Warning: Japanese encephalitis B cases surge.

The proportion of Japanese encephalitis B patients (among the total number of encephalitis patients) has surged compared to the same period in 2013, with cases concentrated mainly in Hanoi. Although the total number of cases has not increased, hospitalizations have not been massive, and all related epidemiological factors have not been fully analyzed, experts are concerned and have raised questions about the effectiveness of the Japanese encephalitis B vaccination program.

2 notable signs

According to the National Children's Hospital, the total number of encephalitis patients as of June 25th is approximately 130 cases – no increase compared to previous years, and there hasn't been a sudden surge in hospital admissions.

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

However, it is noteworthy that among these patients, the proportion of those with Japanese encephalitis B (JE B) surged to 36 cases – accounting for nearly 30%.

Meanwhile, in the same period of 2013, the proportion of VNNB B patients among the total number of encephalitis patients was only 8%. The number of deaths to date is 2, including 1 case testing positive for VNNB B, and 1 case related to the disease.

The second noteworthy point is that the majority of VNNB B patients are from Hanoi, with 11 out of 36 cases (31%), including 6 severe cases requiring mechanical ventilation, while other localities have only scattered 2-3 cases.

"This is currently the peak month of the year for encephalitis cases. While there haven't been any unusual developments, what's concerning is that the number of positive cases for Japanese encephalitis B has increased compared to the same period last year. Therefore, we need to reconsider whether people are avoiding the Japanese encephalitis B vaccine because they fear the side effects of vaccination," assessed Dr. Tran Minh Dien, Deputy Director of the National Children's Hospital.

Currently, the National Children's Hospital has not yet conducted a specific analysis regarding the vaccination status of patients who tested positive for Japanese encephalitis B.

However, in the Infectious Diseases Department's emergency room, out of four encephalitis patients, three had not been vaccinated and one had an unknown vaccination history.

During her inspection of the disease situation at the National Children's Hospital on the evening of June 25th, Minister of Health Nguyen Thi Kim Tien emphasized: Although there are no widespread statistics from many hospitals nationwide regarding encephalitis and Japanese encephalitis B, the two cases mentioned above occurring at the National Children's Hospital are noteworthy and require immediate warning. It is also necessary to find the causes early in order to proactively implement control measures.

"The fact that Hanoi has the highest number of Japanese encephalitis B patients doesn't allow for any definitive conclusions yet, as patients may be going to the National Children's Hospital more often because it's closer. But what's strange is that the positive rate for Japanese encephalitis B has increased significantly, whereas in previous years it wasn't. This raises the question of whether there are any issues with the vaccine or immunization program," said the Minister of Health.

Ms. Tien stated that she would request the Department of Preventive Medicine to review the vaccination program against Japanese encephalitis B to make adjustments if necessary. In addition, a nationwide survey of the Japanese encephalitis situation is needed for accurate assessment and timely response.

Early patient triage and preparation of response plans.

Drawing on the "profound" lessons from the measles outbreak, where poor patient triage led to severe overcrowding and heavy cross-infection, and where human and material resources for the measles response were not prepared in a timely and adequate manner, Dr. Tran Minh Dien, Deputy Director of the National Children's Hospital, stated that in light of the current developments of encephalitis and Japanese encephalitis B, the hospital has proactively developed and implemented a plan to respond to encephalitis now (before a massive influx of cases requiring hospitalization).

Drawing lessons from the measles outbreak, the National Children's Hospital has already prepared a plan for patient triage and response in case of a surge in cases. (Photo: CQ)

Accordingly, a different plan is implemented if the number of patients is between 50 and 70 compared to when the number of patients exceeds 70. The patient admission process also starts from the outpatient clinic and continues with triage in the emergency department; any cases diagnosed with encephalitis are then transferred to the Infectious Diseases department.

The diagnostic methods for the disease, as stipulated in 2006, still utilize PCR tests and cerebrospinal fluid analysis, and are performed early within 24 hours to ensure immediate patient classification.

Regarding the treatment area, measles cases currently under treatment have been transferred to the Traditional Medicine and Psychiatry departments, so there are still many available beds to accommodate encephalitis patients (approximately 120 beds), ensuring one bed per child. If the number increases further, the hospital will dedicate the Infectious Diseases department specifically for encephalitis and Japanese encephalitis B patients, and will mobilize other units to cooperate with adequate equipment.

Given the current situation with encephalitis and measles, simply increasing the night shift staff in the Infectious Diseases Department is necessary to improve care. On June 23rd, the hospital added 8 nurses to this department so that one nurse can care for two patients on ventilators, preventing healthcare workers from becoming "exhausted" as happened during the peak of the measles outbreak not long ago.

According to vietnamnet