JAPANESE ENCHEPHALITIS VACCINES - Immunization
 
JAPANESE ENCHEPHALITIS VACCINES
Last Updated : 3/25/2016
Sayenna Uduman*, M I Sahadulla**, Raja Lakshmi***
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INTRODUCTION
Preamble: This review outlines briefly on epidemiological features and clinical background of Japanese encephalitis (JE) virus infection. Although symptomatic infection is rare, the vaccine prevention aspect of this deadly virus infection is discussed in detail.
Japanese encephalitis (JE), previously known as Japanese B encephalitis, is caused by the mosquito-borne JE virus; a member of the genus flavivirus (of the Flaviviridae family). This is related antigenically to West Nile virus and St. Louis encephalitis virus and has similar ecologic and clinical features. Dengue virus and tick-borne encephalitis virus are less closely related flaviviruses. JE virus was first discovered and originally restricted to Japan. Now, the JE is one of the most important forms of epidemic and sporadic encephalitis in the tropical regions of Asia, including Japan, China, Taiwan, Korea, Philippines, all of Southeastern Asia, and India. Very rarely JE had been reported in North American region among those returned travelers to USA from Far East endemic regions.
The virus is transmitted to humans primarily by Culex mosquitoes, which breed in flooded rice fields and pools of stagnant water. The virus is maintained is an enzootic cycle involving mosquitoes and amplifying vertebrate hosts, mainly pigs and splashing birds providing links to human population through their close proximity to residential locations. The current epidemiologic trend suggests the disease incidence in Northern (Uttar Pradesh) & central India is escalating, and larger epidemics may occur in future. Almost, half of the human population is now lives in countries where the disease has been endemic. The most human JE infections are predominantly subclinical & in apparent; a life threatening encephalitis occur < 1% of the infected persons. The annual incidence of clinical disease varies both across and within endemic countries. This has been estimated nearly 68 000 clinical cases of JE globally each year, with approximately 13 600 to 20 400 deaths. JE primarily affects children below 15 years of age and individuals of any age could be affected.
Case fatality averages 30% if clinically unrecognized and a high percentage of the survivors are left with permanent neurological sequelae. Cases of deadly JE have risen nearly five-fold in last five years in India's northeast Assam state as a result of climatic changes, warming weather and changing rainfall. JE virus is the most common vaccine-preventable cause of encephalitis occurring throughout Asia and parts of the western Pacific.

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Contributor Information and Disclosures

Sayenna Uduman*, M I Sahadulla**, Raja Lakshmi***
*MD, FAAP Visiting Professor, Infection Control Committee & ID Division of the KIMS
Thiruvananthapuram, Kerala, India

**CMD, ID Division- KIMS.
***Consultant ID, ICC Chair – KIMS


First Created : 3/25/2016

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