1
|
Thomson TN, Marsland MJ, Minko C, Snow KJ, Friedman ND. Japanese encephalitis: A rapid review of reported prevalence of infection, clinical disease and sequelae in immunologically naive populations to inform Australia’s response. Aust N Z J Public Health 2023; 47:100041. [PMID: 37024425 DOI: 10.1016/j.anzjph.2023.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 04/05/2023] Open
|
2
|
Van K, Korman TM, Nicholson S, Troutbeck R, Lister DM, Woolley I. Case Report: Japanese Encephalitis Associated with Chorioretinitis after Short-Term Travel to Bali, Indonesia. Am J Trop Med Hyg 2020; 103:1691-1693. [PMID: 32783793 DOI: 10.4269/ajtmh.19-0330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Japanese encephalitis (JE) virus is a mosquito-borne flavivirus endemic throughout Asia. Incidence in non-endemic countries is rare, with an estimate of less than one case per one million travelers. Most human JE infections are asymptomatic or cause a mild, nonspecific febrile illness. Neurological involvement, if present, is usually severe and associated with high mortality or ongoing neurological sequelae in survivors. Ocular manifestations are rare with JE, but uveitis has been described to be associated with other flavivirus infections, including West Nile virus. We report the first probable case of JE chorioretinitis acquired by a 45-year-old Australian traveler to Bali. This case highlights the importance of a detailed ocular examination when there is clinical suspicion of JE.
Collapse
Affiliation(s)
- Karen Van
- Monash Infectious Diseases, Monash Health, Clayton, Australia
| | - Tony M Korman
- Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Australia.,Monash Infectious Diseases, Monash Health, Clayton, Australia
| | - Suellen Nicholson
- Victorian Infectious Diseases Reference Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Robyn Troutbeck
- Department of Ophthalmology, Monash Health, Clayton, Australia
| | - David M Lister
- Monash Infectious Diseases, Monash Health, Clayton, Australia
| | - Ian Woolley
- Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Australia.,Monash Infectious Diseases, Monash Health, Clayton, Australia
| |
Collapse
|
3
|
Turtle L, Easton A, Defres S, Ellul M, Bovill B, Hoyle J, Jung A, Lewthwaite P, Solomon T. 'More than devastating'-patient experiences and neurological sequelae of Japanese encephalitis§. J Travel Med 2019; 26:5554873. [PMID: 31504712 PMCID: PMC6792067 DOI: 10.1093/jtm/taz064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Japanese encephalitis (JE), caused by the mosquito-borne JE virus, is a vaccine-preventable disease endemic to much of Asia. Travellers from non-endemic areas are susceptible if they travel to a JE endemic area. Although the risk to travellers of JE is low, the consequences may be severe. METHODS Here, we describe three cases of JE in British travellers occurring in 2014-15. In addition, we report, through interviews with survivors and their families, personal experiences of life after JE. RESULTS Three cases of JE were diagnosed in British travellers in 2014/15. One was acquired in Thailand, one in China and one in either Thailand, Laos or Cambodia. All three patients suffered severe, life-threatening illnesses, all were admitted to intensive care units and required medical evacuation back to the UK. One patient suffered a cardiac arrest during the acute stage but made a good recovery. The other two patients remain significantly paralysed and ventilator dependent. All three cases had clear indications for vaccination, and all have been left with life-changing neurological sequelae. CONCLUSIONS Travel health providers should be aware of the severity of JE, as well as the risk, allowing travellers to make fully informed decisions on JE vaccination.
