In adults, infection is asymptomatic, which means that the patient is a carrier of the infection, but experiences no symptoms or only mild feverish illness.The mortality rate is less than 1% and most patients with encephalitis clinical symptoms recover completely. Up to 20% of patients develop behavioral problems or recurrent seizures. Pathophysiology
Initial infection by the virus and primary spread of the virus causes the onset of non-specific symptoms such as headache and fever. Secondary spread and the multiplication of the virus in the CNS (central nervous system) causes symptoms such as stiff neck, lethargy and seizures. It then can result in encephalitis, when inflammation of the brain, produced by infection by the virus, damages nerve cells, which affects signaling of the brain to the body. After the virus enters the body via a mosquito bite, the virus undergoes local replication at the skin site where virus entered the body. A primary spread of virus occurs, with seeding of the reticuloendothelial system, mainly in the liver, spleen, and lymph nodes. With the ongoing replication of the virus a secondary spread occurs, with the seeding of the CNS. Not all the cases reach this stage, depending on the efficiency of viral replication at the different stages and the degree of virus spread. The California encephalitis virus invades the CNS through either the cerebral capillary endothelial cells or the choroid plexus. Treatment
Treatments are given to manage the symptoms the patient is having. In patients who are very sick, supportive treatment, such as mechanical ventilation, is equally important.
For this reason, patients who develop and report these symptoms, and subsequently byssinosis, are one of the reasons why the term Monday Fever exists. Byssinosis can become chronic in a patient if they are continually exposed to cotton, jute, or yarn dust over time. Byssinosis can be misdiagnosed as COPD, or asthma however the difference in these lung diseases and byssinosis comes from the etiology. Byssinosis can ultimately result in narrowing of the airways, lung scarring and death from infection or respiratory failure. Extended exposure to cotton or jute dust can lead to impaired lung function and further respiratory complications. Patients may require oxygen to assist with breathing and may also have difficulty exercising. Diagnosis
It can be difficult to accurately diagnose a patient with byssinosis due to symptoms that are similar to other respiratory diseases such as chronic obstructive pulmonary diseases (COPD), asthma, or bronchitis. Byssinosis can be misdiagnosed as other pneumoconioses therefore a chest x-ray and/or lung function test is needed to accurately diagnose a patient who may have byssinosis. The main distinction of byssinosis from other respiratory diseases comes from the initial exposure. Patients who have byssinosis have typically been exposed to cotton or just dust for an extended period of time and experience symptoms of chest tightness and coughing.Patient history should reveal exposure to cotton, flax, hemp, or jute dust. Measurable change in lung function before and after working shifts is key to diagnosis. Patients with byssinosis show a significant drop in FEV1 over the course of work shift.