Sudden high fever in summer, careful to suffer from JE

Hateful mosquitoes can spread a variety of diseases, and Japanese encephalitis is a serious central nervous system disease transmitted by mosquito vectors. The onset of JE is urgent, the progress is fast, the symptoms are different, most of them are light or recessive infections. Typical clinical symptoms are hyperthermia, disturbance of consciousness, convulsions, respiratory failure and meningeal irritation, and severe cases can lead to death. About 30% of critically ill patients will have serious sequelae, which will cause a heavy mental and economic burden on society and families. July-August is the high season of JE in Zhejiang Province, and it is the epidemic period.

Severe sequelae of Japanese encephalitis

JE occurs in tropical, subtropical and temperate regions, mainly in Southeast Asia and the Western Pacific. It is a natural epidemic disease transmitted by humans and animals that are transmitted by mosquito bites (China is mainly Culex pipiens pallens). After human infection with Japanese encephalitis virus, only short-term viremia occurs regardless of latent infection or dominant infection, so it is not the main source of infection. Pigs (especially piglets) are important sources of infection for JE: mosquitoes with JE virus bite pigs, the virus will multiply in pigs (pig as a storage host for JE virus, it will not develop), then bite If a mosquito that has been infected with Japanese encephalitis virus bites another person, it may spread the Japanese encephalitis virus to humans.

The population is generally susceptible to Japanese encephalitis virus, but most are mild or latent infections. Long-lasting immunity is obtained after infection in humans, and re-occurrence is rare. Children with weak constitution, elderly people, and chronically ill patients are high-risk groups of JE, and should be protected.

So far, there is no specific drug for JE treatment, so timely inoculation of JE vaccine is the most effective measure to prevent and control JE. Although the JE vaccine has been widely used worldwide, there are still about 67,900 people suffering from the disease each year, resulting in about 13,600 to 20,400 deaths. It is estimated that there are currently about 24 countries reporting cases of JE, with an overall incidence of about 1.8/100,000. The rate of disability of Japanese encephalitis is extremely high, and about 30% of critically ill patients have severe physical, psychological, neurological or intellectual disabilities.

Zhejiang Province was once an epidemic area of ​​Japanese encephalitis. In the late 1960s and early 1970s, a pandemic occurred. In 1967, the incidence rate exceeded 45/100,000, with nearly 15,000 cases and more than 1,000 deaths. With the wide application of JE vaccine and the improvement of hygienic conditions, the JE epidemic situation has been effectively controlled. Since then, the overall trend has been declining. Since 1975, the incidence rate has remained below 10/10 million. After 1991, the incidence rate has further dropped to 1110. Below 10,000, the number of cases of Japanese encephalitis reported in the following years after 2010 is less than 100 cases, and in the past three years, it is less than 20 cases. The cases of Japanese encephalitis in Zhejiang are mainly children under 15 years old and infants. In the past five years, the age of children aged 5-9 years has the highest incidence. The top three are scattered children, students and children.

Despite this, the experts in immunization planning have not stopped the prevention and control of JE. Recently, 60 cases of Japanese encephalitis cases in 2013-2018 were followed up by the Institute of Immunization of Zhejiang Provincial Center for Disease Control and Prevention. After research, it was found that nearly half of patients had at least one neurological, mental or psychological sequelae, mainly characterized by exercise restriction or dysfunction, memory and impaired understanding, decreased learning ability and mental retardation or abnormality.

Experts support J-brain

During the survey visit, there were three typical cases that left a deep impression on the experts.

Must be vaccinated in time

Xiaobao (pseudonym), born in 2017, followed his parents from other provinces to Zhejiang to work in 2018. He did not receive the JE vaccine in time. As a result, Zhejiang soon became unfortunately suffering from JE. The family that was not rich was spent tens of thousands of treatments. Although it saved lives, it left behind the sequelae: Xiaobao’s left foot has obvious obstacles to his motor function, and because of his age, his intelligence is affected. Not completely sure.

Experts remind: Be sure to take your child with JE vaccine in time. JE vaccine is divided into two types: attenuated and inactivated JE vaccine. Among them, the live attenuated JE vaccine is a national class I free vaccine, and the JE inactivated vaccine is a self-funded vaccine. A total of 2 doses of live attenuated JE vaccine were given at the age of 8 months and 2 years of age. The inoculation of the inactivated cerebral vaccination was carried out in four doses, and the inoculation was started at the age of 8 months. The second needle was inoculated on the 7th to 10th day after the first needle, and one needle was inoculated separately at the age of 2 and 6 years.

In particular, children who follow their parents and live in their place of birth like Xiaobao must go to the community health service center where they live, and promptly vaccinate a class of vaccines including JE vaccine to make them healthy. Protection. According to the requirements of the National Vaccination Work Regulations (2016 edition), for children aged ≤ 14 years old born after 2008, if they are not vaccinated with JE vaccine, if they are replanted with the JE attenuated vaccine, 2 doses can be supplemented free of charge. Inoculation interval ≥ 12 months.

