Viral Encephalitis

GENERAL INFORMATION:

What is viral encephalitis? Viral encephalitis (en-sef-ah-LI-tis) is an inflammation (swelling) of the brain due to a virus (germ) infection. It occurs when a virus enters the body and goes to the brain, usually through the blood. You may become sick all of a sudden if the virus enters directly into your brain. Sometimes, you may first have an infection in another part of the body, which can later lead to encephalitis.

What causes viral encephalitis? Viral encephalitis may be caused by any of the following different viruses:

• Mosquito-borne or tick-borne viruses: You may get encephalitis from a virus you after being bitten by an infected mosquito or tick. These include the LaCrosse, St. Louis, West Nile, and Japanese B encephalitis viruses. Viral encephalitis caused by any of these viruses may be more common during summer months. It may also occur as an outbreak.
  
  
• Herpes viruses: You may get encephalitis from a virus that you have had for many years. An example would be the herpes simplex virus (HSV) which causes cold sores or genital herpes. The viruses, which cause infectious mononucleosis, chickenpox, and shingles, may also infect the brain. These viruses may lie dormant (sleeping) in your body for many years and cause encephalitis later in life.
  
  
• Other viruses: Viral infections, commonly seen in children, may cause encephalitis shortly after the illness. These include measles, mumps, and rubella (German measles). You may have encephalitis after having an upper respiratory viral infection, such as influenza (flu). Viral encephalitis may also be due to the polio virus or rabies, which directly attacks the brain.

Who is at a high risk of getting viral encephalitis? Viral encephalitis can affect anyone of any age. The following factors may place you at a higher risk of developing or having a more severe form of this disease:

• People with advanced age or who are very young.
  
  
• People who have long-term illnesses, such as cancer.
  
  
• People who have weak immune systems. The immune system is the part of your body that fights infection.
  
  
• People who travel a lot, especially to places where the mosquito-borne or tick-borne viruses are common.
  
  
• People who usually stay or work outdoors.

What are the signs and symptoms of viral encephalitis? Signs and symptoms of viral encephalitis may include fever, nausea (upset stomach), and vomiting (throwing up). You may also have the following signs and symptoms:

• Bright light may bother your eyes.
  
  
• Confusion (cannot think clearly), anxious, or act or talk differently than normal.
  
  
• Feeling more tired or sleepier than usual.
  
  
• Headache, stiff neck, and neck pain.
  
  
• Red skin rash.
  
  
• Seizures (convulsions) or twitching.
  
  
• Children may have additional symptoms, including:
  
  
  • More restless or irritable than normal.
    
    
  • May eat poorly.

How is viral encephalitis diagnosed? Your caregiver will take a detailed health history from you. This includes information about your past travels or activities. He may ask you about exposure or contact with an infected person, or any diseases you may have had. It is important to let your caregiver know if a certain disease or illness is present in your community. You may need one or more of the following tests:

• Lumbar puncture: This procedure may also be called a spinal tap. During a lumbar puncture, you will need to lie very still. Caregivers may give you medicine to make you lose feeling in a small area of your back. Caregivers will clean this area of your back. A needle will be put in, and fluid removed from around your spinal cord. The fluid will be sent to a lab for tests. The tests check for infection, bleeding around your brain and spinal cord, or other problems. Sometimes medicine may be put into your back to treat your illness.
  
  
• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Brain biopsy: In rare cases, a brain biopsy may be done to find out what is causing your illness. This is when a small piece of tissue is removed from the brain. It is then sent to the lab for tests. This can help caregivers learn the cause of your symptoms.
  
  
• CT scan:
  
  
  • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
    
    
  • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
  
  
• EEG: This test is also called an electroencephalogram. Many small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain. Caregivers look at the tracing to see how your brain is working.
  
