Abstract
Few data regarding the use of Japanese encephalitis (JE) vaccine in clinical practice are available. We identified 711 travelers at higher risk and 7,578 travelers at lower risk for JE who were seen at US Global TravEpiNet sites from September of 2009 to August of 2012. Higher-risk travelers were younger than lower-risk travelers (median age = 29 years versus 40 years, P < 0.001). Over 70% of higher-risk travelers neither received JE vaccine during the clinic visit nor had been previously vaccinated. In the majority of these instances, clinicians determined that the JE vaccine was not indicated for the higher-risk traveler, which contradicts current recommendations of the Advisory Committee on Immunization Practices. Better understanding is needed of the clinical decision-making regarding JE vaccine in US travel medicine practices.
Highlights
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus that is endemic in much of Asia and parts of the western Pacific
The Advisory Committee on Immunization Practices (ACIP) further states that the vaccine should be considered for short-term (< 1 month) travelers going to rural areas whose itineraries or activities place them at increased risk of JE virus exposure, short-term travelers going to areas with known outbreaks, and short-term travelers who are unsure of their itinerary.[2]
Travel for research/education, to visit friends and relatives (VFR), and for humanitarian service work represented a greater proportion of higher-risk travel than lower-risk travel, and business travel represented a greater proportion of lower-risk travel
Summary
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus that is endemic in much of Asia and parts of the western Pacific. An estimated 70,000 JE cases occur per year; the case-fatality ratio is 20–30%, and 30–50% of survivors have neurologic or psychiatric sequelae.[1,2,3] For travelers, the risk of disease is generally low but varies with destination, trip duration, season of travel, and planned activities.[2] Fiftyfive travel-associated JE cases were reported in the literature during 1973–2008.4. The Advisory Committee on Immunization Practices (ACIP) recommends JE vaccination for all travelers who plan to spend 1 month or more in JE-endemic regions during the transmission season. Until 2013, IXIARO was licensed for use only in people ages 3 17 years
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