Encephalitis maniac in Bihar, Death toll rises to 57

The death toll of children due to suspected Acute Encephalitis Syndrome (AES) in Muzaffarpur on Friday went up to 57.

The State government has announced that it will open a new 100-bed ward for children, and six additional ambulances would be deployed for the government-run Sri Krishna Medical College and Hospital (SKMCH).

Earlier on Wednesday, a four-member team of doctors, led by Dr. Arun Sinha, visited the SKMCH, where children with symptoms of AES have been admitted. The team then issued guidelines and suggestions to local medical experts and doctors.

Though the State government had previously said the cause of death of small children, mostly from poor families, was hypoglycemia, or low blood sugar levels, experts and private doctors in Muzaffarpur told The Hindu that “AES is a broader aspect of hypoglycemia”.

What is Encephalitis?

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According to WHO, viral encephalitis is inflammation of the brain, caused by any one of a number of viruses. Symptoms include high fever, headache, sensitivity to light, stiff neck and back, vomiting, confusion and, in severe cases, seizures, paralysis and coma. Infants and elderly people are particularly at risk of severe illness. Arboviruses – viruses transmitted through insect bites – are among the most common causes of viral encephalitis, and include Japanese encephalitis and tick-borne encephalitis viruses.

Treatment

Encephalitis is usually a viral illness, which means that antibiotics are not used to treat viral infections. However, some antiviral drugs have been used to treat HSV infections, and some doctors may attempt to use antiviral drugs on other acute viral infections. No antiviral drugs to date are used to treat arboviral infections.

As mentioned previously, there are other nonviral causes (see above) of encephalitis, so the treatment for a given case depends on the doctor’s working diagnosis. If the encephalitis is due to non-viral causes, then other treatments, specific to the cause, are warranted. Many clinicians consult an infectious-disease, immunology, or cancer expert to help manage the various types of treatments. With the exception of herpes encephalitis, the mainstay of treatment is symptom relief. People with viral encephalitis are kept hydrated with IV fluids while monitoring for brain swelling. Anticonvulsants like lorazepam (Ativan) can be given for seizure control. Steroids have not been established as being effective although they may still be used in some cases. Diuretics may be used to lower intracranial pressure in individuals who have encephalitis and increased intracranial pressure.

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