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24 / 10 / 2017
Encephalitis
 
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Encephalitis

 
INFECTIOUS DISEASE

Viral Illnesses

 

Encephalitis means "inflammation (irritation and swelling) of the brain," but it usually refers to brain inflammation caused by a virus. This severe and potentially life-threatening disease is rare.

Encephalitis takes two forms, categorized by the two ways that viruses can infect your brain:

  • Primary encephalitis. This occurs when a virus directly invades your brain and spinal cord. It can happen to people at any time of the year (sporadic encephalitis), or it can be part of an outbreak (epidemic encephalitis).
  • Secondary (post-infectious) encephalitis. This form occurs when a virus first infects another part of your body and secondarily enters your brain.

The primary form of the disease is more serious, while the secondary form is more common. But because of the milder nature of secondary encephalitis, doctors actually see more cases of primary encephalitis.

See your doctor if you experience signs and symptoms of primary or secondary encephalitis because the course of the disease is unpredictable.

Signs and symptoms

Most people infected with viral encephalitis have only mild or no symptoms, and the illness doesn't last long. Serious cases can cause:

  • Drowsiness

  • Confusion and disorientation

  • Seizures

  • Sudden fever

  • Severe Headache

  • Nausea and vomiting

  • Tremor or convulsions

  • Stiff neck — occasionally

  • Bulging in the soft spots (fontanels) of the skull in infants

Emergency signs and symptoms may include altered levels of consciousness. In infants, the key signs are a stiff neck and a bulging in the soft spots (fontanels) of the skull. In older children, watch for severe headaches, lethargy, confusion and sensitivity to light. In adults, mental disturbances may be more prominent.

Causes

Three broad categories of viruses — herpes viruses, childhood infections and arboviruses — typically trigger primary and secondary encephalitis.

Herpes viruses
Some herpes viruses that cause common infections may also cause encephalitis. These include:

  • Herpes simplex virus. There are two types of herpes simplex virus (HSV) infections. HSV type 1 (HSV-1) causes cold sores or fever blisters around your mouth. HSV type 2 (HSV-2) causes genital herpes. HSV is the most common cause of sporadic encephalitis, with HSV-1 being the more common culprit. However, you're not more likely to contract encephalitis if you suffer from cold sores. When untreated, the mortality rate from herpes simplex encephalitis is between 60 percent and 80 percent. That number drops to 15 percent to 20 percent with treatment.

  • Varicella-zoster virus. This virus is responsible for chickenpox and shingles. It can cause encephalitis in adults and children, but tends to be mild.

  • Epstein-Barr virus. This herpes virus causes infectious mononucleosis (mono). If encephalitis develops, it's usually mild but results in death in about 8 percent of cases.

Childhood infections
In rare instances, secondary encephalitis occurs after common childhood viral infections, including:

  • Measles (rubeola)

  • Mumps

  • Rubella (German measles)

This type of occurrence of encephalitis may be due to a hypersensitivity reaction — an overreaction of your immune system to a foreign substance.

Arboviruses
Viruses that are transmitted by mosquitoes and ticks (arboviruses) are the most common cause of epidemic encephalitis. In recent years, these viruses have also produced the most publicized cases of encephalitis. However, this kind of encephalitis is rare, even though encephalitis is the most common mosquito-borne disease. Here's how the transmission cycle works:

Organisms that transmit disease from one animal host to another are called vectors. Mosquitoes are vectors for the transmission of encephalitis from small creatures — usually birds and rodents — to humans.

Birds that live near bodies of standing water, such as freshwater swamps, are susceptible to infection with an encephalitis virus. When a bird is infected with encephalitis, it carries high levels of the virus in its blood for a short time before recovering from the infection and developing immunity to the disease. If a mosquito feeds on an infected bird, the mosquito becomes a lifelong carrier of the disease. The mosquito transmits the infection to the next bird it feeds on, which in turn passes it to more mosquitoes.

Usually, this transmission pattern cycles through without serious impact on either creature and without affecting humans. This is partly because mosquitoes' primary hosts are birds and small mammals, and they bite humans only as a second choice. However, sometimes environmental disasters, unusual weather or other climate changes cause an increase in the number of infected birds, as well as an increased number of mosquitoes that feed on both birds and humans. Under these conditions, humans may be affected.

You're at risk of these types of mosquito-borne encephalitis:

  • Eastern equine encephalitis. Eastern equine is the most serious encephalitis virus in North America. As the name suggests, it afflicts horses. But it also can affect humans. Eastern equine encephalitis outbreaks occur most commonly in the eastern United States. This virus infects birds that live near freshwater swamps. Although some people experience it only as a mild illness, eastern equine encephalitis is fatal in about half of people who develop severe signs and symptoms. However, less than five cases are reported in most years. Most cases occur in late summer, though they can happen year-round in southern states. Symptoms of eastern equine encephalitis usually appear four to 10 days after a bite by an infected mosquito.

  • Western equine encephalitis. Like eastern equine encephalitis, this virus affects horses and humans. Most reports of western equine encephalitis come from the central and western Plains of the United States. This virus flourishes in birds that live near irrigated fields and farming areas. Western equine encephalitis is less likely fatal than its eastern cousin, but it's still serious. Brain damage and other major complications occur in about 13 percent of people of all ages infected with the disease, and in one-third of infants. About 3 percent of people who develop severe signs and symptoms die of western equine encephalitis. This virus also is rare, with less than five cases reported each year. Human infections are usually first detected in June or July. Symptoms appear between five and 10 days after a bite.

  • St. Louis encephalitis. This virus is transmitted to mosquitoes by birds. The mosquito vector of St. Louis encephalitis breeds in areas of standing water, including polluted pools, roadside ditches and containers such as birdbaths, flowerpots and discarded tires. Although many young people have mild or no symptoms when infected, the disease can be severe in seniors over age 60. The mortality rate is between 2 percent and 20 percent.

  • La Crosse encephalitis. This virus was named for La Crosse, Wis., where the virus was first recognized in 1963. It's most common in the hardwood forest areas of the Upper Midwest and in Appalachia. Unlike other forms of viral encephalitis, this virus is passed to mosquitoes from chipmunks and squirrels. La Crosse encephalitis usually affects children and has a mortality rate of less than 1 percent. An average of 70 cases is reported annually. Symptoms appear five to 15 days after a bite by an infected mosquito.

  • West Nile encephalitis. This virus first appeared in the United States in 1999. It's also found in Africa and the Middle East and in parts of Europe, Russia, India and Indonesia. The virus is similar to the St. Louis virus in that birds are its main animal hosts. However, in rare cases, it's possible for the disease to spread from person to person through organ transplant, blood transfusion or breast-feeding, or from mother to unborn child. Symptoms of West Nile encephalitis are generally mild, but the disease can be severe, especially in older adults and those with weakened immune systems. Symptoms appear within five to 15 days of being bitten by an infected mosquito.

Encephalitis > 1 > 2 > 3 > 4

 
 
 
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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.
 
 
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