Encephalitis is a rising global threat, with infectious cases posing growing public health concern

The World Health Organization (WHO) and Encephalitis International have jointly launched a new technical brief on encephalitis. This report provides crucial insights into the global burden of encephalitis, highlighting key recommendations for prevention, diagnosis, and treatment. In an interaction with Kalyani Sharma, Dr Ava Easton, Chief Executive of Encephalitis International, shares more details on the same

Can you share the key findings from the new WHO Technical Brief on encephalitis? What are the main recommendations outlined in the report for prevention, diagnosis, and treatment?

Encephalitis is inflammation of the brain:  a serious and often life-threatening neurological condition that can affect all age groups around the world.  The condition has high mortality (death) rates and high morbidity (disability and after effects as a result).  The condition also poses high economic burden.

Encephalitis is caused by both infectious and autoimmune causes but in many cases the cause remains unknown.  Some forms of infectious encephalitis can be prevented by vaccination but in many causes there is no specific treatment available. 

Encephalitis is a growing global threat with infectious encephalitis an increasing public health concern, and an urgent public health imperative.

All types of encephalitis require rapid assessment, diagnosis and treatment to prevent death and disability.  In addition hospital based, specialist, multidisciplinary support improves patient outcomes.

Encephalitis disproportionately affects people living in low-to-middle-income countries (LMICs).  Health services and resources are often more limited in these settings.

Regardless of location the consequences of encephalitis can be devastating for patients, who may require access to rehabilitation, long-term community support including financial and social assistance.

The detection, prevention and management of the condition requires improved surveillance systems, diagnostic capacity and targeted public health initiatives.  Substantial political and financial commitments are required to strengthen health systems.

Unless action is taken encephalitis will continue to drive avoidable deaths and disability, fuelled by increased population density in under-resourced settings, vaccine hesitancy intensive farming practices and our proximity to animals, climate change and emerging and re-emerging infections.

Please not the actual key actions in the document are specified in the document so i have not listed the detail here.

What are the specific challenges India faces in managing encephalitis?

India faces annual outbreaks of various infections that can cause encephalitis often affecting the children of the country.  There are other factors that can complicate matters for India such as access to healthcare in rural locations and access to vaccination programs for the causes of encephalitis that are vaccine preventable.  Of course India continues to have challenges with Rabies prevention which also causes encephalitis.

The WHO Technical Brief is an important document for all countries around the world.

The document makes clear recommendations for action which countries can begin to address.

The target audience for this brief includes policymakers, public health professionals, health programme managers and planners, healthcare providers, and researchers involved in service design and improving care for people with encephalitis.

We would like to see India policymakers engage with the document and form part of the collaborations Encephalitis International are planning to make the change needed.

Are there particular regions in India that are more vulnerable to encephalitis outbreaks, and why? What role do socioeconomic factors play in the prevalence and treatment of encephalitis in India?

In recent years India has seen a number of outbreaks of encephalitis from Chandipura virus, Nipah virus, and indeed often sees regular annual outbreaks such as Japanese encephalitis, Dengue, Scrub Typhus, Chikungunya.  Like Rabies, another cause of around 20,000 deaths each year in India, some of these causes are vaccine preventable.  Socioeconomic factors will play a role in the prevalence of and treatment of encephalitis in India.  The WHO Technical Brief makes it clear that encephalitis disproportionately affects people living in low-to-middle-income countries (LMICs).  Health services and resources are often more limited in these settings.

Why is early diagnosis crucial in managing encephalitis, and what are the biggest obstacles to achieving this? What advancements have been made in encephalitis diagnosis and treatment?

Early diagnosis and treatment of encephalitis is crucial.  Prevention where possible in the form of vaccination is also an imperative.  

Having affordable access to crucial diagnostics such as lumbar puncture packs, scanning capacity and laboratory diagnostics, along with treatments such as aciclovir and immunotherapies are important in achieving quick and accurate diagnosis and treatment. 

Advances have been made and recently, for example the Brain Infections Global Study (University of Liverpool) worked with NIMHANS and CMC Vellore to improve diagnostics through the implementation of simple measure such as bedside lumbar puncture packs. 

How can healthcare systems improve access to timely and appropriate treatment, especially in resource-limited settings?

Governments and policy makers can now use the Technical Brief on encephalitis to develop and action some of the key recommendations.  Collaborations for change can also be formed.  Initiatives like those with Encephalitis International and the Brain Infections Global project can support countries like India to assess what needs to be done and how it can be achieved effectively and efficiently

How can governments and healthcare organisations collaborate to enhance training and awareness programs?

Encephalitis International is currently developing a global training program aimed at low to middle income countries and we would be open to any discussions around collaboration and promotion of the program when complete in India.

What role do international organisations like the WHO and Encephalitis International play in shaping public health responses to encephalitis

Organisations like the WHO and Encephalitis International are critical in taking the global temperature in terms of what is already out there and working well and what the gaps are.  The Encephalitis International Global Report (https://www.encephalitis.info/global-impact-report/) was a critical lever for change and India features heavily in terms of what we identified in country for change. The WHO Technical Brief complements this work and is specifically aimed at changing policy and encouraging research needed where gaps exist.  

Awareness campaigns such as World Encephalitis Day (22nd February) led by Encephalitis International are critical in drawing global attention to initiatives such as this new Technical Brief on encephalitis.  Moreover the campaign is also able to drive calls to action for its implementation. Encephalitis International will be picking up the mantel of some of the report’s recommendations and is already underway with addressing  important key recommendations.  

Encephalitis International is planning collaborative efforts with a range of global stakeholders to address the report’s recommendations and would welcome hearing from anyone interested in joining forces.

kalyani.sharma@expressindia.com

journokalyani@gmail.com