What Are the Causes and Symptoms of Encephalitis? Doctors Explain

Encephalitis, a fatal disease which affects the brain tissue, has sent a wave of panic through Bihar.

The Bihar Health Department on Sunday, 23 June, put the total number of acute encephalitis syndrome (AES) casualties across 20 districts at 152.

While some were rushed to hospitals, others died before medical help could be sought. Being referred to as ‘chamki bukhaar’ in Bihar’s Muzzafarpur and other parts of the state, the possibility of acute encephalitis syndrome (AES) or Japanese encephalitis (JE) has triggered panic all across the area.

Doctors and authorities are speculating the cause of these deaths to be encephalitis and hypoglycemia (low blood sugar).

Terms like chamki, AES or brain fever are being interchangeably used in Bihar, since the true cause of these symptoms is unclear at this juncture. Every year, similar symptoms lead Bihar and east Uttar Pradesh to makes headlines. The exact reasons behind the outbreak still cannot be confirmed. According to experts, malnutrition, unhygienic conditions, humidity and heat, and weak immunity are some reasons that could lead to it.

What is Encephalitis?

Encephalitis is a disease which affects the brain tissue, causing it to swell. Mostly a viral infection that affects the brain, if left untreated, it can prove to be fatal. However, in some cases it can also be caused by bacteria and non-infectious inflammatory conditions. It can lead to coma or mental or physical disability.

Causes of Encephalitis

Viral infection is seen as the primary reason behind the disease. Gorakhphur-based social activist, Dr RN Singh, who has been running a campaign against encephalitis since 2005, says that so far three reasons can be listed down behind encephalitis.

1. Infected by the JE Virus: This particular form of encephalitis is called Japanese Encephalitis (JE). Many cases of these are witnessed in Asia and is caused by a mosquito bite. Vaccination is available to prevent this.
2. Dirty Water Causing Enteroviral Encephalitis: This is contracted through infected water. This form of the disease is not treatable; there is no vaccine available for it.
3. Bacteria or Parasite Leading to Scrub Typhus: Of the total encephalitis cases, a mere 2 percent are of scrub typhus. This infection is caused by presence of bacteria or parasites.

Symptoms of Encephalitis

Flu-like symptoms are the most common among those inflicted with encephalitis, according to Mayo Clinic. These include:

• Headache
• Fever
• Muscle and joint ache
• Weakness and fatigue
  

If the disease progresses, symptoms can include:

• Disorientation
• Impaired speech or hearing
• Paralysis
• Unconsciousness

Common symptoms among children:

• Nausea
• Stiffness in the body
• Loss of appetite
• Irritation

In case of these symptoms, medical help should be sought immediately. In 2017, doctors at Gorakhpur Medical College stated that children were often brought in at the last stage of the disease. Such a situation makes it tough to fight it.

Treating Encephalitis

High fever, strong headache and unconsciousness require immediate medical attention. Dr Shailesh Prasad Singh, Civil Surgeon, Muzzafarpur, told FIT that time is of essence when it comes to treating suspected cases of encephalitis. Any delay can prove fatal for the patient.

Dr RN Singh commented on this in the following manner.

“Prevention is the cure of encephalitis and this requires widespread awareness of the disease among people.”

Dr RN Singh

Prevention of Encephalitis

Here are some simple guidelines to follow:

• Paying extra attention to hygiene
• Protection from mosquitoes. Fogging and prevention of mosquito breeding around the house should be done.
• Vaccination
• Pigsty should be built at a distance of at least three kilometres from human settlement
• Drinking clean, purified water

The health department issued an advisory in Muzzarfarpur that asked parents to not let kids go to bed on an empty stomach. It also asked them not to let children step out or play outdoors in the heat.

Understanding Encephalitis' Presence in India

Dr Singh explains the disease and its geographical presence further.

“This disease is not simply confined to east Uttar Pradesh or Bihar, but has affected a total of almost 19 states. Along with UP and Bihar, Assam, West Bengal have also reported cases. This is why it’s important to launch a nationwide campaign against it.”

Dr RN Singh

He further mentions that earlier AES or just encephalitis were primarily caused by the Japanese Encephalitis virus (JEV). A vaccination drive for the same was also conducted. However, despite that, there was not a significant fall in deaths.

After looking closely at the disease, it was concluded that not all encephalitis cases are caused by JEV. It can also be caused by water-related enteroviral encephalitis, as mentioned previously. However there is still further study needed to confirm more accurate causes for its presence in India.

(This story was originally published on Fit Hindi. It has been translated to English by Rosheena Zehra.)