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Evolving Epidemiology of Japanese Encephalitis: Implications for Vaccination

Abstract

Purpose of Review

We examine the present global burden of Japanese encephalitis (JE) in endemic populations, summarize published cases in travelers since 2009, examine current guidelines for vaccination for international travelers, and consider challenges in prevention of this vector-borne disease.

Recent Findings

We identified 11 JE cases in travelers that were published in peer-reviewed literature since 2009. JE incidence in endemic countries appears to be declining but the number of JE cases reported to the World Health Organization (WHO) varied from estimates derived from other published reports based on serosurveys or sentinel surveillance. Current JE vaccines appear to be safe and are not associated with delayed hypersensitivity in contrast to the older mouse brain vaccine.

Summary

Given differences between WHO-reported cases and local surveillance data, future research on true incidence is needed. Regular assessment will inform JE risk in travelers. National and international guidelines on JE vaccination varied; we suggest areas for improvement.

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References

Papers of particular interest, published recently, have been highlighted as • Of importance •• Of major importance

  1. Solomon T. Japanese encephalitis. In: Magill A, editor. Hunter’s tropical medicine and emerging infectious disease, expert consult—online and print. 9th ed. Elsevier Health Sciences; 2013. p. 358–365.

  2. Schuh AJ, Ward MJ, Leigh Brown AJ, Barrett ADT. Phylogeography of Japanese encephalitis virus: genotype is associated with climate. PLoS Negl Trop Dis. 2013;7(8) https://doi.org/10.1371/journal.pntd.0002411.

  3. Zhang J, Zhao Q, Guo X, Zuo S, Cheng J, Jia N. Isolation and genetic characteristics of human genotype 1 Japanese Encephalitis Virus, China, 2009. PLoS One. 2011;6(1) https://doi.org/10.1371/journal.pone.0016418.

  4. Tajima S, Yagasaki K, Kotaki A, et al. In vitro growth, pathogenicity and serological characteristics of the japanese encephalitis virus genotype v muar strain. J Gen Virol. 2015;96(9):2661–9. https://doi.org/10.1099/vir.0.000213.

    Article  PubMed  CAS  Google Scholar 

  5. Li Y-X. Japanese encephalitis, Tibet, China. Emerg Infect Dis. 2011;17(5):934–6.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Nga PT, del Carmen Parquet M, Cuong VD, et al. Shift in Japanese encephalitis virus (JEV) genotype circulating in northern Vietnam: implications for frequent introductions of JEV from Southeast Asia to East Asia. J Gen Virol. 2004;85(6):1625–31. https://doi.org/10.1099/vir.0.79797-0.

    Article  PubMed  CAS  Google Scholar 

  7. Gao X, Liu H, Wang H, Fu S, Guo Z, Liang G. Southernmost Asia is the source of Japanese encephalitis virus (genotype 1) diversity from which the viruses disperse and evolve throughout Asia. PLoS Negl Trop Dis. 2013;7(9):1–10. https://doi.org/10.1371/journal.pntd.0002459.

    Article  CAS  Google Scholar 

  8. Schuh AJ, Tesh RB, Barrett ADT. Genetic characterization of Japanese encephalitis virus genotype II strains isolated from 1951 to 1978. J Gen Virol. 2011;92(3):516–27. https://doi.org/10.1099/vir.0.027110-0.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Schuh AJ, Li L, Tesh RB, Innis BL, Barrett ADT. Genetic characterization of early isolates of Japanese encephalitis virus: genotype II has been circulating since at least 1951. J Gen Virol. 2010;91(1):95–102. https://doi.org/10.1099/vir.0.013631-0.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Pan X-L, Liu H, Wang H-Y, Fu SH, Liu HZ, Zhang HL, et al. Emergence of genotype I of Japanese encephalitis virus as the dominant genotype in Asia. J Virol. 2011;85(19):9847–53. https://doi.org/10.1128/JVI.00825-11.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Takhampunya R, Kim HC, Tippayachai B, Kengluecha A, Klein TA, Lee WJ, et al. Emergence of Japanese encephalitis virus genotype V in the Republic of Korea. Virol J. 2011;8:449. https://doi.org/10.1186/1743-422X-8-449.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. Li MH, Fu SH, Chen WX, et al. Genotype v Japanese encephalitis virus is emerging. PLoS Negl Trop Dis. 2011;5(7):1–7. https://doi.org/10.1371/journal.pntd.0001231.

