Japanese Encephalitis Medication

  • Author: Asim A Jani, MD, MPH, FACP; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jan 6, 2012
 

Medication Summary

As previously stated, mannitol is used to decrease intracranial pressure, when needed.

Also as previously discussed, in terms of prevention, 3 Japanese encephalitis vaccines are used worldwide: inactivated mouse brain vaccine (Nakayama and Beijing-1 strains),[15] inactivated primary hamster kidney cell vaccine (P3 strains), and live attenuated primary hamster kidney cell vaccine (SA14-14-2 strain). Each is based on Japanese encephalitis virus (JEV) genotype III but is cross-protective against the other genotypes.

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Osmotic Diuretics

Class Summary

Mannitol is recommended by some experts to help reduce intracranial pressure. Mannitol induces diuresis, which increases serum osmotic concentration. In the brain, this causes water to flow from brain cells into vascular space, thereby decreasing intracranial pressure.

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Mannitol (Osmitrol, Resectisol)

 

Mannitol may be used to decrease intracranial pressure. It may reduce subarachnoid space pressure by creating an osmotic gradient between CSF in the arachnoid space and plasma. This agent is not for long-term use.

Initially assess the patient for adequate renal function by administering a test dose of 200 mg/kg intravenously over 3-5 min. It should produce a urine flow of at least 30-50 mL per hour of urine over 2-3 hours.

In children, assess for adequate renal function by administering a test dose of 200 mg/kg intravenously over 3-5 minutes. It should produce urine flow of at least 1 mL/kg/h over 1-3 hours.

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Vaccine

Class Summary

Induction of the antibody response to vaccine provides the capability to neutralize live Japanese encephalitis virus (JEV).[19]

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Japanese encephalitis vaccine (Ixiaro, JE-VAX)

 

Vaccine is indicated for active immunization to prevent JEV infection.

Ixiaro is an inactivated vaccine prepared by propagating JEV strain SA14-14-2 in Vero cells. It is available in prefilled, single-dose syringes without preservatives or thimerosal.

JE-VAX is a murine-derived, inactivated vaccine derived from the Nakayama JEV strain. Available in a multidose vial, it contains thimerosal and gelatin.

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Contributor Information and Disclosures
Author

Asim A Jani, MD, MPH, FACP  Clinician-Educator and Epidemiologist, Consultant and Senior Physician, Florida Department of Health; Diplomate, Infectious Diseases, Internal Medicine and Preventive Medicine

Asim A Jani, MD, MPH, FACP is a member of the following medical societies: American Association of Public Health Physicians, American College of Physicians, American College of Preventive Medicine, American Medical Association, American Public Health Association, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Joseph F John Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Alexander J Kallen, MD Instructor of Medicine, Department of Internal Medicine, Division of Outcomes Research, Dartmouth Medical School, Veterans Affairs Medical Center of White River Junction, VT

Alexander J Kallen, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, California Medical Association, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Klaus-Dieter Lessnau, MD, FCCP Clinical Associate Professor of Medicine, New York University School of Medicine; Medical Director, Pulmonary Physiology Laboratory; Director of Research in Pulmonary Medicine, Department of Medicine, Section of Pulmonary Medicine, Lenox Hill Hospital

Klaus-Dieter Lessnau, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Medical Association, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Sepracor None None

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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Geographic distribution of Japanese encephalitis. Courtesy of the CDC.
Japanese encephalitis, 2006. Courtesy of the WHO.
 
 
 
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