Collapse
Affiliation(s)
- Lance Turtle
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Tropical & Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - Ava Easton
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Encephalitis Society, Malton, North Yorkshire, YO17 7DT, UK
| | - Sylviane Defres
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Tropical & Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - Mark Ellul
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| | - Begona Bovill
- Tropical and Infectious Diseases, North Bristol NHS Trust, Bristol, Southmead Road, Westbury-on-Trym, BS10 5NB, UK
| | - Jim Hoyle
- Neuro-Intensive Care Unit, Royal Hallamshire Hospital, Sheffield, Glossop Rd, S10 2JF, UK
| | - Agam Jung
- Leeds General Infirmary, Leeds, LS1 3EX, UK
| | - Penny Lewthwaite
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, Beckett Street, LS9 7TF, UK
| | - Tom Solomon
- Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, 8 West Derby Street, Liverpool, L69 7BE, UK.,Walton Centre NHS Foundation Trust, Liverpool, L9 7LJ, UK
| |
Collapse
|
4
|
Hills SL, Walter EB, Atmar RL, Fischer M. Japanese Encephalitis Vaccine: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2019; 68:1-33. [PMID: 31518342 PMCID: PMC6659993 DOI: 10.15585/mmwr.rr6802a1] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This report updates the 2010 recommendations from the CDC Advisory Committee on Immunization Practices (ACIP) regarding prevention of Japanese encephalitis (JE) among U.S. travelers and laboratory workers (Fischer M, Lindsey N, Staples JE, Hills S. Japanese encephalitis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010;59[No. RR-1]). The report summarizes the epidemiology of JE, describes the JE vaccine that is licensed and available in the United States, and provides recommendations for its use among travelers and laboratory workers.JE virus, a mosquitoborne flavivirus, is the most common vaccine-preventable cause of encephalitis in Asia. JE occurs throughout most of Asia and parts of the western Pacific. Approximately 20%-30% of patients die, and 30%-50% of survivors have neurologic, cognitive, or behavioral sequelae. No antiviral treatment is available.Inactivated Vero cell culture-derived JE vaccine (Ixiaro [JE-VC]) is the only JE vaccine that is licensed and available in the United States. In 2009, the U.S. Food and Drug Administration (FDA) licensed JE-VC for use in persons aged ≥17 years; in 2013, licensure was extended to include children aged ≥2 months.Most travelers to countries where the disease is endemic are at very low risk for JE. However, some travelers are at increased risk for infection on the basis of their travel plans. Factors that increase the risk for JE virus exposure include 1) traveling for a longer period; 2) travel during the JE virus transmission season; 3) spending time in rural areas; 4) participating in extensive outdoor activities; and 5) staying in accommodations without air conditioning, screens, or bed nets. All travelers to countries where JE is endemic should be advised to take precautions to avoid mosquito bites to reduce the risk for JE and other vectorborne diseases. For some persons who might be at increased risk for JE, the vaccine can further reduce the risk for infection. The decision about whether to vaccinate should be individualized and consider the 1) risks related to the specific travel itinerary, 2) likelihood of future travel to countries where JE is endemic, 3) high morbidity and mortality of JE, 4) availability of an effective vaccine, 5) possibility (but low probability) of serious adverse events after vaccination, and 6) the traveler's personal perception and tolerance of risk.JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (e.g., ≥1 month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (e.g., <1 month) travelers with an increased risk for JE on the basis of planned travel duration, season, location, activities, and accommodations and for travelers to JE-endemic areas who are uncertain about their specific travel duration, destinations, or activities. JE vaccine is not recommended for travelers with very low-risk itineraries, such as shorter-term travel limited to urban areas or outside of a well-defined JE virus transmission season.
