Download PDF Japanese encephalitis

By Alina Ellerington, Encephalitis Society and peer-reviewed by Hannah Brindle, Institute of Infection and Global Health, University of Liverpool, UK

What is Japanese encephalitis (JE)?

Japanese encephalitis is a type of infectious encephalitis caused by Japanese encephalitis virus (JEV). The virus is found in pigs and birds and is transmitted by Culex mosquitoes which breed in water pools and flooded rice fields; they bite mainly during the night or just after sunset. The virus cannot be transmitted directly from person-to-person.

Japanese encephalitis occurs mostly in South-East Asia and the Western Pacific islands with nearly three billion people living in at-risk areas and an estimated 68,000 cases annually. Where vaccination programmes are in place, cases have diminished. Japanese encephalitis is predominantly seen in children, however, some adults who have no prior immunity may be at risk. Japanese encephalitis continue to cause a huge health and economic burden to affected countries.

Symptoms of Japanese encephalitis

Most people who are infected have only mild or no symptoms with 1 in 250 cases being severe. The time from infection to developing symptoms is between 5-15 days. The illness can present with fever, chills, headache, muscle pain and spasm, movement disorders, seizures (particularly in children) and a reduction in the level of consciousness.

Diagnosis

The symptoms of Japanese encephalitis are not specific for this illness. People living/travelling in the endemic areas should be suspected and tested for JEV if they present with symptoms of encephalitis (fever, seizures, a change in consciousness level or neurological signs). Diagnosis can be confirmed, usually, by finding specific antibodies in the cerebrospinal fluid (CSF) following a lumbar puncture (LP or spinal tap) or in the blood.

Treatment

There is no specific antiviral treatment for Japanese encephalitis. The treatment is mostly symptomatic and supportive. In the severe cases, the treatment aims to manage seizures and raised intracranial pressure (due to brain inflammation) and support breathing.

Consequences of Japanese encephalitis

It is estimated that death occurs in 20-30% of the patients and up to 30% of the severe cases are left with neurological, psychosocial, cognitive (intellectual) and/or physical disabilities, particularly in children.

Prevention

The risk of JE in travellers and people living in endemic areas depends on their destination duration of travel, season, and activities. Those staying for longer periods in rural areas are at greater risk. Prevention consists of general prevention measures and vaccination.

  • General measures of prevention against mosquito bites: using repellent, bed nets, wearing adequate clothing (long sleeves/trousers).
  • There are three types of vaccine recommended by the World Health Organisation. Talk to you GP or a health clinic before you travel to Asia.

More information on prevention and guidelines for travellers is provided on our website 


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FS006V3 Japanese Encephalitis

Date created: March 2002/Last updated: December 2017/ Review date: December 2020

Disclaimer: We try to ensure that the information is easy to understand, accurate and up-to-date as possible. If you would like more information on the source material the author used to write this document please contact the Encephalitis Society. None of the authors of the above document has declared any conflict of interest which may arise from being named as an author of this document