Rathi A K, Kushwaha K P, Singh Y D, Singh J, Sirohi R, Singh R K, Singh U K
Department of Pediatrics, Biochemistry and Microbiology, Medical College, Gorakhpur.
Indian Pediatr. 1993 Mar;30(3):325-33.
Gorakhpur region experienced the most serious outbreak of Japanese encephalitis (JE) in 1988 in which 875 children were admitted in the Department of Pediatrics, BRD Medical College, Gorakhpur. Children between 7-10 years age group constituted half (49.3%) of these cases, convulsions (83.8%), altered sensorium (78.2%), headache (68.8%) and hypertonia (77.0%) were the main presenting features. IgM against JE virus was demonstrated in 18/25 CSF and 27/53 sera collected from these children. Significant titres of HI antibodies against JE were present in 498/670 patients. Patients were managed symptomatically. Dexamethasone and dopamine were given to only 137 (15.7%) children admitted with shock and peripheral circulatory failure. Almost a third (31.8%) of the patients expired, 51.4% recovered completely and 10.7% recovered partially. Corticosteroids did not improve the outcome. Twenty four patients had recurrence of symptoms after excellent recovery from acute attack of whom two died and 5 developed neurological deficits.
1988年，戈勒克布尔地区经历了最严重的日本脑炎（乙脑）疫情，875名儿童被收治于戈勒克布尔BRD医学院儿科。7至10岁年龄组的儿童占这些病例的一半（49.3%），惊厥（83.8%）、意识改变（78.2%）、头痛（68.8%）和肌张力亢进（77.0%）是主要临床表现。从这些儿童采集的25份脑脊液样本中有18份、53份血清样本中有27份检测出乙脑病毒IgM。670例患者中有498例存在显著滴度的乙脑血凝抑制（HI）抗体。对患者进行了对症治疗。仅137名（15.7%）因休克和外周循环衰竭入院的儿童接受了地塞米松和多巴胺治疗。近三分之一（31.8%）的患者死亡，51.4%完全康复，10.7%部分康复。皮质类固醇并未改善预后。24例患者在急性发作后恢复良好，但出现了症状复发，其中2例死亡，5例出现神经功能缺损。
