Encephalitis – What it is, who is at risk, and how it is treated
Our readers may have read earlier this week the newspaper reports about the former NSW Premier, Mr Morris Iemma, now being paralysed in his legs and attending physiotherapy in the attempt to get feeling and function back after being laid low by a severe case of encephalitis.
The word “encephalitis” means inflammation of the brain, and is usually a result of infection by any number of viruses, such as the herpes viruses (shingles, chicken pox, Simplex 1 or 2, etc), arboviruses transmitted by mosquitoes, ticks or other insects, rabies transmitted through animal bites, or Epstein Barr virus, amongst others. Bacterial infections such as Lyme disease can also lead to encephalitis, as can parasitic infections like toxoplasmosis. Experts believe that many cases are so mild that they go unrecognised, but some people do develop a life threatening form of it.
The course of the disease is unpredictable so it is always advisable to seek medical advice if there are symptoms from the following: headache, irritability, lethargy, fever, and joint pain. More serious infections can cause confusion, hallucinations, personality changes, double vision, seizures, muscle weakness, loss of sensation or paralysis in certain areas of the body, tremors, rash and loss of consciousness. Urgent signs are altered levels of consciousness, loss of feeling, seizures, or mental disturbances. In infants these symptoms mean that immediate medical attention should be sought: stiffness, inconsolable crying, vomiting, and bulging in the soft spots on the baby’s head.
Numerous factors can put some people at a greater risk than others. For instance, some forms of encephalitis are much more severe in the very young, or the very old. People with weakened immune systems (from organ transplantation or chemotherapy or due to HIV/AIDS) are very susceptible to infection. Visiting areas of the country where mosquito-borne viruses are common increases one’s risk, such as Far North Queensland. People with outdoor jobs, or hobbies such as gardening, bushwalking, camping, jogging, or bird-watching are at increased risk especially in the hot months of summer which are the most likely time for mosquito bites.
For those people who develop complications, like Mr Iemma did, some of the problems can last for a year or more, including fatigue, weakness, depression, personality changes, gait problems, and memory difficulties. Paralysis, loss of speech clarity and vision and hearing defects may even be permanent. Treatment is usually rest, plenty of liquids, a healthy diet, and use of pain relief for the fever and headaches. Antiviral medications may be used, if it is determined that it was viral in origin. Anticonvulsant medications and anti-inflammatory drugs such as corticosteroids to reduce swelling and pressure within the skull, are also used. After the illness physical and speech therapy may be needed.
Prevention is always best, so that means being aware of mosquito season in visited regions, vigilant use of repellent, and covering up with barrier clothing, as well as staying up to date with immunisations for chickenpox, rubella, mumps, and rubeola.
We sincerely wish Mr Iemma a full recovery from his very unfortunate case of encephalitis, and we join the many well-wishers through out New South Wales who will be praying for him and his family as he goes through rehabilitation.
Reference: http://www.mayoclinic.com/health/encephalitis/DS00226