    Article  CAS  Google Scholar 

  13. • Cao L, Fu S, Gao X, et al. Low protective efficacy of the current Japanese encephalitis vaccine against the emerging genotype 5 Japanese encephalitis virus. PLoS Negl Trop Dis. 2016;10(5):1–12. https://doi.org/10.1371/journal.pntd.0004686. Presents both in vivo and in vitro tests demonstrating poor protective efficacy of current genotype III-based inactivated and live-attenuated vaccines against genotype V .

    Article  CAS  Google Scholar 

  14. Le Flohic G, Porphyre V, Barbazan P, Gonzalez JP. Review of climate, landscape, and viral genetics as drivers of the Japanese encephalitis virus ecology. PLoS Negl Trop Dis. 2013;7(9):5–11. https://doi.org/10.1371/journal.pntd.0002208.

    Article  Google Scholar 

  15. Cao M, Feng Z, Zhang J, Ma J, Li X. Contextual risk factors for regional distribution of Japanese encephalitis in the People’s Republic of China. Tropical Med Int Health. 2010;15(8):918–23. https://doi.org/10.1111/j.1365-3156.2010.02563.x.

    Article  Google Scholar 

  16. Van Den Hurk AF, Ritchie SA, Johansen CA, Mackenzie JS, Smith GA. Domestic pigs and Japanese encephalitis virus infection, Australia. Emerg Infect Dis. 2008;14(11):1736–8. https://doi.org/10.3201/eid1411.071368.

    Article  PubMed Central  Google Scholar 

  17. Lord JS, Gurley ES, Pulliam JRC. Rethinking Japanese encephalitis virus transmission: a framework for implicating host and vector species. PLoS Negl Trop Dis. 2015;9(12):1–7. https://doi.org/10.1371/journal.pntd.0004074.

    Article  Google Scholar 

  18. Kumari R, Kumar K, Rawat A, Singh G, Yadav NK, Chauhan LS. First indigenous transmission of Japanese encephalitis in urban areas of National Capital Territory of Delhi, India. Tropical Med Int Health. 2013;18(6):743–9. https://doi.org/10.1111/tmi.12104.

    Article  Google Scholar 

  19. •• Cappelle J, Duong V, Pring L, Kong L, Yakovleff M, Prasetyo DB, et al. Intensive circulation of Japanese encephalitis virus in peri-urban sentinel pigs near Phnom. PLoS Negl Trop Dis. 2016;10(12):1–14. https://doi.org/10.1371/journal.pntd.0005149. Demonstrates a high prevalence of JE seropositivity in pigs in surveillance of piggeries in densely-populated outskirts of Phnom Penh, Cambodia

    Article  Google Scholar 

  20. Lindahl JF, Stahl K, Chirico J, Boqvist S, Thu HTV, Magnusson U. Circulation of Japanese encephalitis virus in pigs and mosquito vectors within Can Tho City, Vietnam. PLoS Negl Trop Dis. 2013;7(4):1–8. https://doi.org/10.1371/journal.pntd.0002153.

    Article  Google Scholar 

  21. • Ricklin ME, García-Nicolás O, Brechbühl D, Python S, Zumkehr B, Nougairede A, et al. Vector-free transmission and persistence of Japanese encephalitis virus in pigs. Nat Commun. 2016;7:10832. https://doi.org/10.1038/ncomms10832. Demonstrates under experimental conditions transmission of JEV between pigs via oronasal secretions; clinical and histological signs of infection did not differ between routes of transmission

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Gajanana A, Thenmozhi V, Samuel PP, Reuben R. A community-based study of subclinical flavivirus infections in children in an area of Tamil Nadu, India, where Japanese encephalitis is endemic. Bull World Health Organ. 1995;73(2):237–44.

    PubMed  PubMed Central  CAS  Google Scholar 

  23. Halstead SB, Thomas SJ. Japanese encephalitis: new options for active immunization. Clin Infect Dis. 2010;50(8):1155–64. https://doi.org/10.1086/651271.

