Q. How is
Japanese encephalitis transmitted?
A. By rice field breeding mosquitoes (primarily the Culex tritaeniorhynchus group)
that become infected with Japanese encephalitis virus (a flavivirus antigenically
related to St. Louis encephalitis virus).
Q. How do people
get Japanese encephalitis?
A. By the bite of mosquitoes infected with the Japanese encephalitis
virus.
Q. What is
the basic transmission cycle?
A. Mosquitoes become infected by feeding on domestic pigs and wild
birds infected with the Japanese encephalitis virus. Infected mosquitoes
then transmit the Japanese encephalitis virus to humans and animals during
the feeding process. The Japanese encephalitis virus is amplified in the
blood systems of domestic pigs and wild birds.
Q. Could you
get the Japanese encephalitis from another person?
A. No, Japanese encephalitis virus is NOT transmitted from person-to-person.
For example, you cannot get the virus from touching or kissing a person
who has the disease, or from a health care worker who has treated someone
with the disease.
Q. Could you
get Japanese encephalitis from animals other than domestic pigs, or from
insects other than mosquitoes?
A. No. Only domestic pigs and wild birds are carriers of the Japanese
encephalitis virus.
Q. What are
the symptoms of Japanese encephalitis?
A. Mild infections occur without apparent symptoms other than fever
with headache. More severe infection is marked by quick onset, headache,
high fever, neck stiffness, stupor, disorientation, coma, tremors, occasional
convulsions (especially in infants) and spastic (but rarely flaccid) paralysis.
Q. What is
the incubation period for Japanese encephalitis?
A. Usually 5 to 15 days.
Q. What is
the mortality rate of Japanese encephalitis?
A. Case-fatality rates range from 0.3% to 60%.
Q. How many
cases of Japanese encephalitis occur in the world and the U.S.?
A. Japanese encephalitis is the leading cause of viral encephalitis
in Asia with 30-50,000 cases reported annually. Fewer than 1 case/year
is reported in U.S. civilians and military personnel traveling to and
living in Asia. Rare outbreaks in U.S. territories in Western Pacific
have occurred.
Q. How is Japanese
encephalitis treated?
A. There is no specific therapy. Intensive supportive therapy is
indicated.
Q. Is the disease
seasonal in its occurrence?
A. Seasonality of the illness varies by country (see
table).
Q. Who is at risk
for getting Japanese encephalitis?
A. Residents of rural areas in endemic locations, active duty military
deployed to endemic areas, and expatriates who visit rural areas. Japanese
encephalitis does not usually occur in urban areas (see table).
Q. Where is Japanese
encephalitis endemic?
A. See map.
Q. Where do
Japanese encephalitis outbreaks occur?
A. Japanese encephalitis outbreaks are usually circumscribed and
do not cover large areas. They usually do not last more than a couple
of months, dying out after the majority of the pig amplifying hosts have
become infected. Birds are the natural hosts for Japanese encephalitis.
Epidemics occur when the virus is brought into the peridomestic environment
by mosquito bridge vectors where there are pigs, which serve as amplification
hosts, infecting more mosquitoes which then may infect humans. Countries
which have had major epidemics in the past, but which have controlled
the disease primarily by vaccination, include China, Korea, Japan, Taiwan
and Thailand. Other countries that still have periodic epidemics include
Viet Nam, Cambodia, Myanmar, India, Nepal, and Malaysia.
New! Q. Who should
be vaccinated against Japanese encephalitis?
A.The statement of the Advisory Committee on Immunization Practices (ACIP) provides recommendations for use of JE vaccine among travelers and laboratory workers. (See: Centers for Disease Control and Prevention. Japanese Encephalitis Vaccines, Recommendations of the Advisory Committee on Immunization Practices (ACIP), Morbidity and Mortality Weekly Report, Mar 12, 2010: 59(01);1-27) The 2-page Vaccine Information Statement provides helpful information on who should be vaccinated against Japanese encephalitis virus and the benefits and risks of the vaccine.
Q. Where
can I get more information on Japanese encephalitis?
A. See the CDC Japanese Encephalitis Home Page (http://www.cdc.gov/ncidod/dvbid/jencephalitis)
and CDC Health Information for Travelers to Southeast Asia (http://www.cdc.gov/travel/seasia.htm).
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