Toddler dies from Japanese Encephalitis: Must-know information about this disease

Living in the tropics, we know about the dangers of mosquito-borne diseases like dengue and Zika. However, our knowledge about other similar, potentially deadly infections — such as Japanese Encephalitis  — is limited. If you are planning a family trip to Indonesia (Bali in particular) during Japanese Encephalitis virus transmission season, it’s important to know more about this disease. In particular, the symptoms of Japanese Encephalitis and how to keep your little ones safe from this disease can make all the difference.

Only two months ago, a two-year-old Indonesian baby died from Japanese Encephalitis.

We bring you her story in order to raise awareness about this potentially fatal disease for children. 

If you are travelling to countries where this disease is common, it’s best to avoid Japanese Encephalitis virus transmission season as much as possible. Source: File Photos

Toddler dies because of the symptoms of Japanese Encephalitis 

Gavriella, the little toddler, before she contracted the fatal disease (left) and finally finding peace (right). Sources: Nathalia Chi’s Facebook Timeline (left, right)

Little Gavriella was a happy, healthy toddler, until tragedy struck in the form of a deadly mosquito-born disease during Japanese Encephalitis virus transmission season. 

Her mother’s childhood friend, Nathalia Chi, describes what happened on in a Facebook post and crowdfunding platform when the disease first struck (translated from Indonesian):

How Japanese Encephalitis stole this little girl’s life

A Silent Killer

Two-year-old Gavriella abruptly developed a fever on Wednesday, 10 January 2018. Her body temperature rose up to 38 degrees Celcius. She also complained of a sore stomach, but did not suffer from diarrhoea.

The fever persisted on the next day, so she was given medication to control it. On the evening of the same day, she was taken to Mitra Kelapa Gading Hospital, where Dr. Retno diagnosed her as being infected with a virus.

While waiting for the medication from the pharmacy, Gavriella was still very active. She was running around the hospital. Yulia, her mother, tried to put Gavriella to sleep while cuddling and feeding her milk. 

However, the little girl began shivering not long after, and was immediately taken to the ER. While laying in bed, Gavriella  began convulsing and her body temperature rose further to 41 degrees.

Thing didn’t improve…

Gavriella was also fitted with a monitor as she needed additional oxygen. At that time, her heart began throbbing intensely and she also vomited profusely, so the doctor admitted her into the PICU (Paediatric Intensive Care Unit). 

On January 12 at 6 am, the duty doctor at the PICU reported that Gavriella had three seizures. An hour later, she was unconscious and in critical condition. 

At 11 o’clock, Gavriella underwent a CT scan.  The doctors found swollen blood vessels in the back of her brain. It was only later that doctors realised she was suffering symptoms of Japanese Encephalitis. Thereafter, a diagnosis of Japanese Encephalitis was made.

Various attempts  were made to provide Gavriella treatment, including raising funds to help ease her parents’  financial burden. Unfortunately, God had other plans.

On January 19, 2018, Gavriella passed away after struggling for a week or so.

The facebook post of the fateful day Gavriella found peace from the symptoms of Japanese Encephalitis, by Gavriella’s Dad, Ridwan Xu. Source: Ridwan Xu’s facebook post

Rest in peace, dear Gavriella. We at theAsianparent are sending out prayers to you and your family. 

What is Japanese Encephalitis?

Japanese encephalitis is an inflammatory brain disease that is caused by a virus. This disease is common in Asia and is spread by the nocturnal mosquito Culex tritaeniorhynchus. Humans can contract Japanese encephalitis if they are bitten by an infected Culex mosquito. 

Culex mosquitoes are widely found in paddy fields and irrigated areas, especially in rural areas.

The prime Japanese Encephalitis virus transmission season is the rainy season (April-October), as this is when cases of Japanese encephalitis spike due to increased mosquito breeding. Although the disease can affect anyone, it is most dangerous in children, who are also more susceptible to getting it. 

Symptoms of Japanese Encephalitis 

Initially, the disease manifests with very mild symptoms, if any. The first symptoms of the disease usually appear about 5-15 days after an infected Culex mosquito bites a human.

Here are the symptoms of Japanese Encephalitis:

• high fever
• shivering / tremors 
• headache 
• nausea
• fatigue
• vomiting
• rigidity at the back of the neck, usually in adult patients
• disorientation coma (decreased consciousness)
• seizures, usually in paediatric patients
• paralysis

Some more facts about the symptoms of Japanese Encephalitis: 

• Among the infected, 20-30% usually pass away.
• Symptoms usually improve after the critical phase is over.
• 30% to 50% of patients suffering from Japanese encephalitis suffer from cognitive neurological disorders.
• Annually, the disease is estimated to have 14,000 to 20,000 fatal cases of acute illness and 14,000 to 27,000 survivors with long-term cognitive disorders.

