Clinical Analysis Of143Cases Of Japanese Encephalitis In Children

Objective: To investigate the features of epidemiology and clinic in local children ofJapanese encephalitis (JE) in local children in recent5years.Methods: The clinical data of143cases inflicted with JE admitted to the affiliated hospitalof Zunyi medical college from May2009to October2013was collected, and werefollowed up after discharge at least half a year. All cases were divided into two groups，group A for eighty-one cases from2009to2011and group B for sixty-two cases from2012to2013. The epidemiology, clinical types, clinical manifestations, auxiliaryexaminations and prognosis of JE were retrospective analyzed between the two groups.Results:(1) The gender ratio of JE was1.5:1in group A and the other group is1.2:1.The average age of onset in group A (5.18±2.88years) was less than that in group B (6.49±3.19years)(P <0.05), and most patients are pre-school children in both groups. Theproportion of cases in rural area was88.89%in group A and90.32%in group B. The rateof no vaccination in the two groups was93.83%and88.71%, respectively. The areasdistribution, gender ratio and vaccination history of JE have no significant diffierence inthe two groups (P>0.05). The transmission season was mainly concentrated from July toSeptember, and the peaking in August.(2) the most common clinical types of JE in twogroups children is the severe and ordinary types, and the severe type cases in group A weremore than group B (P <0.01).(3) The fever, convulsions, unconsciousness, meningealirritation positive were main clinical manifestations in all cases. And the persistent time offever, intermittent convulsions and total unconsciousness of JE in the group A waslonger(P <0.01) and the rato of complication of JE (P <0.05)was higher, comparied withgroup B（.4）Auxiliary examination, The rate of neuroimaging positive in group A (53.12%)was higher than that in group B (35.00%)(P <0.05). The rate of abnormal neuroimagingwas not obvious in early stage of JE (1week) and the rate of abnormal CT within the firstweek of the disease attack was higher than that after a week.4cases were checked by MRIexamination within the first week of the disease attack, and2cases was found abnormalities, while16cases were checked by MRI examination after the first week andall of them were abnormalities. further more,20cases from group A and group B, eachgroup was10cases, was found abnormalities (100%). The more abnormalities of EEG, andthe disease is more severity, and the prognosis is more poor. There was no significantdifference in white blood cells (WBC) in serum，WBC and protein in cerebrospinal fluidand the special antibody IgM of JE between group A and group B(P>0.05).(5) Theprognosis of patients in group B was better than that in group A (P <0.001).Conclusion:(1) The onset age of JE mainly concentrated in pre-school children, most ofthem come from rural area and with unvaccination history. The rate of neuroimagingpositive in the first week of JE was low, so it need more neroimaging after first week tomake a definitive diagnosis.(3) The abnormal EEG was observed in most of children withJE, which may be useful to indicate the severity of disease and prognosis.