    Article  PubMed  Google Scholar 

  24. Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT. Japanese encephalitis. J Neurol Neurosurg Psychiatry. 2000;68(4):405–15. https://doi.org/10.1136/jnnp.68.4.405.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  25. Hills SL, Rabe IB, Fisher M. Chapter 3: infectious diseases related to travel, Japanese encephalitis. Centers for Disease Control Yellow Book. https://wwwnc.cdc.gov/travel/yellowbook/2018/infectious-diseases-related-to-travel/japanese-encephalitis. Published 2017.

  26. Wang H, Liang G. Epidemiology of Japanese encephalitis: past, present, and future prospects. Ther Clin Risk Manag. 2015;11:435–48.

    PubMed  PubMed Central  CAS  Google Scholar 

  27. Ravanini P, Huhtamo E, Ilaria V, Crobu M.G., Nicosia A.M., Servino L., Rivasi F., Allegrini S., Miglio U., Magri A., Minisini R., Vapalahti O., Boldorini R. Japanese encephalitis virus RNA detected in Culex pipiens mosquitoes in Italy. Euro Surveill. 2012;17(28).

  28. • Simon-Loriere PDE. Autochthonous Japanese encephalitis with yellow fever coinfection in Africa. N Engl J Med. 2017;376(15):13–5. Report of a JE infection in Angola in 2016, representing what would be the first autochthonously-acquired infection outside of Asia or Oceania

    Article  Google Scholar 

  29. Wang L, Zhang W, Ding F, et al. Spatiotemporal patterns of Japanese encephalitis in China, 2002-2010. PLoS Negl Trop Dis. 2013;7(6):1–8. https://doi.org/10.1371/journal.pntd.0002285.

    Article  CAS  Google Scholar 

  30. Burke DS, Leake C. Japanese encephalitis. In: Monath T, editor. The arboviruses: epidemiology and ecology, vol. 3. Boca Raton: CRC Press; 1988.

    Google Scholar 

  31. Tsai TF. New initiatives for the control of Japanese encephalitis by vaccination: minutes of a WHO/CVI meeting, Bangkok, Thailand, 13–15 October 1998. Vaccine. 2000;18(Supplement 2):1–25.

    Article  PubMed  Google Scholar 

  32. •• Campbell G, Hills S, Fischer M, Jacobson J, Hoke C, Hombach J, et al. Estimated global incidence of Japanese encephalitis. Bull World Health Organ. 2011;89(10):766–74. https://doi.org/10.2471/BLT.10.085233. Most recent comprehensive assessment of global JE burden, estimating an annual incidence of 68,000 cases based on extrapolation of published sentinel surveillance studying

    Article  PubMed  PubMed Central  Google Scholar 

  33. Heffelfinger JD. Japanese encephalitis surveillance and immunization—Asia and the western Pacific, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(33):653–7. http://www.ncbi.nlm.nih.gov/pubmed/23965827

    Google Scholar 

  34. Metelka J, Robertson C, Stephen C. Japanese encephalitis: estimating future trends in Asia. AIMS Public Health. 2015;2(4):601–15. https://doi.org/10.3934/publichealth.2015.4.601.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Testa G, Borghese L, Steinbeck JA, Bru O. Meeting report. Cell. 2007;153–156. https://doi.org/10.1016/j.stem.2007.07.006.

  36. Report M. Meeting report. Rejuvenation Res. 2005;8(4):264–6. https://doi.org/10.1038/embor.2009.169.

    Article  Google Scholar 

  37. •• World Health Organization. WHO vaccine-preventable diseases: monitoring system. 2017 global summary. http://apps.who.int/immunization_monitoring/globalsummary/. Published 2017. Accessed 18 Dec 2017. Provides data on incidence and vaccination rates, as self-reported by individual countries.

  38. Paul RC, Rahman M, Gurley ES, et al. A novel low-cost approach to estimate the incidence of Japanese encephalitis in the catchment area of three hospitals in Bangladesh. Am J Trop Med Hyg. 2011;85(2):379–85. https://doi.org/10.4269/ajtmh.2011.10-0706.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Touch S, Hills S, Sokhal B, Samnang C, Sovann L, Khieu V, et al. Epidemiology and burden of disease from Japanese encephalitis in Cambodia: results from two years of sentinel surveillance. Tropical Med Int Health. 2009;14(11):1365–73. https://doi.org/10.1111/j.1365-3156.2009.02380.x.

