Japanese encephalitis virus: changing the clinical landscape of encephalitis in Australia

Molecular mechanisms of Japanese encephalitis virus infection and advances in vaccine research

Japanese encephalitis (JE) is a central nervous system disease caused by the Japanese encephalitis virus (JEV), resulting in high morbidity and mortality, especially in Asia. This review summarizes the current understanding of the JEV infection cycle, including virus attachment and entry, genome replication, viral protein translation, and virus particle assembly and release. The roles of host factors and viral proteins in these processes are discussed. Furthermore, the latest advancements in JE vaccine research are emphasized, including the development of attenuated vaccine SA14-14-2, inactivated mouse brain-derived vaccine, inactivated cell culture vaccine, and chimeric attenuated vaccine. The efficacy and safety of these candidate vaccines and ongoing efforts to enhance their immunogenicity are also reviewed. A comprehensive understanding of the molecular mechanisms of JEV infection and advancements in vaccine research is crucial for the development of effective strategies for JE control and prevention.

Improving knowledge of rare disorders since 1993: the Australian Paediatric Surveillance Unit

The Australian Paediatric Surveillance Unit (APSU), established in 1993 to address the paucity of national data on rare childhood disorders, has become an invaluable research resource. It facilitates prospective, active surveillance for a variety of rare disorders, with monthly reporting by ~1500 paediatricians, who are invited to notify incident cases and provide demographic and clinical data. APSU is highly collaborative (used by >400 individuals/organisations), patient-informed and productive (>300 publications). In 30 years, 72 studies have been initiated on rare infections, and genetic, psychological and neurological disorders, and injuries. Return rates of monthly report cards were >90% for 30 years and paediatricians have provided data for >90% of notified cases. Although there are limitations, including case underascertainment in remote regions, APSU often provides the only available national data. APSU has assisted the government in reporting to the WHO, developing national strategies, informing inquiries and investigating disease outbreaks. APSU data have informed paediatrician education, practice, policy, and service development and delivery. APSU was integral in establishing the International Network of Paediatric Surveillance Units (INoPSU) and supporting development of other units. APSU's expanded remit includes one-off surveys, hospital audits, systematic reviews, studies on the impacts of rare disorders on families, surveillance evaluations, and joint studies with INoPSU members. Paediatricians value the APSU, reporting that APSU data inform their practice. They must be congratulated for an outstanding collective commitment to the APSU, in providing unique data that contribute to our understanding of rare disorders and support optimal, evidence-based care and improved child health outcomes.