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Japanese Encephalitis

Japanese encephalitis virus is the main cause of vaccine-preventable viral encephalitis in Asia, resulting in nearly 68 000 clinical cases each year. It is transmitted through the bite of an infected mosquito.  While most people infected by the virus will show no symptoms, about 1 in 250 will develop severe symptoms including seizure, coma and may result in death.  The case-fatality rate is about 20% to 30% among those who develop symptoms; 20%-50% of survivors will develop permanent problems such as paralysis, recurrent seizures and inability to speak.  Risk of Japanese encephalitis is generally very low in urban areas, but is much higher in rural areas especially where flood irrigation is being practiced.  Travellers who plan to stay over 1 month in risk areas during transmission season or plan to frequently revisit such areas should be vaccinated.  Those who will be spending substantial time in rural/agricultural areas during virus transmission season should also be vaccinated even if they do not plan to stay over 1 month, especially if they plan to be outdoors in the evening or at night, or stay in accommodations without bed nets, window screens, or air conditioning.  


Travellers 18 years of age or older may receive Ixiaro vaccine to protect themselves from infection by Japanese encephalitis virus.  It is a 2-dose series given on day 0 and 28, and ideally should be completed at least 1 week before travel.  A booster dose may be given after 1 year if needed.