    Article  Google Scholar 

  40. Tarantola A, Goutard F, Newton P, de Lamballerie X, Lortholary O, Cappelle J, et al. Estimating the burden of Japanese encephalitis virus and other encephalitides in countries of the Mekong region. PLoS Negl Trop Dis. 2014;8(1):4. https://doi.org/10.1371/journal.pntd.0002533.

    Article  Google Scholar 

  41. Lindahl J. Japanese encephalitis virus in pigs and vectors in the Mekong Delta with special reference to urban farming. 2012.

  42. Yang Y, Liang N, Tan Y, Xie Z. Epidemiological trends and characteristics of Japanese encephalitis changed based on the vaccination program between 1960 and 2013 in Guangxi Zhuang Autonomous Region, southern China. Int J Infect Dis. 2016;45:135–8. https://doi.org/10.1016/j.ijid.2016.03.004.

    Article  PubMed  Google Scholar 

  43. Huanyu W, Yixing L, Xiaofeng L, Guodong L. Japanese encephalitis in mainland China. Jpn J Infect Dis. 2009;62:331–6.

    Google Scholar 

  44. Yin Z, Wang H, Yang J, et al. Japanese encephalitis disease burden and clinical features of Japanese encephalitis in four cities in the People’s Republic of China. Am J Trop Med Hyg. 2010;83(4):766–73. https://doi.org/10.4269/ajtmh.2010.09-0748.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Directorate of National Vector Borne Disease Control Programme - Delhi. State wise number of AES/JE Cases and Deaths from 2010–2017. Dir Natl Vector Borne Dis Control Program. 2017:11651. http://nvbdcp.gov.in/Doc/je-aes.pdf.

  46. Murhekar MV, Oak C, Ranjan P, Kanagasabai K, Shinde S, Pandey AK, et al. Coverage & missed opportunity for Japanese encephalitis vaccine, Gorakhpur division, Uttar Pradesh, India, 2015: implications for Japanese encephalitis control. Indian J Med Res. 2017;145(February):63–9. https://doi.org/10.4103/ijmr.IJMR.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kumar D, Singh AJ. Response of various stakeholders towards newly introduced Japanese encephalitis vaccine in a North Indian State. J Vaccines. 2014;2014:1–4.

    Article  Google Scholar 

  48. Kari K, Liu W, Gautama K, Mammen MP, Clemens JD, Nisalak A, et al. A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia. BMC Med. 2006;4(1):8. https://doi.org/10.1186/1741-7015-4-8.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Ompusunggu S, Hills SL, Maha MS, Moniaga VA, Susilarini NK, Widjaya A, et al. Confirmation of Japanese encephalitis as an endemic human disease through sentinel surveillance in Indonesia. Am J Trop Med Hyg. 2008;79(6):963–70.

    PubMed  Article  Google Scholar 

  50. World Health Organization. Japanese Encephalitis reported cases. http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencejapenc.html. Published 2017. Accessed 1 Jan 2017.

  51. Wagner H. Protecting the environment from the impact of the growing industrialization of livestock production in East Asia. In: 26th Session of Animal Production and Health Commission of Asia and the Pacific, Food and Agriculture Administration of United Nations. 2002. http://www.fao.org/docrep/005/ac801e/ac801e09.htm.

  52. Vallée J, Dubot-Pérès A, Ounaphom P, Sayavong C, Bryant JE, Gonzalez JP. Spatial distribution and risk factors of dengue and Japanese encephalitis virus infection in urban settings: the case of Vientiane, Lao PDR. Tropical Med Int Health. 2009;14(9):1134–42. https://doi.org/10.1111/j.1365-3156.2009.02319.x.

    Article  Google Scholar 

  53. Solomon T, Thi TT, Lewthwaite P, et al. A cohort study to assess the new WHO Japanese encephalitis surveillance standards. Bull World Health Organ. 2008;86(3):178–86. https://doi.org/10.2471/BLT.07.043307.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Wong SC, Ooi MH, Abdullah AR, Wong SY, Krishnan S, Tio PH, et al. A decade of Japanese encephalitis surveillance in Sarawak, Malaysia: 1997-2006. Tropical Med Int Health. 2008;13(1):52–5. https://doi.org/10.1111/j.1365-3156.2007.01967.x.

    Article  Google Scholar 

  55. Oo PM, Hlaing T, Lwin S, Pittyawonganon C. A large outbreak of Japanese encephalitis in Rakhine State, Myanmar: implication for vaccine policy. Osir. 2016;9(2):8–15.