Since most of the symptoms of this disease are similar to other common ailments, you need to consult a doctor and undergo a laboratory examination for an accurate diagnosis. Usually, lab tests not only include taking blood samples, but also examining bone marrow fluid.

How the virus spreads and tourist sites at risk

During Japanese Encephalitis virus transmission season, the virus spreads in hosts such as water birds and pigs in irrigated rice fields.

However, not to worry parents! Pork is safe to eat. According to the Ministry of Health in Singapore, the virus cannot survive in dead cells, will be killed so long as the pork is cooked until 60 degrees Celcius. Even if it does reach our gut, the stomach acid kills it off.

Thankfully, unlike other contagious diseases, infected humans are a dead-end host. This means that even if you have contracted the disease during Japanese Encephalitis virus transmission season, an uninfected mosquito that bites you will NOT be able to further spread the disease. Touching or kissing your little one also does NOT spread the disease.

Unfortunately, because the virus grows in pigs and birds and is common in Asia, some popular tourist areas may be risky to visit during Japanese Encephalitis virus transmission season.

Some of these places include Bali, Ubud in Indonesia, and also Sarawak and Langkawi in Malaysia.

According to the CDC, much of Asia, including Korea, Japan, Thailand and India are known at-risk areas for the disease.

Thankfully, ever since the government phased out pig farming, cases of this disease have been rare in Singapore. Still, it’s good to know how to keep our little ones safe from such a devastating disease. 

Preventive measures to take during Japanese Encephalitis virus transmission season

There is NO treatment that cures Japanese encephalitis. The medication provided only attempts to relieve symptoms of Japanese Encephalitis experienced by patients.

Patients who definitely have contracted the Japanese encephalitis virus are required to undergo inpatient care for intensive observation. However, there are ways to prevent this deadly disease, including avoiding mosquito bites.

Here are some tips to avoid the symptoms of Japanese Encephalitis: 

• Spray mosquito repellents that are suitable for your skin.
• Wear clothes that fully cover the body while outdoors.
• Use mosquito nets when asleep
• Avoid nighttime activities, especially around paddy fields and pig farms. This is where most Culex mosquitoes reside. 

The Japanese Encephalitis Virus Vaccine

The best and most protective method to prevent disease onset is via the Japanese Encephalitis Virus vaccine.

Keep in mind that the vaccine has no effect on infected patients. You should get a vaccine, and check on your child’s vaccination records, if you intend to travel to any of the JE hotspots indicated earlier in our article. 

The Japanese encephalitis vaccine is suitable for children aged two months old till adulthood. Speak to your child’s paediatrician about it. 

This vaccine should be administered twice within 28 days. Booster vaccines may be given to adults above 17 years old, with a minimum period of 1 year for re-administration after two vaccine doses are given.

However, not everyone should get the vaccine. Infants younger than two months and people who have had a life-threatening allergic reaction to the JE vaccine or any ingredient in the vaccine may not be suitable for the Japanese Encephalitis Vaccine.

Always remember to consult your doctor before getting vaccinated if you have serious allergies or are pregnant. 

Where can I get the vaccine?

If you are travelling to areas at risk with your little ones, do get the shot one to two weeks before heading there.

Many hospitals in Singapore provide the Japanese Encephalitis virus vaccine — just speak to your doctor about it. 

Raffles Hospital, meanwhile, matches the vaccine schedule to that of your country if you have stayed overseas for a long period of time. Their websites also detail the trip duration, what other vaccines you should take, travel tips, and vaccine prices. 

We at the Asianparent hope this information is useful. theAsianparent offers condolences to little Gavriella’s family.

Share this article with your friends and family so that they are better informed on the symptoms of Japanese Encephalitis and can take active steps to reduce contracting this deadly disease.

Also read: Thousands of Newborn Babies suffer from brain damage, allegedly due to the Zika Virus

Republished with permission from theAsianparent Indonesia. Translated from Indonesian and further edited by Nalika Unantenne and Kevin Wijaya Oey

References:

Star , MOH, ECDC, vaccines.gov , PATH, Kitabisa.com , Hello Sehat, SGH, TTSH, NHS, CDC,  Singhealth, Raffles Hospital

CDC, NHS, WHO