JAPANESE ENCEPHALITIS. Lin Chaoshuang The Third Affiliated Hospital Sun-Yet sen University. Overview. Etiology Epidemiology and history Pathogenesis and Pathology Clinical Manifestation Diagnosis Treatment Prevention and Control. Etiology: The Organism. Arbovirus Flavivirus
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The Third Affiliated Hospital
Sun-Yet sen University
Etiology: The Organism
It has three proteins
Etiology: The Organism
Flaviviruses replication process includes the entry by receptor-mediatedendocytosis, uncoating, protein synthesis, viral genome synthesis, assembly, and virus release by budding from plasma membrane or internal membrane.
(62% case-fatality rate)
India: recognized in 1954, over 6,000 cases in 1978
Outbreak 2005 in India
Prevalence in Shanxi Province Yuncheng: From 13 July to 14 Augest, 2006.
65 cases，19 deaths.
Transmission: Sourcesof Infection
Transmission: Routesof Transmission
Transmission: Susceptible Population
Recovery with residual complications
Host - Amplifying
Host - Carrier
The nature of flavivirus disease is determined primarily by
Adequate immunological Weak immunological
subclinical or mild invades the CNS
systemic diseaseinduce mortality
Clinical manifestations depend upon:
Clinical spectrum of JE infection
Routine:clear, tension elevated,
Neutrophilsmay predominate in early CSF samples but alymphocytic pleocytosisis typical
proteinis moderately elevated
glucose and chloride normal level
Specific IgM antibody
A significant rise in IgG antibody titer should be seen with paired samples from the acute and convalescent stages.
Isolated from CSF by inoculating into 2-4 day old mice and the virus is identified by haemagglutination inhibition.
JE virus may also be identified by infection of cell cultures (chicken embryo or hamster kidney cells, or the mosquito cell line C3/36).
Physical method: ice, alcohol, cool saline.
Sedation, Corticosteroids may be used
Oxygen supply, artificial respiration
Mannitol iv.drip 1mg/Kg every 6~8 hrs.
the interval is 1~2 weeks in infancy,
boosting 1.0ml in children.