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Japanese Encephalitis Symptoms, Treatment, Vaccine Cost, and Prevention Tips in PH

In the past days, a viral infection caused by a type of mosquito has been a hot topic in the social media. Although both the Department of Health (DOH) and the Pediatric Infectious Disease Society of the Philippines (PDISP) has already said that there is no reason for the public to panic over the mosquito-borne disease, some cannot contain the urge to panic.

What is Japanese Encephalitis?

This particular viral infection that is closely related to West Nile encephalitis, dengue and yellow fever is a serious condition which causes the brain of the infected person to swell.  The virus is found in infected pigs and birds. This is passed on to mosquitoes, particularly Culex Tritaeniorhynchus, when they feed on infected animals. These infected mosquitoes’ can then transmit the virus to humans through their bites. This type of mosquito is commonly found in areas where there are wading birds, pig farms, and rice fields. This type of infection is not transferable from person to person.

The World Health Organization said that children below the age of 15 are most vulnerable to the disease, with children younger than four years being nine times more likely to be infected with Japanese encephalitis than older children. About 15 percent of Japanese Encephalitis cases are adult victims.  

Three billion people are at risk from Japanese Encephalitis, According to WHO the average fatality rate of is 3 out of 10 who showed severe symptoms or 1 out of 250 people who have contracted the illness.

Countries affected by JE and recent Japanese Encephalitis cases in Ph

In 1987, the first clinical case of JE was documented in Japan. The country has suffered numerous large outbreaks since then. It quickly spread to other East and Southeast Asian countries. In Korea, the first case of JE occurred in 1933. In China JE cases emerged in 1940. And in the Philippines, as early as 1950’s reports on JE was recorded.

Since 2014, the DOH has been monitoring the illness in five Areas including Regions I, III, VII, XI and the cordillera Administrative Region. Currently there are at least 133 cases of JE recorded between January 1 and August 26 this year. A total of 53 cases was recorded in Central Luzon. There were 9 reports of fatalities; four (4) from Pampanga province, two (2) from Zambales and three (3) were recorded in Pangansinan, Laguna and Nueva Ecija.

The mosquito are most common in rural and agricultural areas and are active during day and night. In urban areas, they go to houses with water storage containers.

Common Symptoms of Japanese Encephalitis

Commonly, most people infected by the Japanese Encephalitis virus have either no symptoms, or mild, short-lived symptoms and most of the times is mistaken for flu. According to the NHS website, this flu like symptoms includes high temperature and headache. However, according to WHO, approximately 1 out of 250 infections will rapidly progress into severe complications as the infection spreads to the brain.  This usually occurs between 5 to 15 days after infection. Symptoms can include:

  • Confusion or disorientation
  • Seizures
  • Changes in personality and behavior
  • Stiff neck
  • Inability or difficulty to speak
  • Uncontrollable shaking of the body parts (tremor)
  • Muscle weakness or paralysis

If you noticed any of the following symptoms, send the patient to the ER immediately.

Where to get treatment for JE in PH

There is no cure for Japanese Encephalitis. Infected individuals who are admitted to hospitals will get treatment which will support the functions of the body while it is trying to fight the infection. They will usually be given fluids, oxygen and medication. According DOH Secretary Ubial, when we get sick or our children develop fever for two days or flu-like symptoms; seek immediate consultation at the nearest health facilities.

How much is the vaccine cost

Although there is no identified cure for Japanese Encephalitis as of the moment, a WHO-recommended vaccine was licensed for use in the Philippines in 2013. It is also a part of the Department of Health’s vaccine program for school-aged children, which are similar to programs in other countries.

According to Sanofi Pasteur, the only company accredited by the Food and Drug Administration to distribute the JE vaccine in the Philippines, the vaccine is administered subcutaneously as a single dose for those 9 months and older. For individuals 9 months to 17 years old, a booster dose is recommended 12 to 14 months after the primary dose.

The DOH estimates the price of each dose between P 2, 000 to P 5, 000. Because of the rise in the need of the vaccine, some individuals are opting to buy the vaccine online. The FDA issued an advisory against buying the vaccine from unauthorized dealers. Dr. Salvador Gatchalian, PIDSP vice president said “There is one licensed brand in the Philippines for the vaccine that is Imojev from Sanofi Pasteur”. He also warned parents that buying the vaccine online could be risky for their children.

How to avoid Japanese Encephalitis

The best way to avoid JE is to get vaccinated, but not everyone can afford the expensive vaccine. If you are one of the many people who cannot afford the vaccine yet, there are preventive measures which might help you avoid acquiring Japanese Encephalitis.

DOH Secretary Ubial identified the following preventive measures:

  • Following the 4-S against Dengue and other mosquito-borne diseases including getting rid of standing water, maintaining environmental cleanliness and eliminating potential breeding places of mosquitoes.
  • Wear protective clothing such as long-sleeves and pants or socks to avoid mosquito bites.
  • Use mosquito nets at night time or even day time
  • Stay in well mosquito protected places like screened homes.
  • Use FDA-approved insect repellents.

According to DOH undersecretary Bayugo, not all who acquired the JE virus develop severe sickness or get sick at all. But that 1 percent who had problems will have cognitive malfunction and a mortality rate of 20 to 30 percent. The Department of Health is planning to include the Japanese Encephalitis vaccine for free in early 2018. But it also emphasized that prevention of the virus, like dengue should focus on the identification and destruction of mosquito breeding sites and environmental cleanliness.

Contributor : R.Corpuz
Image credit : Mental Floss