Encephalitis in Children
Encephalitis is an inflammation (iritation and swelling) in the brain. Unlike cerebral abscess which is localized and caused by bacteria or fungi, encephalitis is usually caused by virus and the infection is more extensive.2 Several viruses, including enteroviruses, mumps virus, and lymphocytic choriomeningitis virus, produce mild encephalitis. Severe encephalitis is caused primarily by HSV and arbovirus. Rabies virus may cause fatal infection, but not more than 6 cases per year since 1979 in United States.
Encephalitis is acquired by either direct introduction to the brain and spinal cord (primary encephalitis) or as a secondary effect of a separate virus or condition (secondary or post-infectious encephalitis) already present in the body. Although less common than secondary encephalitis, primary encephalitis tends to be more dangerous.
Anyone can get encephalitis. It tends to be more common in the summer and fall. Some types are found in those who are bitten by infected mosquitoes or other insects. Some types are found in those who get infected stool particles in their mouths. Some types are found in those who just spend time in the same room as someone infected with the virus.
Symptoms in milder cases of encephalitis usually include:
- fever
- headache
- poor appetite
- loss of energy
- a general sick feeling
In more severe cases of encephalitis, a person is more likely to experience high fever and any of a number of symptoms that relate to the central nervous system, including:
- severe headache
- nausea and vomiting
- stiff neck
- confusion
- disorientation
- personality changes
- convulsions (seizures)
- problems with speech or hearing
- hallucinations
- memory loss
- drowsiness
- coma
It’s harder to detect some of these symptoms in infants, but important signs to look for include:
- vomiting
- a full or bulging soft spot (fontanel)
- crying that doesn’t stop or that seems worse when an infant is picked up or handled in some way
- body stiffness
Because encephalitis can follow or accompany common viral illnesses, there sometimes are signs and symptoms of these illnesses beforehand. But often, the encephalitis appears without warning.
Measles, mumps, rubella, chickenpox, and even rabies encephalitis may be prevented by appropriately timed vaccines. Other types of encephalitis may be prevented by avoiding mosquito bites.
Fecal-oral transmission precautions are the best way to prevent enteroviral infections, the most common cause of encephalitis in places where vaccines are commonly used. Careful hand washing before eating and after toileting or diaper changes is essential. This is an important hygiene lesson to teach our children.