Clinical features & prognostic indicators of Japanese encephalitis in children in Lucknow (India)

This communication reports the clinical features of 92 children with Japanese encephalitis diagnosed on the basis of viral isolation from brain or cerebrospinal fluid and/or a 4-fold or higher rise in antibody titre in paired sera by haemagglutination inhibition (HI) test, followed by detection of specific IgM HI antibody. More than a third of the patients (38%) were from urban areas. A high incidence of fever (94.5%), coma (100%) and convulsions (84.7%) was seen. Focal neurological deficit was found in 29.3 per cent of patients and pleocytosis in the cerebrospinal fluid in 32.3 per cent. An extrapyramidal syndrome developed in 21.3 per cent patients during the convalescent stage. Thirty four (36.9%) patients died while in hospital. Mortality was significantly related to a short prodromal stage, deep coma, abnormalities in tone and breathing and decerebrate posturing. Japanese encephalitis represents a severe disease in children with a high early mortality.