Japanese encephalitis

This is the most common arbovirus encephalitis worldwide and is endemic in Southeast Asia, Japan, China, the Philippines, Borneo, and large areas of the Indian subcontinent.11,39 Birds and domestic animals are the reservoir, mosquitoes the vector. Encephalitis is seen most commonly in those under 15 years and in the elderly. After an incubation period of one to two weeks there is abrupt onset of encephalitis, often with myalgia. Extrapyramidal features have been noted and a polio-like illness is now recognised. Convalescence may be prolonged and sequelae are common. Although there is no effective antiviral agent for Japanese encephalitis, good supportive management can improve the outcome. Diagnosis is by virus isolation or the demonstration of specific antigen or antibodies in the CSF or blood.40 Prevention is by vector control and use of effective vaccination.

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