Characteristics and Outcomes of Japanese Encephalitis in the Northeast State of India: A Retrospective Case Series Study

Background: Japanese Encephalitis (JE) is a serious public health issue in an Asian region, causing high mortality and disability rates across all age groups.Objectives: The current study aims to examine the clinical characteristics, laboratory findings, treatment patterns, and discharge outcomes of JE-admitted patients at a tertiary care neurology hospital in the Northeast state of India.Methods: The medical records of diagnosed JE patients were reviewed retrospectively between January ۲۰۲۱ and December ۲۰۲۲. Demographic and clinical characteristics were analyzed. Characteristics of the disease severity were assessed based on the discharge status: routine discharge, Discharge Against Medical Advice (DAMA), and mortality during the hospital stay.Results: A total of ۲۸ JE patients were included; their average age was ۴۰.۷ (±۲۰.۲) years, males predominantly (۶۰.۷%), and the majority belonged to the lower socioeconomic level (۸۵.۶%). The most common clinical symptom was fever with altered sensorium (۸۹.۳%), with involved hyperintensities in the thalamus (۲۵.۰%). Twenty-six patients required Neurological Intensive Care Unit (Neuro-ICU) management with tracheostomy-assisted ventilation due to neurological deterioration. Symptomatic treatment was prescribed such as prophylactic antibiotics and osmotic diuretics. JE patients’ mortality (۲۵.۰%) during a hospital stay due to superadded septic shock and elevated intracranial pressure, ۲۱.۴% were routine discharge, and ۵۳.۶% underwent DAMA.Conclusion: The prevalent reasons for JE patient mortality were superadded septic shock, increased intracranial pressure, and disease severity. Fever with altered sensorium and thalamus involvement were major findings. Many patients were DAMA because of their low socioeconomic level, which was a barrier to monitoring the progression of the disease.

Keywords:

Flavivirus , Prevention and control , Prognostic factors