All issues > Volume 26(7); 1983

Original Article

J Korean Pediatr Soc. 1983;26(7):655-662. Published online July 31, 1983.

Clinical Features and Hemagglutination Inhibition(H-I) Test Results in 140 Cases of Japanes B Encephalitis Encountered in 1982.

Young Kyung Park¹, In Sung Lee¹, Ki Bok Kim¹

¹Department of Pediatrics，Kwangju Christian Hospital，Kwangju, Korea

Abstract

In 104 cases of Japanese B encephalitis admitted to the Department during the epidemic in the Summer of 1982, the clinical features and the results of the H-I test were analysed. The results are summarized as follows: 1) All 104 cases occurred between August 1 and October 31, with 76 cases or 73.1% coming in September. 2) The incidence was greatest in children between 4 and 9 years of age, 58.6% of all patients. The sex ratio of male to female was 2.1 ： 1. 3) Incidence was predominantly rural, but the incidence in urban areas increased over time. 4) Principal clinical signs and symptoms on admission were, in decreasing order of frequency: fever(97.1 %), nuchal rigidity(92.3%), Kernig’s sign(71.2%), headache (49.3%), vomiting(44. 2%), drowsiness(40.4%), convulsion(20.2%) etc. 5) Peripheral blood study revealed leukocytosis of over 10,000/mm3 in 80.8% of patients, associated mainly with increased polymorphonuclear leukocytes. 6) The findings in the cerebrospinal fluid were: In 80.4% of all cares the cell count was between 10~500/mm3; glucose was either within normal range or increased in 95.2%; protein over 40 mg% was found in 90.4%; chloride was within normal range in 75% ； and LDH over 40 units was detected in 52.9%. 7) The H-I test was performed in all 104 patients, and in 51 patients(49.0%) positive tests. (>1 : 160) or rising 4 fold) were detacted. The percentage of positive H-I test progressively incresed. By the 9th to 10th day of illness, a positive H-I test was found in more than 90% of patients who ultimately became positive, and all patients had a H-I titer over 1 : 80. 8) Out of 51 patients who had a positive H-I test, 40 patients(78.4%) were cured, while 11 patients(21.6%) either died or were discharged with sequelae.On the other hand, among 53 patients who had a negative H-I test 13 patients(24.5%) were cured, whereas 36 patients (67.9%) either died or were discharged with sequelae. 9) Among the 30 patients dying, the 2nd H-I test could be done in only 3 patients, with positive results in all. The other 27 patients had only the 1st H-I test. Twenty five patients who died (83.3%), had a H-I titer of less than 1 : 80 on the 1st test. 10) The prognosis was generally poor in patients who, on admission, were unconscious, (with or without meningeal signs), had temperature over 39°C, or increased protein and LDH in the cerebrospinal fluid. 11) The overall mortality was 28.8%, and sequelae occured in 16.3% of all cases

Keywords :Encephalitis; Clinical features;Hemagglutination Inhibition test(H-I test).