What is Japanese Encephalitis?

It is an inflammation of the brain caused by the Japanese Encephalitis virus (Flaviviridae).

How is JE transmitted?

JE is transmitted by the Culex mosquitoes which carries the virus from infected pigs to man

What are the signs and symptoms?

Most infections in man are asymptomatic and mild. About 1 in 300 infections will result in encephalitis. Those affected may present with high fever, severe headache, nausea and vomiting, and they may become confused and disorientated

Is JE a serious illness?

The disease is fatal in 20% - 50% of persons with encephalitis

What is the treatment for JE?

There is no specific treatment for JE. Treatment is mainly supportive.

Can the mosquitoes transmit the virus from an infected person to another person?

As the virus does not multiply in the human host it cannot be transmitted by mosquito from man to man.

Can a person get infected through close contact with an infected person?

No. The virus has not been shown to be transmitted from man to man.

Who is at risk of getting the infection?

Persons living in rural areas in endemic locations are most at risk.

Can a person contract JE through eating pork?

No. Once the pig is slaughtered the JE virus will not survive in the pork. The JE Virus can only survive in living cells. On top of that any virus will be killed by cooking, roasting or boiling the meat at a temperature of more than 60 degrees Celsius. Our digestive enzymes and acid in the stomach can also kill the virus.

How common is JE in India?

JE has been reported from all states and union territories in India except Arunachal, Dadra, Daman, Diu, Gujarat, Himachal, Jammu, Kashmir, Lakshadweep, Meghalaya, Nagar Haveli, Orissa, Punjab, Rajasthan, and Sikkim. Highly endemic states include West Bengal, Bihar, Karnataka, Tamil Nadu, Andhra Pradesh, Assam, Uttar Pradesh, Manipur, and Goa. The risk is highest in children aged 1-15 years, in rural areas and in the monsoon/ post monsoon season.

Is vaccination available?

Yes.

Who should go for vaccination?

Those who come in close contact with live pigs or will be travelling to affected areas e.g. rural areas with pig farming are advised to get themselves vaccinated. It is not advisable for others to receive the vaccination. The doctors at the clinic will determine if the person needs it and only administer the vaccination if necessary.

What are the recommendations of IAP and Government of India (GoI) for JE vaccination?

The vaccination against JE is not recommended for routine use, but only for individuals living in endemic areas. Though occasional cases have been reported from urban areas in few districts, JE is exclusively a disease of rural areas. Hence, even in endemic areas, the children residing only in rural areas should be targeted for vaccination Government of India has identified around 180 districts to be endemic for JE in India so far JE vaccine is also recommended for travelers to JE endemic areas provided they are expected to stay for a minimum of 4 weeks in rural areas in the JE season.

What different types of JE vaccines available in India?

Following vaccines are available for use against JE:

• Live Attenuated, Cell culture-derived SA 14-14-2
• Inactivated SA-14-14-2 vaccine (IC51) (IXIARO® by Intercel & JEEV® by Biological Evans India Ltd.)
• Inactivated Vero cell culture-derived Kolar strain, 821564XY, JE vaccine (JENVAC® by Bharat Biotech)

Sources:

• IAP Guidebook on Immunization 2013-14. Available from: www.iapindia.org
• Frequently Asked Questions On Japanese Encephalitis. available from: www.moh.gov.sg