  
• MRI: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. You will need to lay still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

How is viral encephalitis treated? Treatment for encephalitis will depend on the virus that caused it and how bad the symptoms are. Treatment may include one or more of the following:

• Aiding devices: These may include respirators and oxygen to help with your breathing.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Medicines: Caregivers may give you medicine to treat your infection or its symptoms, such as pain, headache, and fever. Caregivers may also give you medicine to decrease swelling and pressure within your skull (head). Other medicine you may be given may include the following:
  
  
  • Antibiotics: Antibiotic medicines may be given if you have a bacterial infection, in addition to your viral infection.
    
    
  • Anti-convulsants: Medicines may be given to control seizures.
    
    
  • Anti-virals: Anti-viral medicine may be limited to the treatment of a few viruses, but will not always work on viral encephalitis.
    
    
  • Immunoglobulins: Immunoglobulins may be given to help the immune system fight your infection.
  
  
• Rehabilitation programs: A rehab program may include mental, speech, and physical exercises. These exercises may help improve and maintain functions that are important to daily living, such as self-care.
  
  
• Rest: You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed.

How can viral encephalitis be prevented?

• Avoid mosquito bites:
  
  
  • Apply an insect repellant containing DEET (active ingredient) to your skin and clothing. An insect repellant helps keep mosquitoes away. You may also apply an insect repellant with permethrin (active ingredient) on clothes. Babies, who are less than 2 months old, should use repellants with 30 percent DEET or less. Always read and follow the instructions on the label when using an insect repellant. Do not use DEET on the hands of young children or on babies who may rub their eyes or mouth.
    
    
  • Do not go outside, especially at dawn (sunrise) and dusk (sunset). Mosquitoes feed most actively during these times. Avoid unnecessary activity in places where mosquitoes are commonly present.
    
    
  • Put screens on all windows and outside doors of your house.
    
    
  • Wear long-sleeved shirts and long pants to keep your skin covered.
  
  
• Control mosquito breeding: Mosquitoes lay their eggs and mature in water. It is important not to have any standing water around. You may do the following to decrease mosquito breeding:
  
  
  • Avoid leaving containers that can collect water in an uncovered or upright position. These containers may include wheelbarrows, drums, buckets, or cans. Properly store any open containers that are not being used, such as buckets and cans.
    
    
  • Change water in animal feeders every few days.
    
    
  • Put holes in containers that cannot be thrown out to drain water. Fill in any potholes, patches, and other areas where water is likely to collect or get stagnant. Regularly check ponds, birdbaths, animal feeders, drinking troughs, and other bodies of standing water.
    
    
  • Drain or pump out standing water on your property. Some examples include clogged gutters, ditches, and empty pop cans.
    
    
  • Use aeration, whenever possible, as a way to prevent mosquito growth. One way to use aeration is to constantly circulate water, which does not allow water to become stagnant. Circulating water also prevents mosquitoes from laying their eggs and maturing.
  
  
• Colds or the flu: Stay away from people who have colds or the flu. Ask your caregiver if you should get shots to keep from getting the flu and pneumonia. Also try to stay away from large groups of people. This decreases your chance of getting sick.
  
  
• Get vaccinated: Get vaccinated (shots) against infections caused by different viruses. These include vaccines against the flu, measles, mumps, rubella, chicken pox, and polio. A flu shot lasts for one year and are usually given in October and November. A vaccine against the Japanese encephalitis virus is also available. You may also get a rabies shot, especially if you work with animals or have been bitten recently. Ask your caregiver which vaccinations are right for you. It is also good to have your pet vaccinated against rabies.

Where can I find support and more information? Accepting that you have viral encephalitis may be hard. You and those close to you may feel scared, sad, or angry. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may contact the following for more information:

• Centers for Disease Control and Prevention
  National Center for Infectious Diseases
  Phone: 1-888-4437232
  Web Address: http://www.cdc.gov/ncidod/
  

• National Institute of Allergies and Infectious Diseases
  NIAID Office of Communications & Public Liaison
  6610 Rockledge Drive, MSC 6612
  Bethesda, Maryland 20892-6612
  Phone: 1-301-496-5717
  Web Address: www3.niaid.nih.gov
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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