Memory and learning seems to be related to cholinergic dysfunction in the JE rat model.

Cognitive changes have been known in encephalitis but in Japanese encephalitis (JE) such studies are limited. This study aims at evaluating the spatial memory and learning and correlate with markers of cholinergic activity in the brain.12day old Wistar rats were inoculated with dose of 3×10(6)pfu/ml of JE virus. On 10, 33 and 48days post-inoculation (dpi), spatial memory and learning was assessed by Y maze. Brain biopsies from frontal cortex, corpus striatum, hippocampus and cerebellum were taken. Muscarinic cholinergic receptor was assayed by Quinuclidinyl benzylate (H3-QNB) binding, CHRM2 gene expression by real time PCR and choline acetyl transferase (ChAT) by Western blot. Spatial learning and memory showed significant decline in rats inoculated with JEV on 10 and 33dpi (47.5%, p<0.01; 30.2%, p<0.01). It started recovering on 48dpi. Muscarinic cholinergic receptors showed significant decrease in frontal cortex (31%, p=0.001; 26%, p=0.003), hippocampus (57%, p=0.001; 39.9%, p=0.002) and cerebellum (31.2%, p=0.008; 21.6%, p=0.007) but not in corpus striatum as compared to control. The mRNA expression of CHRM2 receptor gene showed significant decrease in the expression in frontal cortex (48%, p<0.001; 38%, p<0.01), hippocampus (43%, p<0.001; 37%, p<0.05) and cerebellum (46%, p<0.001; 42%, p<0.05) on 10 and 33dpi. ChAT showed significant fold decrease in the expression in frontal cortex (2.11, p<0.01, 1.12, p<0.05) and hippocampus (2.2, p<0.01, 1.41, p<0.05) on 10 and 33dpi. Correlation between ChAT, CHRM2 and total muscarinic receptor activity with spatial memory were found at different dpi. There was transient spatial learning and memory impairment which was associated with reduction of total muscarinic receptor binding, CHRM2 gene and ChAT expression in different brain region of rat infected with JE Virus.

Japanese Encephalitis in Assam, India: Need to Increase Healthcare Workers' Understanding to Improve Health Care.

INTRODUCTION: Japanese encephalitis (JE) is a major cause of high morbidity and mortality in several states across India. However, in 2014, a sharp rise was observed in the number of cases of JE in north-eastern Assam state, and 51% of the total cases of JE in India were reported from the Assam in the same year. In this regard, a study was conducted to evaluate the knowledge and attitudes of healthcare workers in Darrang, a district of Assam highly affected by JE. METHODS: A cross sectional study was conducted for 2 months among HCWs in the major district hospital of Darrang, Assam. A pre-tested, self-administered questionnaire was used to collect data from the participants. Convenience sampling approach was used to collect data from different departments of the hospitals. Descriptive and logistic regression analyses were used to express the results. RESULTS: The knowledge of HCWs regarding JE was poor with a mean knowledge score of 11.02±2.39 (out of 17), while their attitudes were positive with a mean attitudes score of 43.16± 2.47 (ranging from 13 to 52). Overall, 40.4% and 74.3% of participants demonstrated good knowledge and positive attitudes respectively. Cut-off score for good knowledge and positive attitudes toward JE was set as ≥12 and >40 respectively. Older participants (40-49 years) and experienced workers (>10 years) were significantly associated with good knowledge as compared to their referent group (p<0.05), while knowledge of nurses and other orderlies were significantly lower than physicians (p<0.01). Similar factors were associated with the positive attitudes of the participants with the exception of experience. Television was the major source of information regarding JE reported by HCWs (79%). CONCLUSION: Although the knowledge was not optimized, HCWs exhibited positive attitudes towards JE. Future research is required to design, implement and evaluate interventions to improve the knowledge of JE among HCWs.

Knowledge, attitudes and practices of caregivers regarding Japanese encephalitis in Shaanxi Province, China.

OBJECTIVES: To describe the level of knowledge, attitudes and practices (KAP) of caregivers regarding Japanese encephalitis (JE) before and after the launch of a demonstration project to transition JE vaccination into the routine Expanded Programme on Immunization and strengthen the JE immunization programme in Baoji Prefecture, Shaanxi Province; and to identify factors determining vaccination. STUDY DESIGN: Cross-sectional surveys on KAP on JE disease and vaccination at baseline and post intervention. METHODS: KAP surveys among caregivers were conducted in six counties of Baoji Prefecture using the World Health Organization probability proportional to size sampling method. RESULTS: The surveys at baseline (3781 respondents) and after a 2-year project (3780 respondents) demonstrated that the intervention resulted in a significant increase in the level of knowledge about, and changes in attitudes towards JE disease and vaccination, and an improvement in the proportion of children vaccinated. A probit regression of pooled pre- and post-intervention survey data suggested that knowledge, education level and age of caregivers were significantly associated with the likelihood of a child getting vaccinated. CONCLUSIONS: Routine availability of vaccine and information, education and communication strategies played important roles in improving knowledge and achieving high vaccination rates.

Behavioural disturbances following Japanese B encephalitis.

Clinically, Japanese B encephalitis (JBE) is often overlooked as its occurrence in Western countries is rare. However, its neurological, cognitive and psychiatric sequelae constitute a major public health problem in the Far East where JBE is endemic. European and American subjects may however experience the JBE when returning from a Far East journey. In such cases, misdiagnosis is frequent because of the unawareness of psychiatrists and physicians. The present review, therefore, documents the behavioural and cognitive sequelae of JBE. This reactivates the debate concerning the vaccination against the virus all the more that the literature enlightens the importance of the vaccination for those who undertake frequent and extensive tourist excursions to the Orient but still discusses it for occasional travellers. Following is a case-report of a young western European post-graduate student who has contracted JBE by experiencing an acute febrile delirium during an unusual short stay in South East Asia. Pyramidal syndrome, Parkinsonism and amnesia were the prominent acute deficits. Whereas these faded in great part during convalescence, emotional and behavioural instability associated with affective involvement, obsessive-compulsive symptoms and cognitive impairments appeared. A partial recovery was however obtained with neuroleptics, lithium and following electro-convulsive therapy. Organic personality syndrome was persistent and thereafter constituted the main sequelae syndrome. Hypersomnia and several enuretic episodes persisted.