Currently, the patient is conscious and breathing independently, but still suffers from residual weakness and paralysis of all four limbs, especially the right side, and is unable to care for themselves.

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, and has since been known as Japanese encephalitis virus.

Most cases of Japanese encephalitis virus infection are asymptomatic or present with a fever, which then resolves spontaneously. Less than 1% develop encephalitis, however, it is usually severe and has a high mortality rate; among those who survive, neurological sequelae are very common.

The virus is transmitted through mosquito bites, and in Vietnam, it has been identified as being transmitted by the Culex mosquito. This species of mosquito commonly resides in rice paddies, especially in seedling fields, and spreads widely across the fields, hence it is also known as the rice paddy mosquito.

Mosquitoes breed most actively during the hot, rainy summer months (May, June, and July in Northern Vietnam); they usually fly out to feed on the blood of humans and animals at dusk.

The primary hosts of the virus are animals, most importantly birds (which migrate from forests to plains during the fruit-rich season, carrying the pathogen from the wild and then infecting farmed pigs), and pigs (approximately 80% of farmed pigs in affected areas are infected with the virus).

Humans are both the accidental and final hosts in the chain of transmission, because the virus cannot multiply in the human body to infect mosquitoes in sufficient numbers; therefore, there is no direct person-to-person transmission.

In Vietnam, the virus circulates throughout the country, most commonly in the northern delta and midland provinces, and can infect people of all ages, but is most frequently seen in children under 15 years old.

Preventive measures against Japanese encephalitis virus include avoiding mosquito bites, especially in areas near pig farms, rice fields, and at dusk; however, vaccination is the most effective method.

Vaccines have been included in Vietnam's expanded immunization program since 1977, and by 2014 had been rolled out in all provinces and cities nationwide.

After the three basic doses (completed within approximately two years), booster shots should be given every 3-4 years, recommended until the child is over 15 years old. Parents should ensure their children receive all necessary vaccinations to prevent Japanese encephalitis.

Angina and myocardial infarction due to 30 years of smoking.

Mr. Thong, residing in Go Vap District, Ho Chi Minh City, has no underlying medical conditions but has smoked one pack of cigarettes a day for over 30 years. The day before experiencing chest pain, he lifted weights for more than two hours, leading him to believe the pain was related to muscle strain.

Long-term smokers should undergo regular cardiovascular disease screenings to prevent risks and receive timely treatment, avoiding dangerous complications.

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

The patient was scheduled for an emergency coronary angiography, which revealed complete blockage of the right coronary artery, with numerous blood clots adhering to the vessel lumen.

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

Smoking can cause atherosclerosis through several mechanisms. Firstly, the concentration of carbon monoxide (a substance abundant in cigarettes) increases, damaging the flexibility of blood vessel walls and leading to the formation of atherosclerotic plaques.

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

If atherosclerotic plaques in blood vessels suddenly rupture or erode, the clotting process is initiated, creating blood clots that block the coronary artery, causing acute myocardial infarction. Without timely emergency treatment and intervention, patients are likely to experience sequelae such as cardiac arrhythmias, heart failure, and cardiac arrest.

Doctor Long warns that regular smoking can cause more angina attacks and heart attacks compared to not smoking.

Furthermore, people who smoke tend to experience heart attacks at an earlier age and with more dangerous complications compared to non-smokers. Therefore, in addition to a healthy diet and exercise, quitting smoking is paramount to maintaining a healthy heart.

Long-term smokers should undergo regular cardiovascular disease screenings to prevent risks and receive timely treatment, avoiding dangerous complications.

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