    Google Scholar 

  56. Ram ST, Neuberger A, Thapa LJ, Vir Singh RP, Shofty B, Schwartz E. Japanese encephalitis among patients with acute encephalitic syndrome admitted to a tertiary hospital in Chitwan, Nepal—a prospective observational study. PLoS One. 2014;9(6). https://doi.org/10.1371/journal.pone.0099999.

  57. Pant SD. Epidemiology of Japanese encephalitis in Nepal. J Nepal Paediatr Soc. 2009;29(1):35–7. https://doi.org/10.3126/jnps.v29i1.1600.

    Article  Google Scholar 

  58. Robertson C, Pant DK, Joshi DD, Sharma M, Dahal M, Stephen C. Comparative spatial dynamics of Japanese encephalitis and acute encephalitis syndrome in Nepal. PLoS One. 2013;8(7):e66168. https://doi.org/10.1371/journal.pone.0066168.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  59. Kumar Pant D, Tenzin T, Chand R, Kumar Sharma B, Raj Bist P. Spatio-temporal epidemiology of Japanese encephalitis in Nepal, 2007-2015. PLoS One. 2017;12(7):2007–15. https://doi.org/10.1371/journal.pone.0180591.

    Article  CAS  Google Scholar 

  60. Lopez AL, Aldaba JG, Roque VG, Tandoc AO, Sy AK, Espino FE, et al. Epidemiology of Japanese encephalitis in the Philippines: a systematic review. PLoS Negl Trop Dis. 2015;73(March 2014):1–17. https://doi.org/10.1371/journal.pntd.0003630.

    CAS  Article  Google Scholar 

  61. Sunwoo J, Jung K, Lee S, Lee SK, Chu K. Reemergence of Japanese encephalitis in South Korea, 2010-2015. 2016;22(10):1841–3. https://doi.org/10.3201/eid2210.160288.

  62. Choe YJ, Taurel AF, Nealon J, Seo HS, Kim HS. Systematic review of seroepidemiological studies on Japanese encephalitis in the Republic of Korea. Int J Infect Dis. 2018;67:14–9. https://doi.org/10.1016/j.ijid.2017.11.023.

    Article  PubMed  Google Scholar 

  63. Chang YK, Chang HL, Wu HS, Chen KT. Epidemiological features of Japanese encephalitis in Taiwan from 2000 to 2014. Am J Trop Med Hyg. 2017;96(2):382–8. https://doi.org/10.4269/ajtmh.16-0330.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Olsen SJ, Supawat K, Campbell AP, Anantapreecha S, Liamsuwan S, Tunlayadechanont S, et al. Japanese encephalitis virus remains an important cause of encephalitis in Thailand. Int J Infect Dis. 2010;14(10):e888–92. https://doi.org/10.1016/j.ijid.2010.03.022.

    Article  PubMed  Google Scholar 

  65. Hills SL, Griggs AC, Fischer M. Japanese encephalitis in travelers from non-endemic countries, 1973-2008. Am J Trop Med Hyg. 2010;82(5):930–6. https://doi.org/10.4269/ajtmh.2010.09-0676.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Yen NT, Duffy MR, Hong NM, Hien NT, Fischer M, Hills SL. Surveillance for Japanese Encephalitis in Vietnam, 1998–2007. 2010;83(4):816–819. doi:https://doi.org/10.4269/ajtmh.2010.10-0262.

  67. SAGE Working Group on Japanese encephalitis vaccines (World Health Organization). Background paper on Japanese encephalitis vaccines. 2016;(March):1–74.

  68. Grossman RA, Edelman R, Willhight M, Pantuwatana S, Udomsakdp S. Study of japanese encephalitis virus in Chiang Mai Valley, Thailand. Am J Epidemiol. 1973;98(2):133–49.

    Article  PubMed  CAS  Google Scholar 

  69. Xufang Y, Huanyu W, Shihong F, Xiaoyan G, Shuye Z, Chunting L, et al. Etiological spectrum of clinically diagnosed Japanese encephalitis cases reported in Guizhou Province, China, in 2006. J Clin Microbiol. 2010;48(4):1343–9. https://doi.org/10.1128/JCM.01009-09.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Feng Y. High incidence of Japanese encephalitis, southern China. Emerg Infect Dis. 2013;19(4):4–5.

