Impact of SA 14-14-2 vaccination on the occurrence of Japanese encephalitis in India

Abstract

ABSTRACT Japanese encephalitis virus is the major cause of encephalitis in India. To control the increasing incidence and fatal outbreaks, SA 14-14-2 vaccine was introduced initially in 104 endemic districts in phased manner from 2006 to 2011. As there is no data available before 2008 on the number of Japanese encephalitis (JE) cases excluding cases of Acute Encephalitis Syndrome (AES), a four year average of the number of JE vs. AES cases reported during 2008– 2011 was calculated and the value was used to determine the percentage of JE cases out of AES cases for the period 1994 to 2007. The analysis of data for the period 1994 to 2017 showed that there was a substantial increase of JE cases after the initiation of vaccination in 2006. Since the JE vaccination was given only in selected districts, comparing the vaccinated district with non vaccinated district would be more appropriate to determine the impact of vaccination. However, the data available on JE is only at the state wide. Hence, Tamil Nadu state where, district-wise JE data is available from 1993 onwards was used as a model state to determine the impact of vaccination. Even though the data for entire Tamil Nadu state showed an increasing trend, the analysis of data for vaccinated districts reveals that, the increase was due to increase of JE cases in non-vaccinated districts. It shows that, there was a reduction in JE case incidences in the vaccinated districts of Tamil Nadu in particular and India as a whole following the introduction of SA 14-14-2 vaccination.