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1、EpidemicEncephalitisBCasereportHistorytaking：Aboy,4yearsold，borninthecountryside.Feverlastfor4days，convulsionandconfusionlastabout6hours.Physicalexamination：T40.5℃，R30bpm，P120bpm，BP100/60mmHg.Unconsciousness,conjunctivaledema,lungscanbeheardwheezes.Musclehypertonia,kneehyperreflexia,Babinskisign(+)O
2、therhistory?Accessoryexamination?AbstractJapaneseencephalitis(JE),anacuteinfectiousdiseasecausedbythemosquito-borneJapaneseencephalitisvirus(JEV)andfeaturedasinflammationinbrainparenchyma.Fever,confusion,coma,convulsion,pathologicalreflexandmeningealirritation.Respiratoryfailureinseverecases,highmor
3、tality,and10%resultinpermanentneuropsychiatricsequelea.EtiologyAsinglestrandedRNA,40-50nm,11kilobasesgenomes.RNAgenomeispackagedinthecapsidproteinformingthecoreofthevirus.Thegenomesalsoencodesseveralnonstructuralproteins(NS1,NS2a,NS3,NS4a,NS4b,andNS5)JEVcanbekilledbydisinfectant,100℃2minutesor56℃30m
4、inutesEtiologyAntigenicstability,infectioncanproducecomplement-bindingantibodies,neutralizingantibodiesandhemagglutinationinhibitionantibodies,contributetoclinicaldiagnosisandepidemiologicalinvestigationEpidemiologySourcesofinfection:JEisazoonosis,mosquitoesbecomeinfectedbyfeedingdomesticpigsandwild
5、birdsinfectedwiththeJEV.JEVisamplifiedinthebloodsystemsofthedomesticpigsandwildbirds.Pigsaretheimprotantamplifiedandreservoirs.Otherreserviorincludescow,sheep,horse,duck,gooseandchicken.EpidemiologyRouteoftransmission:thebiteofaninfectedmosquito,primarilyCulexspecies.Humansareadead-endhostintheJEVtr
6、amsmissioncycle.JEVisnottransmittedfromperson-to-person.OnlydomesticpigsandwildbirdsarecarriersoftheJEV.Epidemiology.Susceptiblepopulation:Generallysusceptible,especiallyresidentsofruralareasinendemiclocation,mostlyasymptomatic.Theratioofpatientsandlatentinfectionwas1:1000-2000.Pre-existingantibodie
7、s.CountriesthatstillhaveperiodicepidemicsincludeIndia,Cambodia,Nepalandsoon.Epidemiology.Epidemicfeature:mostcasesintemperateandsubtropicalareasoccurfromJunetoSeptember,whileintropicalareasoccurthroug
