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Etiologic agent;
Unknown maybe caused by a variety pathologic agents including bacteria, viruses, fungi, chemical substances or trauma.

Incubation period;

1- 15 days, with a range from 4-21 days.

Mode of transmission;
Transmitted to bite of an infected mosquito. Then it becomes infected by biting an infected bird, and after incubating the virus in its own body for 5-7days, they carry the virus to healthy birds, horses, pigs and humans. Infection of human is end of the cycle. Man man Mosquito does NOT carry virus from human.

Primary encephalitis - an infection caused by DIRECT invasion of the CNS by the virus resulting an inflammatory reaction. These arthropodborne viruses are as follows; 1. Eastern Equine Encephalitis - serious epidemic dse. of horses. -principally affecting children <5y/o. - this virus can multiply in the AEDES SULLICITANS mosquito.

2. Western Equine Encephalitis (WEE)

- Milder and usually infecting adults. 3. St. Louise Encephalitis - the organism believed to gain entrance through the Olfactory tract. - Caused by bite of an infected mosquito Culex tarsalis.

4. Japanese Encephalitis
- A potentially severe viral dse., spread by CULEX TRITEANIORHYNCHUS, that live in rural rice-growing and pig farming regions. Once mosquito is infected, it will carry the virus and capable of transmitting the dse. for life. - case fatality 30% - 35% - affecting children 5-10y/o.; Male>Female with ratio or 3:1 -peak season; March-april; september october, where ricefields are flooded to hasten growth of plants that also favor the breeding site of mosquito.

Secondary Encephalitis;

Post infection encephalitis complication or a sequelae to some viral dse like measles, chicken pox, and mumps.

b. Post Vaccinal Encephalitis most common is anti-rabies vaccine.

Clinical Manifestations;
A. Japanese Encephalitis Flu-like symptoms (fever, chills, headache, nausea, vomiting) Stiff neck, confusion, neurologic manifestations occur within 72hrs. (drowsiness, seizures, bizarre, coma.) Decreased IQ Serious brain damage.

B. General Manifestations

During the prodromal period (1-4 days), pt. experience fever, headache, dizziness, vomiting and apathy. Chills, sore throat, conjunctivitis, arthtralgia, myalgia and abdominal pain. Later, the pt. go through encephalitis signs, manifested by nuchal rigidity, ataxia, tremors, mental confusion, speech difficulties, stupor or hyperexcitability, convulsions, coma and death. Ocular palsy, ptosis, and flaccid paralysis. Disturbance in swallowing, mastication, phonation, respiration and movements of muscles of the eyes or face. Uncontrollable contraction or twitching of muscles of the different parts of the body.

Diagnostic Exam;
CSF analysis Serologic test 90% confirmatory; usually done on the 7th day of illness. ELISA (IgM) Polymerase chain reaction

Nursing Management

Symptomatic and supportive Control of convulsions (Diazepam and barbiturates) as ordered. Sanitary disposal of nose and throat secretions. TSB or alcohol sponge for high fever. Unless pt. is comatose, oral fluid should be encouraged. Oral care should be strictly done. A mouth gag and protective devices, such as bedrails, should be available in case convulsions occur. I&O records are closely monitored. Assessed for neurologic signs, involving speech, swallowing difficulty, twitching, eye movement, and indications of paralysis. The beginning, duration and frequency of all convulsions should be carefully observed and recorded.

Prevention Control

Identification of mosquito vectors.

Elimination of breeding places, destruction of larvae, screening of homes, use of repellents. A broad public education program is an important phase of all preventive programs.