CHP investigates case of Japanese encephalitis

12-Jun-2017 Intellasia | 7thspace | 6:00 AM Print This Post

The Centre for Health Protection (CHP) of the Department of Health (DH) is investigating this evening (June 9) a case of Japanese encephalitis (JE) and again urged the public to maintain strict environmental hygiene, mosquito control and personal protective measures both locally and during travel.

The patient is a man aged 69 with underlying illnesses. According to his family, he attended the Accident and Emergency Department of Tseung Kwan O Hospital on May 30 for headache, dizziness and nausea since May 29 and was subsequently admitted for management. He has developed fever since May 31.

His condition deteriorated on June 1 and was transferred to the Intensive Care Unit for further management. He is now in critical condition.

His cerebrospinal fluid and blood sample tested positive for immunoglobulin M (IgM) antibodies against JE upon laboratory testing.

Initial enquiries revealed that the patient lives in Ying Ming Court, Tseung Kwan O. His home contacts have remained asymptomatic and been put under medical surveillance.

“Although the patient had very brief travel history in the incubation period, based on findings of epidemiological investigations so far, the case is managed as a local case at this stage as a precautionary measure.

As the patient has been comatose, details of his exposure history are pending. We are working closely with the Food and Environmental Hygiene Department (FEHD) to assess and prevent any possible spread of infection,” a spokesman for the CHP said.

“Epidemiological investigations are ongoing. We have informed the FEHD and the Agriculture, Fisheries and Conservation Department for vector investigations, surveillance and control.

Health education in the vicinity where the patient frequented will follow,” the spokesman added.

Officers of the CHP will conduct site visit and field investigations by questionnaire surveys at the patient’s residence for active case finding and arranging blood tests. A health talk will be held jointly with the FEHD to deliver health advice to residents and the public.

Persons who have been to the vicinity of Ying Ming Court with JE symptoms should call the CHP’s hotline (2125 1122) for laboratory investigation or referral as appropriate. It will operate from 9am to 6pm tomorrow (June 10).

“We have informed the Guangdong and Macau health authorities of the case and will issue letters to doctors and hospitals to alert them to the latest situation,” the spokesman added.

This is the first JE case in 2017.

Two (imported) and two (one local, one unclassified) cases were recorded in 2016 and 2015 respectively.

JE is a mosquito-borne disease and JE virus is transmitted by the bite of infected mosquitoes. The principal vector is called Culex tritaeniorhynchus. JE mainly occurs in rural and agricultural areas of Asia and the Western Pacific.

The infected mosquito transmits JE virus to humans and animals during biting. The mosquitoes breed where there is abundant water such as rice paddies and become infected by feeding on pigs and wild birds infected with JE virus.

JE symptoms usually start at around four to 14 days after being infected. Mild infections may occur without apparent symptoms other than fever with headache.

More severe infection is marked by quick onset of headache, high fever, neck stiffness, impaired mental state, coma, tremors, convulsions (especially in children) and paralysis.

There is no specific treatment for JE. Supportive therapy is indicated. The case-fatality rate can be as high as 30 per cent among those with symptoms.

Of those who survive, 20 to 30 per cent suffer from permanent intellectual, behavioural or neurological problems such as paralysis, recurrent seizures or inability to speak.

To prevent JE, the public should take general measures to prevent mosquito bites and avoid going to rural areas from dusk till dawn when the mosquitoes are most active. Travellers to endemic areas should take special note.

The public should:

1. Wear loose, light-coloured, long-sleeved tops and trousers, and use DEET-containing insect repellent on exposed parts of the body and clothing;

2.

Take additional preventive measures in outdoor activities:

Avoid using fragrant cosmetics or skin care products;

Re-apply insect repellents according to instructions;

3. Special notes during travel:

If going to affected areas, arrange consultation with a doctor at least six weeks before travel, and have extra preventive measures to avoid mosquito bite;

During travel in endemic rural areas, carry a portable bed net and apply permethrin (an insecticide) on it. Permethrin should not be applied to skin.

Seek medical attention promptly if feeling unwell; and

Travellers feeling unwell, such as fever, should seek medical advice promptly, and provide travel details to doctor.

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