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国际区域性疾病

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日本脑炎(Japanese Encephalitis)
原作者: Andrea Tenner, Veron 发布日期:2013-02-27
关键词:日本脑炎

Title: Japanese Encephalitis
题目:日本脑炎
Author 作者: Andrea Tenner, Veronic Pei
 
General Information 基本概况:
caused by Japanese encephalitis virus (JEV), closely related to West Nile virus    
由与西尼罗河病毒密切相关的日本脑炎病毒感染引起
transmission is through infected mosquito
由感染的蚊子传播
most common cause of vaccine-preventable cause of encephalitis in Asia
在亚洲是最常见的能够由疫苗预防的脑炎
Incubation period is 5-15 days
潜伏期为5-15天
<1% develop clinical, disease, most asymptomatic
多数病人无症状,只有低于1%发展成临床疾病
Acute encephalitis most common presentation 
急性脑炎是最常见的表现
Sx: altered mental status, focal neuro deficits, movement disorder, seizure, fever, headache, vomiting
症状:神志改变,局部神经功能丧失,运动失调,癫痫,发烧,头痛,呕吐
Classic presentation: Parkinsonian syndrome with mask-like facies, tremor, cogwheel rigidity, and choreoathetoid movements
典型表现:帕金森氏综合征的表现,面罩样脸,颤抖,齿轮样强直,和舞蹈手足徐动症
case-fatality is 20-30%
死亡率为20-30%
 
Area of the world affected:
世界流行地区:
Primarily in Asia – China, Japan, Korea, India, Southeast Asia
主要在亚洲-中国,日本,南韩,印度,东南亚
 
Relevance to the US physician:
美国医生要注意什么:

1. General 常识:
      -- Should be considered in patients concerned for neurological infection with recent travel to endemic country
对最近到过流行区旅游并怀疑有神经系统感染的病人要考虑此病
-- Lab: JEV-specific IgM in serum (after 7 days of sx onset) or CSF (after 4 days of sx onset)
实验检查:日本脑炎病毒(JEV)-血清特异性IgM(起病后7天内)或CSF IgM(起病后4天内)
      -- Viral culture and other viral RNA amplifications tests are not sensitive
病毒培养和其它病毒RNA放大实验并不敏感
      -- Treatment is supportive
治疗主要是支持性
      -- In survivors, 30-50% have significant neurological, cognitive, psychological sequelae
在幸存病人中,30-50%会有明显的神经,认知,和心理方面的后遗症
2. Vaccine 疫苗
      -- One vaccine (Ixiaro) is available in the US    
美国有一个疫苗(Ixiaro)
      -- 2 doses, 28 days apart (96% develop immunity)
要接种两次,相隔28天(96%产生免疫力)
      -- No information on duration of protection
没有有关保护期的资料
      -- Recommended for travelers ≥ 1 month in endemic areas during JEV season
建议给在高发季节到流行区旅游超过1个月以上的旅游者
 
Bottom Line 要点:
Very rare but deadly disease with high mortality and post-infection sequelae.  Think about it in travelers to Asia during summer/fall seasons who have not been immunized.
罕见但具有高死亡率和感染后后遗症的恶性疾病。对在夏秋季到亚洲没有免疫过的旅游者要考虑日本脑炎。
  
References
http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/japanese-encephalitis.htm#2473