    Article  Google Scholar 

  71. Gao X, Li X, Li M, Fu S, Wang H, Lu Z, et al. Vaccine strategies for the control and prevention of Japanese encephalitis in mainland China, 1951–2011. PLoS Negl Trop Dis. 2014;8(8):e3015. https://doi.org/10.1371/journal.pntd.0003015.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Tiwari S, Singh RK, Tiwari R, Dhole TN. Japanese encephalitis: a review of the Indian perspective. Braz J Infect Dis. 2012;16(6):564–73. https://doi.org/10.1016/j.bjid.2012.10.004.

    Article  PubMed  Google Scholar 

  73. Werlinrud AM, Christiansen CB, Koch A. Japanese encephalitis in a Danish short-term traveler to Cambodia. J Travel Med. 2011;18(6):411–3. https://doi.org/10.1111/j.1708-8305.2011.00565.x.

    Article  PubMed  Google Scholar 

  74. Chen L et al. Japanese encephalitis in two children—United States, 2010. Morb Mortal Wkly Rep. 2011;60(9).

  75. Tappe D, Nemecek A, Zipp F, Emmerich P, Gabriel M, Günther S, et al. Two laboratory-confirmed cases of Japanese encephalitis imported to Germany by travelers returning from Southeast Asia. J Clin Virol. 2012;54(3):282–5. https://doi.org/10.1016/j.jcv.2012.03.004.

    Article  PubMed  Google Scholar 

  76. Langevin S, Libman M, Drebot MA, Laverdière M. A case of Japanese encephalitis virus infection acquired during a trip in Thailand. J Travel Med. 2012;19(2):127–9. https://doi.org/10.1111/j.1708-8305.2011.00582.x.

    Article  PubMed  Google Scholar 

  77. Hills SL, Stoltey J, Martínez D, Kim PY, Sheriff H, Zangeneh A, et al. A case series of three US adults with Japanese encephalitis, 2010-2012. J Travel Med. 2014;21(5):310–3. https://doi.org/10.1111/jtm.12127.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Lagarde S, Lagier JC, Charrel R, Quérat G, Vanhomwegen J, Desprès P, et al. Japanese encephalitis in a French traveler to Nepal. J Neuro-Oncol. 2014;20(1):99–102. https://doi.org/10.1007/s13365-013-0226-2.

    CAS  Article  Google Scholar 

  79. Doti P, Castro P, Martínez MJ, Zboromyrska Y, Aldasoro E, Inciarte A, et al. A case of Japanese encephalitis in a 20 year-old Spanish sportsman, February 2013. Eur Secur. 2013;18(35) https://doi.org/10.2807/1560-7917.ES2013.18.35.20573.

  80. • Huang GKL, Tio SY, Caly L, et al. Prolonged detection of Japanese Encephalitis virus in urine and whole blood in a returned short-term traveler. Open Forum Infect Dis. 2017;ofx203. https://doi.org/10.1093/ofid/ofx203. Report of an Australian man with a fatal case of JE acquired during 8-day travel to Thailand, notable for isolation of JEV RNA from whole blood and culture of JEV from urine sample, findings which previously had not been reported.

  81. Yun S-I, Lee Y-M. Japanese encephalitis: the virus and vaccines. Hum Vaccin Immunother. 2014;10(2):263–79. https://doi.org/10.4161/hv.26902.

    Article  PubMed  CAS  Google Scholar 

  82. Practices AC on I. Morbidity and mortality weekly report Japanese encephalitis vaccines recommendations of the Advisory Committee on Immunization Practices. Vol 59. 2010.

  83. Firbas C, Jilma B. Product review on the JE vaccine IXIARO. Hum Vaccines Immunother. 2015;11(2):411–20. https://doi.org/10.4161/21645515.2014.983412.

    Article  Google Scholar 

  84. • Saito Y, Moi ML, Takeshita N, Lim CK, Shiba H, Hosono K, et al. Japanese encephalitis vaccine-facilitated dengue virus infection-enhancement antibody in adults. BMC Infect Dis. 2016;16(1):578. https://doi.org/10.1186/s12879-016-1873-8. Following a single dose of inactivated Vero cell-derived JE vaccine, Japanese adults demonstrated sub-neutralizing levels of cross-reactivity against dengue, implying a risk of more severe infection in the event of dengue infection following JE vaccination

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  85. Kumar R, Tripathi P, Rizvi A. Effectiveness of one dose of SA 14-14-2 vaccine against Japanese encephalitis. N Engl J Med. 2009;360(14):1465–6. https://doi.org/10.1056/NEJMc0808664.

