‘Big gaps’ in timely diagnosis of brain inflammation leads to high mental illness burden

Pharma News: The latest research shows survivors of encephalitis, an inflammation of the brain caused by a viral infection, bacterial infection, autoimmune inflammation and insect bites, are at a high risk of suicide and self-harm and have a high mental illness burden that can negatively impact their recovery.

This week on World Encephalitis Day two ground-breaking papers* show almost 5% of encephalitis survivors surveyed have attempted to take their life and almost 40% have had suicidal thoughts. In those with autoimmune encephalitis, 12.5% of patients had suicidal behaviours during early stages of the illness with nearly half (5.83%) carrying out a suicide attempt.

According to Dr Ava Easton, Chief Executive of the international charity, the Encephalitis Society, and one of the study authors, addressing the mental health impact is vital for ensuring encephalitis death rates and burden of disability are decreased.

“These impactful and important research papers raise awareness that suicidal behaviour is not uncommon and is a serious manifestation of encephalitis in the early stages of the illness, during relapses and perhaps later in a person’s recovery journey.

“Our study found that psychiatric symptoms following encephalitis are common and highlight a need for increased provision of proactive psychiatric care for these patients and represent a call to action for increased research and mental health outcomes of encephalitis so that this patient group can be better supported,” Dr Easton said.

Associate Professor Philip Britton, Infectious Diseases Specialist, University of Sydney told Health Industry Hub “There are big gaps in understanding the incidence and outcomes in adults with encephalitis in Australia, especially long-term outcomes including inability to return to work, cognitive and mental health outcomes.

“People are largely unaware of encephalitis; What is is? How frequent it is compared with bacterial meningitis or multiple sclerosis?

“Clinicians need a better understanding of when to suspect encephalitis, how to test for it and initiate early management. They need a better understanding of how some key causes of encephalitis can be prevented, especially using vaccines.”

In relation to advances in potential therapies that will transform patient care, Professor Britton added “Many of the causes of encephalitis have no known treatments. We need new platforms and funding to support clinical trials in Australia.”

Many Australian encephalitis survivors continue to suffer from various types of encephalitis, however, flood related Japanese Encephalitis Virus (JEV) and Murray Valley Encephalitis (MVE) cases have recently been on the rise with JEV declared as a Communicable Disease Incident of National Significance since March 2022.

Karl Herz, Managing Director of Biocelect, a privately-owned Australian distributor of the Imojev vaccine for JEV, said “As a company with a core strength in infectious diseases, Biocelect is proud to be able to provide a critical product to protect Australians against Japanese encephalitis and support the government with their response. World encephalitis day is a great initiative to raise awareness of the importance of prevention.”

Dr Easton added “There is clearly a need for increased provision of mental health care for encephalitis survivors and as we mark World Encephalitis Day, it’s important to not only bring encephalitis but also its associated mental health impact into discussion.

“Mental health issues, self-injurious thoughts and suicidal behaviours following encephalitis may occur for a number of reasons, including the direct biological effects on the brain during the early stages of encephalitis, the physical or psychological consequences of resulting disability, impaired self-image, limited social life, reduced financial security, dependency on others, pain, substance use or as an adverse effect of treatment.

“We want anyone affected by encephalitis and mental health problems, including thoughts of suicide and selfharm, to know that symptoms are often highly treatable and help and support are available from the Encephalitis Society wherever they live in the world,” said Dr Easton.

The Kings College study involved 445 respondents from 31 countries and also highlighted 53% of survivors reported poor access to mental healthcare, 47% reported initial misdiagnosis of psychiatric or physical illness (18.2% and 66.0% respectively) and 78% reported an ongoing hypersensitivity that further impacted their mental health following encephalitis.

“World Encephalitis Day is a focal point for our Australian community who have been affected or impacted by Encephalitis. On this very important day we want to project unity, common ground and offer support while we raise awareness.”

Some of the key players in the global encephalitis treatment market include Pfizer, Sanofi, Roche, MSD, GlaxoSmithKline and Teva.

Around 500,000 people globally are affected by encephalitis annually, equating to one person every minute. The illness leads to cognitive, physical or emotional difficulties including impaired memory, language problems, changes in decision making, planning and organisation, personality changes, anxiety, depression, mood swings, fatigue, weakness and epilepsy among others.

Encephalitis can be life-threatening, killing up to 30% of those affected. Globally, encephalitis is a leading brain health concern, with a higher incidence than multiple sclerosis, motor neurone disease, bacterial meningitis and cerebral palsy in many countries.

In order to shine a light on encephalitis, 40 famous landmarks and buildings around the world will light up in red for World Encephalitis Day.

*Mental health outcomes of encephalitis, an international web-based study’ released by Encephalitis Society and Kings College London, and ‘Suicidal thoughts and behaviours in Anti-NMDAR Encephalitis: Psychopathological features and clinical outcomes’ published in the Journal of Neuropsychiatry and Clinical Neurosciences

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