Abstract
Japanese encephalitis (JE), a vector-borne viral disease, is endemic to large parts of Asia and the Pacific. An estimated 3 billion people are at risk, and JE has recently spread to new territories. Vaccination programs, increased living standards, and mechanization of agriculture are key factors in the decline in the incidence of this disease in Japan and South Korea. However, transmission of JE is likely to increase in Bangladesh, Cambodia, Indonesia, Laos, Myanmar, North Korea, and Pakistan because of population growth, intensified rice farming, pig rearing, and the lack of vaccination programs and surveillance. On a global scale, however, the incidence of JE may decline as a result of large-scale vaccination programs implemented in China and India.
Highlights
Japanese encephalitis (JE), a vector-borne viral disease, is endemic to large parts of Asia and the Pacific
The annual number of human deaths is 10,000–15,000, and the estimated global impact from JE in 2002 was 709,000 disability-adjusted life years (DALYs) [1,3]. These statistics should be interpreted with care because the transmission of JE is highly dynamic; the disease usually occurs in epidemics, and there is considerable fluctuation in estimates of its global impact
Two distinct epidemiologic patterns of JE have been described. In temperate zones, such as the northern part of the Korean peninsula, Japan, China, Nepal, and northern India, large epidemics occur in the summer months; in tropical areas of southern Vietnam, southern Thailand, Indonesia, Malaysia, the Philippines, and Sri Lanka, cases occur more sporadically and peaks are usually observed during the rainy season [5]
Summary
To poor, rural communities remains a formidable challenge, and compliance and delivery costs have to be considered [10]. The first one is a second-generation, live inactivated, single-dose vaccine grown in Vero cells. In Japan, a large JE outbreak involving >6,000 cases was documented. JE is potentially endemic to Afghanistan, Bhutan, Brunei Darussalam, and the Maldives, but to our knowledge, no cases have been reported in these countries in the past 30 years. The enzootic cycle on those Pacific Islands might not sustain viral transmission; epidemics occur only after introduction of virus from JE-endemic areas. Subtle changes in the spatiotemporal distribution of JEV are difficult to track; the year when a first case of JE in a country is reported does not necessarily correspond with the actual first occurrence of JE in that country (Table 1) [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35]
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