Collapse
|
5
|
Boucher A, Herrmann JL, Morand P, Buzelé R, Crabol Y, Stahl JP, Mailles A. Epidemiology of infectious encephalitis causes in 2016. Med Mal Infect 2017; 47:221-235. [PMID: 28341533 DOI: 10.1016/j.medmal.2017.02.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 02/17/2017] [Indexed: 10/19/2022]
Abstract
We performed a literature search in the Medline database, using the PubMed website. The incidence of presumably infectious encephalitis is estimated at 1.5-7 cases/100,000 inhabitants/year, excluding epidemics. Infectious encephalitis and immune-mediated encephalitis share similar clinical signs and symptoms. The latter accounts for a significant proportion of presumably infectious encephalitis cases without any established etiological diagnosis; as shown from a prospective cohort study where 21% of cases were due to an immune cause. Several infectious agents are frequently reported in all studies: Herpes simplex virus (HSV) is the most frequent pathogen in 65% of studies, followed by Varicella-zoster virus (VZV) in several studies. Enteroviruses are also reported; being the most frequent viruses in two studies, and the 2nd or 3rd viruses in five other studies. There are important regional differences, especially in case of vector-borne transmission: Asia and the Japanese encephalitis virus, Eastern and Northern Europe/Eastern Russia and the tick-borne encephalitis virus, Northern America and Flavivirus or Alphavirus. Bacteria can also be incriminated: Mycobacterium tuberculosis and Listeria monocytogenes are the most frequent, after HSV and VZV, in a French prospective study. The epidemiology of encephalitis is constantly evolving. Epidemiological data may indicate the emergence and/or dissemination of new causative agents. The dissemination and emergence of causative agents are fostered by environmental, social, and economical changes, but prevention programs (vaccination, vector controls) help reduce the incidence of other infectious diseases and associated encephalitis (e.g., measles).
Collapse
Affiliation(s)
- A Boucher
- Maladies infectieuses, CHU de Lille, 59000 Lille, France
| | - J L Herrmann
- Microbiologie, CHU de Garches, 92380 Garches, France
| | - P Morand
- Virologie, CHU Grenoble Alpes, 38700 La Tronche, France
| | - R Buzelé
- Médecine interne, centre hospitalier de Saint-Brieuc, 22027 Saint-Brieuc, France
| | - Y Crabol
- Médecine interne, centre hospitalier Vannes-Aufray, 56000 Vannes, France
| | - J P Stahl
- Maladies infectieuses, CHU Grenoble Alpes, Grenoble - "European Study Group for the Infections of the Brain (ESGIB)", 38700 La Tronche, France.
| | - A Mailles
- Direction des maladies infectieuses, santé publique France - "European Study Group for the Infections of the Brain (ESGIB)", 94410 Saint-Maurice, France
| |
Collapse
|
6
|
Batchelor P, Petersen K. Japanese encephalitis: a review of clinical guidelines and vaccine availability in Asia. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2015; 1:11. [PMID: 28883942 PMCID: PMC5530929 DOI: 10.1186/s40794-015-0013-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 10/16/2015] [Indexed: 11/11/2022]
Abstract
Travelers to Asia are at risk for acquiring Japanese Encephalitis (JEV), an arbovirus with high rates of morbidity and mortality. Recent advances in vaccination resulting in vaccines with low rates of side effects have strengthened the rationale to vaccinate more travelers to this region, as reflected in many updated national guidelines for prevention of disease in travelers. Vaccines however still require a complex pre-travel schedule and are costly, often leading to a requirement or desire for a vaccination option in the destination country. We explore current national guidelines for prevention of Japanese Encephalitis and seek to provide information on availability of JEV vaccines in various Asian countries.
