ENCEPHALITIS

is a sudden onset inflammation of the brain.

ICUINCUBATION PERIOD

The incubation period for Eastern equine

encephalitis virus (EEEV) disease (the time from
infected mosquito bite to onset of illness)
ranges from 4 to 10 days. EEEV infection can
result in one of two types of illness, systemic or
encephalitic (involving swelling of the brain,
referred to below as EEE
MODE OF TRANSMISSION

Some of the modes of

viral transmission include: coughs or
sneezes from an infected person that
release airborne viruses, which are then
inhaled by others. infected insects (such
as mosquitoes or ticks) and animals,
which can transfer some viruses directly
into the bloodstream via their bite.
SIGN AND SYMPTOMS

fever of 103F (39.4C) or higher

confusion
drowsiness
hallucinations
slower movements
coma
seizures
irritability
sensitivity to light
unconsciousness
PATHOGNOMONIC SIGN

Patients with HSE may have a prodrome

of malaise, fever, headache, and nausea,
followed by acute or subacute onset of
an encephalopathy whose symptoms
include lethargy, confusion, and delirium.
... Fever (90%) Headache (81%)
Psychiatric symptoms (71%)
DIAGNOSTIC TEST

Your doctor may also order a magnetic

resonance imaging (MRI) scan, spinal
tap, or
an electroencephalogram (EEG). Blood
tests to check for the presence of bacteria
or viruses and immune cells produced in
response to them can also be helpful.
CONFIRMATORY TEST
Laboratory diagnosis of JE is generally accomplished
by testing of serum or cerebrospinal fluid (CSF) to
detect virus-specific IgM antibodies. JE virus IgM
antibodies are usually detectable 3 to 8 days after
onset of illness and persist for 30 to 90 days, but
longer persistence has been documented. Therefore,
positive IgM antibodies occasionally may reflect a
past infection or vaccination. Serum collected within
10 days of illness onset may not have detectable
IgM, and the test should be repeated on a
convalescent sample. For patients with JE virus IgM
antibodies, confirmatory neutralizing antibody
testing should be performed. In fatal cases, nucleic
acid amplification, histopathology with
immunohistochemistry, and virus culture of autopsy
tissues can also be useful.
 Antiviral medications (if virus is cause)
Antibiotics, (if bacteria is cause)
Steroids are used to reduce brain swelling
Sedatives for restlessness
Acetaminophen for fever
Occupational and physical therapy (if
brain is affected post-infection)
NURSING MANAGEMENT
Maintain adequate fluid intake to prevent dehydration, but avoid
fluid overload, which may increase cerebral edema.
Maintain adequate nutrition. Give small, frequent meals, or
supplement meals with nasogastric tube or parenteral feedings.
To prevent constipation and minimize the risk of increased ICP
resulting from straining at stool, provide a mild laxative or stool
softener.
Carefully positioned the patient to prevent joint stiffness and neck
pain, and turn the patient often.
Provide thorough mouth care.
Maintain a quiet environment. Darkening the room may decrease
headache.
if the patient has seizures, take precautions to protect him from
injury.
Measure and record intake and output.
If the patient becomes delirious or confused, try to reorient him
often.
Teach the patient and his family about the disease and its effects.