日本脑炎教材课程.ppt

Diagnosis Materials of epidemiology Clinical Laboratory Tests Tentative diagnosis Antibody titer: HI, IF, CF, ELISA JE-specific IgM in serum or CSF Definitive diagnosis Virus isolation: Blood, CSF sample, brain Differential Diagnosis Toxic shigellosis and other Toxic Encephalopathy Cerebral Malaria Meningitis (other viral meningitis or encephalitis, partially treated bacterial meningitis, meningococcal meningitis, tuberculous or fungal meningitis) Febrile Convulsions Rey’s Syndrome Rabies Prognosis Approximately 5-35% of cases are fatal, some with a fulminate course lasting a few days and others run a more protracted course in coma. About 30-50% of those who survive may have serious neurologic sequelae. Treatment No specific therapy Supportive care: intensive life support is indicated Surveillance for cases of encephalitis Treatment Treatment of high fever Physical method: ice, alcohol, cool saline. Artificial hibernation Seizure and convulsions management: Sedation, Corticosteroids may be used For respiratory failure: Oxygen supply, artificial respiration For raised intracranial pressure: Mannitol iv.drip 1mg/Kg every 6~8 hrs. Prevention Vector (Mosquito) control Eliminate mosquito breeding areas: Chemical larvicides, Biolarvicides, Environmental management Adult and larval control: Anti-larval treatment Vaccination Personal protective measures Avoid prime mosquito hours: from dusk to dawn Indoor spray and fogging: Use of Insecticide Vaccination Live attenuated vaccine Successful for reducing incidence SA 14-14-2 (Chinese live attenuated vaccine at affordable cost, safe, effective). This vaccine was developed in China and has been used since 1988. It has been licensed and used in South Korea. Inactivated mouse brain vaccine(JE-VAX) Comprising 3 doses: 0.5ml each time and the interval is 1~2 weeks in infancy, boosting 1.0ml in children. Used for endemic or epidemic areas. Recommended for travelers visiting endemic