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By Dr. Ava Easton – Chief Executive, Encephalitis International
“Are you feeling all right?” I asked her.
“I feel all sleepy, ” she said.
In an hour, she was unconscious. In twelve hours, she was dead.
The measles had turned into a terrible thing called measles encephalitis, and there was nothing the doctors could do to save her.
In this excerpt, published in 1986, its author Roald Dahl recounts the sudden death of his eldest child, seven-year-old Olivia. Dahl, a passionate vaccine champion, never got over her death and encouraged anyone who would listen to vaccinate their children.
In 1973, a form of encephalitis that emerged in the late 1800s/early 1900s called Encephalitis Lethargica, was made famous in Oliver Sacks’s book Awakenings. The book became a film of the same name, released in 1990, starring Robin Williams as Sacks and Robert de Niro as lead patient Leonard.
Encephalitis should perhaps be more at the forefront of all our minds, especially when travelling. Dr. Ava Easton explains why.
encephalitis
/ɛnˌsɛfəˈlʌɪtɪs,ɛnˌkɛfəˈlʌɪtɪs/
noun: encephalitis; plural encephalitides
from Greek enkephalos (“brain”) and itis (“inflammation”), inflammation of the brain caused by infection or an autoimmune reaction.
Encephalitis means inflammation of the brain. It can be caused by infections (many ordinary, everyday infections, such as the flu, the cold sore virus, or measles) or by a person’s own immune system attacking the brain in error.
Encephalitis can occur anywhere in the world and affects people of any age, gender or ethnicity.
Encephalitis has a high mortality rate – up to 40%, depending on the cause. In those who survive, many may sustain an injury to the brain as a result.
Encephalitis caused by infectious causes often has a quick onset (hours and days), while autoimmune causes can often present with a much longer and slower onset (days, weeks, and sometimes months).
Both types of encephalitis can present with dramatically different symptoms: infectious encephalitis might begin with flu-like symptoms, dizziness, severe headache, and, in some cases, fever. Later stages indicating a more severe illness are confusion, drowsiness, losing consciousness, and, in some cases, seizures and eventually coma. People may also describe sensitivity to light, other sensory changes, and difficulty speaking or controlling movements. Family members or friends often describe the person as behaving out of character.
Autoimmune causes of encephalitis can present very differently, and many cases may be misdiagnosed initially as having mental health or psychiatric illness. Symptoms will vary depending on the cause but may include confusion, altered personality/behaviour, psychosis, movement disorders, involuntary motor or vocal tics, seizures, hallucinations, memory loss and sleep disturbances.
Travellers should think about the health risks associated with the countries they plan to visit, and consider seeking travel health advice from family doctors, high street pharmacies or specialist travel clinics. Often, travel health advice errs toward likelihood when dispensing information, so in order to help you make a decision that is right for you, ask about severity too.
There are, for example, areas such as South-east Asia and the pacific where serious causes of encephalitis exist such as Japanese encephalitis. On the other hand, many people are not aware that areas in Europe such as Austria, Sweden, and Switzerland, contain rural ‘hot spots’ for certain causes of encephalitis such as tick-borne encephalitis, especially if they are on walking or cycling holidays.
Whilst many causes of encephalitis are not preventable there are some causes that are vaccine-preventable. These include measles, mumps, rubella, chicken-pox, polio, rabies, Japanese encephalitis, tick-borne encephalitis, among many others.
It is important to consider using vaccines to prevent illness when we are in our home countries, but it is also important to keep in mind the threats we may face when we travel to other countries for work and vacations. In these instances, we may encounter illnesses that our immune systems might not be equipped to fight.
In addition to vaccination, many environmental prevention measures can be taken, such as:
For more information, go to https://www.encephalitis.info/infectious-encephalitis-guidelines-for-travellers. Additionally, our Nosilife Collection is perfect for helping prevent tick and mosquito bites.
