Warning of skyrocketing Japanese encephalitis B rates

The rate of Japanese encephalitis B patients (out of the total number of encephalitis patients) has increased sharply compared to the same period in 2013, and the number of cases is mainly concentrated in Hanoi. Although the total number of cases has not increased, the number of patients hospitalized has not increased en masse, and the related epidemiological factors have not been fully analyzed, the professional agencies are concerned and raise issues regarding the vaccination of Japanese encephalitis B.

2 notable signs

The National Children's Hospital said: The total number of encephalitis patients as of June 25 was approximately 130 cases - no increase compared to previous years, and patients were not rushed to the hospital.

Minister of Health Nguyen Thi Kim Tien surveyed the epidemic situation at the National Children's Hospital on the evening of June 25. In the photo is patient Tran Huu Hung Vi (2 years old, from Thai Binh) with encephalitis - Photo: Cam Quyen

However, it is noteworthy that among these, the rate of patients with Japanese encephalitis B (JEB) has skyrocketed with 36 cases - accounting for nearly 30%.

Meanwhile, in the same period of 2013, the rate of VNNB B patients in the total number of encephalitis patients was only 8%. The number of deaths to date is 2 cases, of which 1 case tested positive for VNNB B, 1 related case.

The second notable point is that the majority of VNNB B patients come from Hanoi with 11 out of 36 cases (accounting for 31%) with 6 severe cases requiring ventilators, the remaining localities only have 2-3 scattered cases.

“This is the peak month of the year for encephalitis, there are no unusual developments, but what is a bit worrying is that the number of positive cases of JEV B has increased compared to the same period last year. Therefore, it is necessary to reconsider whether people are afraid of vaccination complications so they do not get vaccinated with JEV B vaccine or not?”, Dr. Tran Minh Dien - Deputy Director of the National Children's Hospital assessed.

Currently, the National Children's Hospital has not had a specific analysis on the vaccination status of patients positive for VNNB B.

However, in the emergency room of the Infectious Diseases Department, there was a room with 4 patients with encephalitis, of which 3 had not been vaccinated and 1 had an unknown vaccination history.

Inspecting the epidemic situation at the National Children's Hospital on the evening of June 25, Minister of Health Nguyen Thi Kim Tien emphasized: Although there are no large-scale statistics in many hospitals nationwide on encephalitis and JEV B, the two above-mentioned cases occurring at the National Children's Hospital are noteworthy and need immediate warning, and the cause must be found early to proactively take control measures.

“The fact that Hanoi has the most patients with JEV B cannot be concluded because it is possible that many patients go to the National Children's Hospital because it is closer. But the strange thing is that the positive rate for JEV B has increased, while it does not occur in previous years, so we need to infer whether there is a problem with vaccines or vaccinations or not?” – said the Minister of Health.

Ms. Tien said she would ask the Department of Preventive Medicine to review the vaccination of JE B vaccine to make adjustments if necessary. In addition, statistics on the JE situation nationwide must be compiled to have an accurate assessment, thereby providing timely treatment.

Early patient triage, prepare response plan

Drawing “profound” lessons from the measles epidemic when poor patient flow caused severe overload and severe cross-infection, and inadequate human and material resources to respond to the measles epidemic, so in the face of the current developments of encephalitis and JEVB B, Dr. Tran Minh Dien, Deputy Director of the National Children's Hospital, said that the hospital has proactively developed and implemented a plan to respond to encephalitis right now (when the number of patients has not yet been hospitalized massively).

Learning from the measles epidemic, from this moment on, the National Children's Hospital has prepared a plan to triage patients and respond in case of an increase in the number of cases (-Photo: CQ)

Accordingly, if the number of patients is within the limit of 50-70, a different plan is implemented than when the number of patients increases to over 70. The patient admission process is also implemented from the clinic back and continues to be classified in the emergency department, then any case of encephalitis is transferred to the Infectious Diseases Department.

Diagnostic methods are still applied from the regulations from 2006 by PCR tests, cerebrospinal fluid and done early within 24 hours to classify patients immediately.

In the treatment area, measles cases being treated are transferred to the Oriental Medicine and Mental Health departments, so there are still many places to accommodate encephalitis patients (the number of beds is about 120), ensuring one bed for each child. If there are more patients, the hospital will reserve the Infectious Diseases Department for encephalitis and JEVB B patients and mobilize other units to coordinate with full equipment.

With the current situation of encephalitis and measles, it is only necessary to increase the night-time staff for the Infectious Diseases Department to provide better care. On June 23, the hospital added 8 nurses to this department so that 1 nurse can take care of 2 cases on ventilators, avoiding the situation where medical staff falls into a state of "exhaustion" as happened at the peak of the measles epidemic not long ago.

According to vietnamnet