Encephalitis threat most serious aspect of WN virus

Published 12:00 am Thursday, August 8, 2002

While there has been much discussion about how to avoid mosquito bites due to the recent outbreak of the West Nile virus in the south, there seemingly has not been as much conversation about the encephalitis which can develop in some humans and animals infected by the disease.

Encephalitis is an acute inflammation of the brain, and it usually affects the brain and the membranes which cover it.

There are two basic types of encephalitis, which are:

Neurotropic-Virus Encephalitis: occurs in an individual as a primary infection. The virus affects mostly wild birds and animals and is translated to humans through insect vectors.

Postinfective encephalitis (PIE): Caused as a complication to other viral infections such as polio, measles, mumps, chickenpox and rubella.

Several signs and symptoms are commonly associated with encephalitis, such as a persistent headache, vomiting, a stiff neck, extreme lethargy.

More advanced cases may be accompanied by such symptoms as seizures, unconsciousness, double vision, speech impairment, hearing loss or paralysis or weakness of the limbs. Sufferers of encephalitis may also experience mood swings and personality changes.

There are various treatments available which can help to relieve and cure encephalitis, and if those symptoms are present there may be laboratory studies of the blood and cerebrospinal fluid and x-rays taken of the skull to determine if the problem is in fact encephalitis.

Acetaminophen can be prescribed to treat a headache or fever and other anti viral drugs such as acyclovir or amantadine may also be suggested.

Five people recently were confirmed to have died from West Nile related encephalitis in Louisiana, and it should be noted that people over 50 and those with compromised immune systems are usually affected the most by the virus. Doctors are also now looking into five possible cases of the human West Nile virus in south central Alabama, one of which may have caused the death of 37-year-old Dothan lawyer Jennifer Atwell.

Treatment of encephalitis is usually aimed at control of high fever, maintenance of fluid and electrolyte balance, and constant maintenance of respiratory and urinary function as required.

Specific treatment for encephalitis will be determined by your physician based on factors such as your age, overall health and medical history, extent of your condition, tolerance for specific medications, procedures or therapies, expectations for the course of the condition and your opinion or preference.

Convalescence from acute courses with serious damage to central nervous system can be prolonged and efforts at physical rehabilitation are typically needed to overcome neurological and musculoskeletal complications that may develop, and in some cases personality changes and emotional disturbances may require extensive treatment.

During an acute case of the illness, the patient is monitored for alterations in neurologic function.

Assessment of level of consciousness, neuromuscular response and pupil size, as well as cranial nerve function and other aspects of neurologic assessment are a major part in the care of the disease. In this acute phase of the disease, a patient will need frequent position changes and range of motion exercises to maintain skin integrity and joint motion.

A quiet environment, according to the encephalitis web site, is necessary to avoid triggering convulsions and to relieve headache and promote rest.

Delirium is also related with encephalitis and the patient may need reassurance and support if suffering symptoms of confusion and disorientation. Family members or those associated with the patient should also note that behavioral changes and other symptoms resulting from irritated nerve tissues are not always permanent and can often stabilize as a patient's condition continues to improve.

In the U.S., several thousand cases of viral encephalitis are reported yearly to the Centers for Disease Control and Prevention (CDC), with an additional 100 cases a year attributed to PIE.