Clinical manifestations of Japanese Encephalitis

The incubation period four to 21 days, Generally 10 to 14 days. The virus in the early mononuclear macrophages breeding, the release into the blood, in the majority of people not developed symptoms after infection, but can be elevated antibodies in the blood, known hidden infection. Some people appeared mild respiratory symptoms; a very small number of patients, the virus through the blood-brain barrier causing central nervous system lesions, there encephalitis symptoms.
Typical patients can be divided into four stages of the disease:
(1) Thermal early period
Course No. 1 ~ 3 days, the temperature in 1 to 2 days increased to 38 ~ 39 ° C, with headache, malaise and lethargy expressions, nausea, and vomiting. Children can have respiratory symptoms or diarrhea.
(B) a view
Course No. 4 ~ 10 days, enter a period, the outstanding performance of sera for systemic symptoms and brain damage symptoms.
1. High fever
The JE there must be performance. The body temperature as high as 39 ~ 40 ° C and above. Light to last three to five days, generally 7 to 10 days and weighing up to several weeks. The higher the heat, heat the longer the process more serious illness.
2. Disturbance of consciousness
Most people in the onset after 1 to 3 days in varying degrees of disturbance of consciousness, such as drowsiness, coma. JE early drowsiness often specific performance. Usually in the 7 ~ 10 days to return to normal, heavy, sustained in January above.
3. Convulsion or seizure
JE is one of serious symptoms. The location and extent of brain lesions different performance can be mild hand, foot, facial twitch or convulsions, but also for systemic paroxysmal twitch or systemic ankylosing cramps, sustained ranging from a few minutes to several minutes.
4. Respiratory failure
JE is the most serious symptoms, but also an important cause of death. The mainly central respiratory failure, respiratory center can damage brain edema, cerebral hernia, hyponatremic encephalopathy, and other causes. Performance for respiratory superficial, not the whole rhythm, double-suction, breathe sigh kind, apnea, and the tide's breathing stopped breathing. Central respiratory failure with the peripheral presence of respiratory failure at the same time. Peripheral respiratory failure mainly for breathing difficulties, changes in respiratory rate, respiratory movement weakened, cyanosis, but the rhythm always tidy. High fever, convulsions and respiratory failure JE is the acute phase of the triple often reinforce each other, mutual influence, aggravated condition.
5. Meningeal irritation
Older children and adults have different levels of meningeal irritation. Absence of performance more babies, but often before Heng uplift.
6. Other neurological symptoms and signs
If Cone-beam damage, and often a limb spastic paralysis, muscular tension increased, Babinski sign positive. Cerebellum and oculomotor nerve involvement, it can happen nystagmus, the pupil can be expanded or reduced, ranging from large, light unresponsive; autonomic often impaired urinary retention, incontinence; shallow weakening or disappearance of the anti-body, deep reflection hyperthyroidism or disappeared.
7. Other
Some Japanese encephalitis can occur in patients with circulatory failure, manifested as decreased blood pressure, pulse rate fine. Sometimes gastrointestinal bleeding. Most of the patients in this end of the temperature dropped, his condition improved, entered recovery. A small number of patients have serious complications or died of brain damage and heavy current.
(C) recovery
After a period of the body temperature at 2 ~ 5 days to normal, coma to a sober, and some patients have a short-term spirit of "doubtful stage," and after the speech, expression, movement and neural reflex gradually returning to normal. Some patients resume slow, and takes one to three months. Individual patient showed low heat, hyperhidrosis, aphasia, and paralysis. But after active treatment, often within six months restore.
(D) sequels period
Despite aggressive treatment, some patients in the incidence six months later still have a nerve, mental symptoms, called sequelae. Occurrence rate of about 5 to 20%. To aphasia, and the paralysis of the most common mental disorders. As well as a further aggressive treatment, to a certain extent still is expected to resume.
According to the severity, JE can be divided into four types:
1. Light
He was always with clarity, drowsiness have, in varying degrees, the general non-convulsion, meningeal irritation not obvious. Body temperature usually in the 38 ~ 39 ° C, multi resume in a week, no recovery symptoms.
2. Medium
Conscious shallow obstacles such as drowsiness or coma. Cremaster abdominal wall reflection and reflection disappeared. Sometimes twitch. At 40 ° C temperature often about the course of about 10 days, have no symptoms of recovery.
3. Heavy
He was unconscious, the body temperature of 40 ° C and above, or persistent twitch reflex. After deep reflection before disappearing hyperparathyroidism, shallow reflection disappeared, strong positive pathological reflex, often positioning lesions. There may be respiratory failure. Over the course in two weeks over convalescence often different levels of spiritual paralysis and abnormal performance, and some patients may have sequelae.
4. Fulminant
Rare. Onset of intense, high fever or ultra-high heat, 1 to 2 days after the rapidly emerging deep coma and repeated strong twitch. If they do not actively save, in the short term internal central respiratory failure and death. Survivors often serious sequelae. JE clinical symptoms to light and the majority of ordinary, or about two-thirds of the total number of cases. Common initial heavy pop, pop light late common.