Neurological symptom vigilance needed for JEV

Public health

By Michael Woodhead

10 Mar 2022

With a worrying outbreak of Japanese encephalitis virus (JEV) occurring around the Murray river, clinicians are being urged to be vigilant for patients with typical neurological symptoms.

Several human cases in Victoria, NSW, South Australia have been reported including one death in NSW from the rare brain disease caused by a virus spread to humans through mosquito bites.

JEV is usually only found in far northern Australia and neighbouring countries, and there is no specific treatment. In the last week JEV has also been detected in pigs in Victoria, New South Wales and Queensland, according to health authorities.

The Department of Health in Victoria notes that most JEV infections are asymptomatic, however those with severe infection (less than 1%) may experience sudden onset of fever, headache and vomiting.

This is followed by mental status changes, focal neurological deficits, generalised weakness, movement disorders, loss of coordination and coma over the next few days.

“The encephalitis cannot be distinguished clinically from other central nervous system infections,” it states.

“Anyone experiencing these symptoms, particularly if they’ve visited the Murray River area between Mildura and Wodonga near the border of Victoria and New South Wales or been in contact with pigs, should seek urgent medical attention,” the advisory statement notes.

Clinicians must consider and test for JEV and other arboviruses in patients with unexplained encephalitis, after other common causes such as Herpes Simplex Virus (HSV), Varicella Zoster Virus (VZV) and enteroviruses have been excluded, according to the Victoria Department of Health.

Recommended testing for patients with encephalitis without another pathogen diagnosis, especially with compatible MRI or CT findings, in adults and children includes blood, CSF and urine samples.

The Federal government has noted that a human case of JEV has also being reported in Queensland and is those who work with animals such as pigs and horses to adopt control measures against mosquitos.

Australia’s Acting Chief Medical Officer, Dr Sonya Bennett, has declared the unfolding situation in Australia concerning the Japanese encephalitis virus (JEV) a Communicable Disease Incident of National Significance.

“A national working group of communicable disease, vaccine and arbovirus experts has been established to support the response, including mosquito surveillance and control measures and identification of those at direct risk, and for the rollout of vaccines. Public health communications regarding mosquito protection will target affected communities.”

“The Australian Government’s health and agriculture departments are working very closely with their state government counterparts to ensure a swift and coordinated response.”

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