We wouldn't have known about the Licayan family until we read Neil Licayan's impassioned and emotional post on Facebook. He was urging parents to have their children vaccinated against Japanese Encephalitis (JE). “Wala siyang cure, pero may vaccine. Please get it for yourselves and your children!” he wrote. “Wish ko lang na wala na sanang magulang ang makakaranas ng pinagdaanan at pagdadaanan pa namin.”
Neil was talking about his 15-year-old daughter, Jessica Denise, who passed away last March 7. The dad recounted how in a span of a week, her daughter suffered symptoms that included fever, pain in the extremities, swelling of the brain, and seizures. But her doctor could not give a definite diagnosis. Numerous blood tests tested negative for diseases like dengue, malaria, hepatitis, and typhoid. A lumbar puncture, a medical procedure where a needle is inserted into the spine to reveal conditions affecting the brain, would have helped. But the hospital in Pampanga, where the family resides, didn't have the means to perform the procedure.
Neil and his family had to travel to Manila for the lumbar puncture. But by the time Jessica was admitted to St. Luke’s Medical Center in Taguig, her brain was swollen already and experiencing seizures -- the test could no longer be performed, Neil told SmartParenting.com.ph.
Before Jessica slipped into a coma, she was unable to recognize her father, mother, and sister. A few hours afterward, the second top student of her school batch whom her father described as “larger than life” passed away.
While his daughter died with no clear diagnosis, Jessica’s pediatrician in Pampanga did suspect JE. When Neil was invited to share his story on Pampanga's local show Oras Na, a doctor, Dr. Walter Rivera, a pediatrician at Jose B. Lingad Regional Hospital in San Fernando, was present. Upon hearing Jessica’s symptoms, he said it was in line with those who suffered encephalitis (not necessarily JE), adding that blood tests can come out negative for the first days of illness, which is why the second round of testing is necessary.
Soon after the grief-stricken dad shared his story on Facebook, other parents started telling him stories of their children whom they lost to JE as well. “I was flooded with comments and messages from devastated parents,” he said.
“There is no cure for Japanese Encephalitis, just supportive treatment,” said Dr. Ma. Eleanor Sevilla-Sia, a pediatrician and neonatologist at St. Luke’s Medical Center in Taguig and at the Asian Hospital and Medical Center in Muntinlupa. Severe cases of JE is seen in 1 in 250 cases, and 30 percent of the patients die.
“In those who survive, 20 to 30 percent suffer permanent intellectual, behavioral and neurological problems paralysis, seizures or the inability to speak,” the pedia added, citing statistics from the World Health Organization.
Japanese Encephalitis is a disease that, like dengue, is acquired from a mosquito bite. According to the Centers for Disease Control and Prevention (CDC), “Symptoms usually take 5-15 days to develop and include fever, headache, vomiting, confusion, and difficulty moving. Symptoms that develop later include swelling around the brain and coma.”
The disease was first documented in Japan, but it is an illness present in 24 countries in Southeast Asia and Western Pacific regions. It’s typically seen in children; those below age 4 are nine times more likely to be infected but any age may be affected. Globally, up to 20,400 die of JE every year.
Its preventive measures are similar to dengue (like eliminating stagnant water and applying insect repellent). But, because it is a serious, life-threatening disease, vaccination is highly recommended by doctors. In fact, it is included in this year’s childhood immunization schedule (see it here) provided by the Philippine Pediatric Society (PPS) and the Philippine Foundation for Vaccination.
“It’s alarming to know that a simple mosquito bite can lead to such a fatal illness. The vaccine should indeed be more available to everyone,” said Dr. Faith Alcazaren, who practices general pediatrics in Perpetual Succor Hospital and Maternity in Marikina and at Marikina Doctors Hospital and Medical Center.
The disease is relatively new to the Philippines. The JE vaccine was only licensed in the country in 2013, reported the Manila Times, and was included in the PPS’s childhood immunization schedule in 2016. “This is can be why not a lot of parents are aware of it,” said Dr. Sevilla-Sia. “I certainly offer it to my patients’ parents and explain the need for the vaccine. Parents just need to be informed.”
“In the Philippines, JE is often underreported and unrecognized for various reasons such as lack of confirmatory lab facilities in many areas and lack of disease surveillance,” reported Business Mirror. According to the Philippine Council for Health Research and Development (PCHRD), there were 34 cases of JE in 2013, and 69 cases in 2014.
The Department of Health has been working to include the JE vaccine in the Expanded Immunization Program. By 2018, JE will be available in health centers, reported the Manila Standard. The immunization program already includes free vaccines for diseases such as hepatitis B; measles, mumps and rubella; rotavirus; and polio. The Philippines has been polio-free since 2000, a monumental success attributed to the national immunization program.
Several countries in Asia have already controlled outbreaks of JE through vaccination including Japan, Korea, China, Taiwan, and Thailand. “The cases are small in the Philippines, but they are unforgettable. It’s a very serious disease,” said Dr. Sevilla-Sia.
As per recommendations, “The vaccine is given at a minimum age of 9 months. Children 9 months to 17 years old should receive one primary dose followed by a booster dose 12 to 24 months after. Those age 18 and above should receive a single dose only. The cost for the vaccine ranges from P3,500 to 4,500,” said Dr. Jamie Isip-Cumpas, a pediatrician from Parkview Children’s Clinic in Makati. She added that the vaccine is a must for those who live in places where there are chicken and pigs in the surroundings.
Get your children vaccinated as well as yourself. “I am sharing my story so that no parent would undergo what we are going through,” said dad Neil. “All I ask is for prayers for my daughter, Jessica Denise. Priceless ang offer of prayers. As for me, I am just trying to endure and finish my mission here on Earth, lalo na para sa bunso namin.
“Pakiingatan ang sarili natin, lalong lalo na ang mga bata.”