    Article  PubMed  CAS  Google Scholar 

  86. Public Health Agency of Canada. An Advisory Committee Statement (ACS-4): statement on protection against Japanese Encephalitis. Vol 34; 2008.

  87. European Centre for Disease Control andPrevention. Facts about Japanese encephalitis. https://ecdc.europa.eu/en/japanese-encephalitis/facts. Published 2017. Accessed 23 July 2017.

  88. •• WHO. Japanese encephalitis vaccines: WHO position paper—February 2015. WHO Wkly Epidemiol Rec Relev épidémiologique Hebd. 2015;21(90):69–88. https://doi.org/10.1186/1750-9378-2-15.Voir. Provides most recent data on laboratory detection of JE and vaccine safety and immunogenecity; recommends vaccination in travelers to endemic areas during transmission season who have "extensive outdoor exposure"

    Article  Google Scholar 

  89. National Health Service GB. Japanese encephalitis—prevention. NHS Choices. http://www.nhs.uk/Conditions/Japanese-encephalitis/Pages/Whileyoureaway.aspx. 2016. Accessed 20 July 2017.

  90. Australian Government Department of Health. Japanese encephalitis. The Australian Immunisation Handbook, 10th ed. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-8#4-8-7. 2017. Accessed 23 July 2017.

  91. Himani D, Kumar HBC, Bhilegaonkar KN, Kumar A. Japanese encephalitis: a veterinary perspective. J Foodborne Zoonotic Dis. 2014;2(4):59–67.

    Google Scholar 

  92. Nah J-J, Yang D-K, Kim H-H, Song J-Y. The present and future of veterinary vaccines for Japanese encephalitis in Korea. Clin Exp Vaccine Res. 2015;4:130–6. https://doi.org/10.7774/cevr.2015.4.2.130.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Erlanger TE, Weiss S, Keiser J, Utzinger J, Wiedenmayer K. Past, present, and future of Japanese encephalitis. Emerg Infect Dis. 2009;15(1):1–7. https://doi.org/10.3201/eid1501.080311.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Kim H, Cha GW, Jeong YE, Lee WG, Chang KS, Roh JY, et al. Detection of Japanese encephalitis virus genotype V in Culex orientalis and Culex pipiens (Diptera: Culicidae) in Korea. PLoS One. 2015;10(2):1–13. https://doi.org/10.1371/journal.pone.0116547.

    CAS  Article  Google Scholar 

  95. Dubischar KL, Kadlecek V, Sablan B, et al. Safety of the inactivated Japanese encephalitis virus vaccine IXIARO® in children—an open-label, randomized, active-controlled, phase 3 study. 2017. https://doi.org/10.1097/INF.0000000000001623.

  96. Rossi IA, Genton B. The reliability of pre-travel history to decide on appropriate counseling and vaccinations: a prospective study. J Travel Med. 2012;19(5):284–8. https://doi.org/10.1111/j.1708-8305.2012.00618.x.

    Article  PubMed  Google Scholar 

  97. Integrated Disease Surveillance Program. National Centre for Disease Control, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India. http://idsp.nic.in. 2017.

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Acknowledgments

The authors thank Dr. Susan Hills for her thoughtful review and suggestions.

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Correspondence to Davidson H. Hamer.

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JPC declares that he has no conflict of interest. LHC reports serving as advisor for Shoreland, Inc. and DSMB for Valneva (unrelated vaccine). DHH reports serving on advisory boards for Valneva and iJET.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Tropical, Travel and Emerging Infection

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Caldwell, J.P., Chen, L.H. & Hamer, D.H. Evolving Epidemiology of Japanese Encephalitis: Implications for Vaccination. Curr Infect Dis Rep 20, 30 (2018). https://doi.org/10.1007/s11908-018-0635-8

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  • DOI: https://doi.org/10.1007/s11908-018-0635-8

Keywords

  • Japanese encephalitis
  • Epidemiology
  • Risk estimates
  • Travelers
  • Vaccination