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Japanese encephalitis is a serious viral infection that can cause inflammation of the brain and lead to devastating consequences. If you’re travelling or living in parts of Southern and South-East Asia including the Pacific rim, then you’re at risk. The virus is transmitted by a night time biting mosquito, the Culex species. Japanese encephalitis is common in rural areas near rice paddies and where pigs are reared, but can also be found in urban areas. For example, Hanoi City in Vietnam has regular outbreaks of Japanese encephalitis during the monsoon season. Dr Gowda, Founder of Health Klinix, has also attended Japanese encephalitis outbreaks in the urban areas of Bellary, Karnataka in India which also has regular outbreaks during the wet season.
Japanese encephalitis, what is it?
Japanese encephalitis vaccination
Although Japanese encephalitis infection can lead to devastating consequences, there’s a simple and safe JE vaccine available. It's more expensive than other travel vaccines, but it’s very effective and potentially life saving vaccine. The vaccine schedule is usually two doses 28 or 7 days apart.
The Japanese encephalitis (JE) Vaccination starts from £116 per dose for adults and £116 per dose for children. If you’re travelling then there’ll be a Travel Consultation cost of £30 per person and the vaccine cost, however, if you’re not travelling then it’s only the vaccination cost you pay.
Japanese encephalitis vaccine price
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You can take simple steps to avoid mosquito bites and therefore reduce the probability of Japanese encephalitis infection. As a traveller you can take the following bite avoidance measures (especially at night): - Cover up as much skin as possible, where possible wear loose fitting clothes with long sleeves and long trousers/skirt - Use insect repellent on any exposed skin (products containing 50% DEET are the most effective) - Sleep under a mosquito net at night, and make sure that this net has been impregnated with permethrin
Prevention
Unfortunately there's no specific treatment, which is why you should consider Japanese encephalitis vaccination if you’re at risk.
Japanese encephalitis treatment
Actually, more often than not, you may not have any symptoms of Japanese encephalitis at all, as most individuals will experience what we call ‘subclinical infection.' However, when symptoms do occur they can be very serious and unfortunately there’s no treatment available - which is why we may recommend the Japanese encephalitis vaccination. The most common symptoms include: - Fever - Headache - Confusion This can lead to inflammation of the brain called encephalitis, which can progress to coma and possibly death. If you do experience symptoms, then the rule of 1/3 applies in Japanese encephalitis. This means 1/3 of those individuals with symptoms will have a severe flu like illness such as influenza but make a complete recovery. Another 1/3 will progress to serious brain inflammation and subsequent, long-term neurological disability. And lastly, the final 1/3 will die without any specific viral treatment being available, which is why we have a low threshold for Japanese encephalitis vaccination.
Japanese encephalitis symptoms
Japanese encephalitis is transmitted by mosquitoes that bite mainly at night. The Japanese encephalitis virus belongs to a group of viruses called flaviviruses. Viruses in this group also include dengue fever, yellow fever and the West Nile virus.
Japanese encephalitis causes
Side effects are relatively few and far between except for a sore injection site, occasional fever or muscle aches.
Japanese encephalitis vaccine side effects
Frequently asked questions
After you've received the primary course of the Japanese encephalitis vaccine, you'll need a further booster one to two years after the primary course if you’re still at risk. After this first booster, you'll need a booster every 10 years.
You should consider Japanese vaccination for the following regions:
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South Asia including Pakistan, Nepal, India, Bangladesh and Sri Lanka
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Southeast Asia – all countries
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Far East - including Japan, Korea, Taiwan and China
If you’re visiting or living in rural parts of high risk countries for long periods of time, then you’re likely to be exposed to the Japanese encephalitis virus. Please note your risk may be increased even during shorter trips and activities that have significant rural, outdoor, or night time exposure. Examples of activities include camping, fieldwork, staying in house stays near rice paddies and backpacking through any of the above regions.
Please be aware that tourists to Bali, Indonesia have become seriously ill with Japanese encephalitis infection even after short resort trips (but this is uncommon).
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Your travel health specialist can first evaluate your risk of Japanese infection for your journey. The manufacturer of the only licensed Japanese encephalitis vaccine in the UK, Ixiaro, recommends that it should be avoided in pregnancy. So if you're at risk, you'll need a consultation with a specialist in travel medicine at Health Klinix.
This is between 5 to 15 days.
No, Japanese encephalitis is transmitted by night time biting mosquitoes.
Authors:
Dr Ravi Gowda, Consultant in Infectious Diseases and Travel Medicine
MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP
Caitlin Lancaster, BSc
Resources:
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Ixiaro - Japanese encephalitis vaccine. Medicines information
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Japanese encephalitis in Travelers: Review of Cases and Seasonal Risk. Journal of travel medicine