Collapse
Affiliation(s)
- Patricia Batchelor
- Australian Federal Police Medical Services, GPO Box 401, Canberra City, ACT 2601 Australia
| | - Kyle Petersen
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799 USA
| |
Collapse
|
7
|
Deshpande BR, Rao SR, Jentes ES, Hills SL, Fischer M, Gershman MD, Brunette GW, Ryan ET, LaRocque RC. Use of Japanese encephalitis vaccine in US travel medicine practices in Global TravEpiNet. Am J Trop Med Hyg 2014; 91:694-698. [PMID: 25070999 PMCID: PMC4183389 DOI: 10.4269/ajtmh.14-0062] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Regina C. LaRocque
- *Address correspondence to Regina C. LaRocque, Division of Infectious Diseases, GRJ 504, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail:
| | | |
Collapse
|
8
|
Wieten RW, van der Schalie M, Visser BJ, Grobusch MP, van Vugt M. Risk factors and pre-travel healthcare of international travellers attending a Dutch travel clinic: a cross-sectional analysis. Travel Med Infect Dis 2014; 12:511-24. [PMID: 25087666 DOI: 10.1016/j.tmaid.2014.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND The number of international travellers is currently estimated to exceed one billion annually. To address travel related health risks and facilitate risk reduction strategies, detailed knowledge of travellers' characteristics is important. METHOD In this cross-sectional study, data of a 20% sample of travellers visiting the Academic Medical Center (AMC) travel clinic Amsterdam from July 2011 to July 2012 was collected. Itineraries and protection versus exposure rates of preventable infectious diseases were mapped and reported according to STROBE guidelines. RESULTS 1749 travellers were included. South-Eastern Asia, South-America and West-Africa were most frequently visited. 26.2% of the population had pre-existing medical conditions (often cardiovascular). Young and VFR travellers had a longer median travel time (28 and 30 days) compared to the overall population (21 days). Young adult travellers were relatively often vaccinated against hepatitis B (43.9% vs. 20.5%, p < .001) and rabies (16.6% vs. 4.3%, p < .001). VFRs were less often vaccinated against hepatitis B (11.6% vs. 30.6%, p < .001) and rabies (1.3% vs. 9.0%, p .012) compared to non-VFR travellers. CONCLUSIONS Pre-travel guidelines were well adhered to. Young adult travellers had high-risk itineraries but were adequately protected. Improvement of hepatitis B and rabies protection would be desirable, specifically for VFRs.
Collapse
Affiliation(s)
- Rosanne W Wieten
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Maurice van der Schalie
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Benjamin J Visser
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1).
| | - Michèle van Vugt
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands(1)
| |
Collapse
|
9
|
Chin R, Torresi J. Japanese B Encephalitis: An Overview of the Disease and Use of Chimerivax-JE as a Preventative Vaccine. Infect Dis Ther 2013; 2:145-58. [PMID: 25134477 PMCID: PMC4108113 DOI: 10.1007/s40121-013-0018-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Indexed: 10/26/2022] Open
Abstract
The Japanese encephalitis virus (JEV) is endemic in many countries in southern Asia and the western Pacific Rim, with new spread to previously unrecognized countries. It is an important cause of childhood neurological disease associated with permanent neurological sequelae and death. Fortunately, JE is a vaccine-preventable disease. The ChimeriVax™-JE (Sanofi Pasteur, Lyon, France) is a live-attenuated chimeric vaccine derived from the live-attenuated yellow fever virus, YF17D, which expresses the envelope proteins of the attenuated JEV vaccine strain, SA14-14-2. It is a safe, well-tolerated vaccine that is highly immunogenic in adults and children. The average geometric mean neutralizing antibody titer (GMT) in adults is 1,392 and over 90% of adults remain seroprotected 5 years after vaccination. In children and toddlers, more than 80% remain seroprotected 2 years after primary vaccination and demonstrate a robust and durable anamnestic response (>500-fold rise in GMT) with 99.1% seroprotection rates 1 year after a booster vaccine dose. The ChimeriVax™-JE is effective in children living in endemic regions where the vaccine could possibly be integrated into existing childhood vaccination programs. ChimeriVax™-JE is also indicated for travelers at risk of JE infection.
Collapse
Affiliation(s)
- Ruth Chin
- Department of Medicine, Austin Hospital, University of Melbourne, Heidelberg, 3084, Australia
| | | |
Collapse
|
10
|
Torresi J, Johnson DF, Leder K. Response to letters. J Travel Med 2013; 20:409-10. [PMID: 24165388 DOI: 10.1111/jtm.12068_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Joseph Torresi
- Department of Infectious Diseases, Austin Hospital, Heidelberg, Victoria, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | | | | |
Collapse
|
11
|
Teitelbaum P. Probing guideline fundamentals: an alternate perspective on adherence. J Travel Med 2013; 20:146-7. [PMID: 23577859 DOI: 10.1111/jtm.12021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 01/16/2013] [Accepted: 01/21/2013] [Indexed: 11/27/2022]
|