In addition to vaccination, it is necessary to prevent mosquito bites.

Dabao (pseudonym) born in 2008 suffers from epilepsy. Because epilepsy is one of the contraindications for JE vaccination, it is not possible to receive JE vaccine. In 2016, Dabao suddenly had a high fever. At first, he thought it was a cold, but his condition was in a state of turmoil and he quickly fell into a coma. After collecting blood and cerebrospinal fluid specimens, the patient was diagnosed with severe JE. After being rescued and treated by hospitals in Shanghai and Hangzhou, Dabao was hospitalized for more than 200 days, and finally turned to safety, but left a serious sequelae. Without parents, there is no way to speak. Dabao, who was about to go to elementary school, embarked on a difficult road of recovery: although the memory and language skills gradually recovered, the motor function was impaired, compared with his peers, his intellectual ability was low, his life could not take care of himself, and he even brushed his teeth. Washing your face is difficult to accomplish independently. In order to take care of Dabao, her mother resigned and stayed at home 24 hours to accompany Dabao. The family has spent more than 1 million medical expenses. The well-off family has a heavy economic and spiritual burden.

Experts remind: JE vaccination has contraindications, including:

●Allergic to vaccine ingredients:

● Patients with acute illness, severe chronic disease, acute exacerbation of chronic diseases and fever:

● Pregnant women:

● immunodeficiency, immunocompromised or receiving immunosuppressive therapy (cannot be vaccinated with live attenuated vaccine);

● People with encephalopathy, uncontrolled epilepsy and other progressive neurological diseases.

In addition, these conditions should be used with caution: family and individual have a history of convulsions, those with chronic diseases, those with epilepsy, allergies, and lactating women.

Patients with immunodeficiency, low immune function, or receiving immunosuppressive therapy may choose a JE inactivated vaccine.

Epilepsy like Dabao, as well as other children who are unable to receive JE vaccine, should pay more attention to prevent mosquito bites. In case of sudden high fever and other suspected symptoms of JE, it is necessary to stay in the hospital and seek medical treatment in time.

Anti-mosquito bites in summer include:

● Go out as far as possible to wear light-colored, long-sleeved clothes for children, spray anti-mosquito liquid, avoid too many places where mosquitoes and other mosquitoes, such as trees and grasses, and outdoor mosquitoes during the active period of dusk.

● Use screen doors, screens, mosquito nets and other anti-mosquito.

● Clean the corners of the sanitation, turn over the pots, and remove all the water.

● If there are aquatic plants in the house, change the water for 3 to 5 days, rinse the roots of the plants, and thoroughly wash the inner wall of the container.

● Rural areas focus on eliminating mosquitoes in livestock sheds (especially pig pens), spraying insecticide water, eliminating mosquito breeding grounds, cutting off transmission routes, and ensuring good sanitary conditions.

● Vaccination, even if it is easier to recover

According to statistics, the J brain in Zhejiang Province is mainly dominated by children, but in recent years there has been a trend toward adult development. Xiao Zhang (pseudonym), born in 1990, had a high fever and headache in the summer of 2017. When he started to have a cold, he continued to have a headache and he went to the hospital. As a result, he was diagnosed with JE. Fortunately, Zhejiang Province has been vaccinated with JE vaccine free of charge since 1953. In 2008, two live attenuated JE vaccines were added to the immunization program, covering children and adolescents under the age of 15 comprehensively. After being examined, Xiao Zhang was vaccinated for 4 times. Brain inactivated vaccine. There is no specific medicine for JE, only symptomatic treatment (ie, high fever, fever, nutritional support, etc.), the doctor will promptly confirm the diagnosis, and give appropriate symptomatic treatment. Xiao Zhang’s condition was quickly controlled and the prognosis was good without leaving any sequelae.

Experts advise: vaccination is the most effective way to prevent JE, but it does not mean that it is 100% sick after vaccination. However, after investigation, it was found that people who have been vaccinated with JE vaccine will get a relatively mild symptom if they have J-brain. It is easier to control the condition after symptomatic treatment in time, and they can fully recover or leave only slight sequelae.

In addition, according to statistics, adult JE patients are more prone to sequelae than young children or children: patients with a history of immunization are less likely to have sequelae or relatively mild. Therefore, adults who have not been vaccinated with JE vaccine when they are young, especially those with poor physical fitness, or who are exposed to outdoor outdoors in summer, may also consider ingesting the encephalitis inactivated vaccine at their own expense.

Written at the end:

With the widespread use of JE vaccine, the JE epidemic has been effectively controlled. However, diseases such as JE that may cause life-long exercise and mental impairment, once suffocated, are a 100% disaster and a heavy blow to a family, and may carry a heavy mental and economic burden for life. I hope that all parents will bring their children to the JE vaccine in a timely manner, do a good job in anti-mosquito and anti-mosquito measures, maintain good sanitary conditions, and stay away from JE.