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Baldwin Z, Hueston L, Roberts-Witteveen A, Stanley P, Sheel M, Winkler N, Koirala A, Macartney K, Case J, Hope K, Glasgow KM. The seroprevalence of antibodies to Japanese encephalitis virus in five New South Wales towns at high risk of infection, 2022: a cross-sectional serosurvey. Med J Aust 2024; 220:561-565. [PMID: 38815982 DOI: 10.5694/mja2.52320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/27/2023] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To determine the proportion of people in New South Wales towns at high risk of Japanese encephalitis virus (JEV) infections during the 2022 outbreak; to identify risk factors for JEV infection. STUDY DESIGN Cross-sectional serosurvey study of the seroprevalence of JEV-specific antibodies in NSW. SETTING, PARTICIPANTS Convenience sample of people (all ages) from five regional NSW towns deemed to be at high risk of JEV infections after first outbreak of Japanese encephalitis in southeastern Australia in early 2022 (Balranald, Corowa, Dubbo, Griffith, Temora), 21 June - 22 July 2022. MAIN OUTCOME MEASURES Proportion of people seropositive for JEV total antibody, assayed by defined epitope-blocking enzyme-linked immunosorbent assay; prevalence odds ratios for exposure risk factors and protective behaviours. RESULTS Eighty of 917 eligible participants (559 girls or women, 61%; 42 Aboriginal and Torres Strait Islander people, 4.6%; median age, 52 years [IQR, 37-62 years]) were seropositive for JEV-specific total antibody (8.7%); the median age of seropositive people was 61 years (IQR, 48-70 years). The seropositivity proportion was largest for people aged 65 years or more (30 of 192; weighted proportion, 13.7%) and larger for male than female participants (30 of 358, 10.6% v 50 of 559, 7.5%). Five of 42 samples from Aboriginal and Torres Strait Islander participants were seropositive (12%). We found mixed associations with a range of potential risk factors. CONCLUSION We found evidence for a substantial number of JEV infections in five regional NSW towns during a single arbovirus season in 2022. Public health responses, including effective surveillance, vaccination against JEV, and mosquito management, are critical for controlling outbreaks. Promoting behaviours that reduce exposure to mosquitoes is a core component of prevention, particularly when the vaccine supply is limited.
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Affiliation(s)
- Zoe Baldwin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Hunter New England Local Health District, Newcastle, NSW
| | - Linda Hueston
- CIDMLS Institute of Clinical Pathology and Medical Research, Sydney, NSW
| | | | | | - Meru Sheel
- Sydney School of Public Health, University of Sydney, Sydney, NSW
| | - Noni Winkler
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, NSW
| | - Archana Koirala
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, NSW
- Nepean Hospital, Nepean Blue Mountains Local Health District, Penrith, NSW
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, NSW
- The University of Sydney, Sydney, NSW
| | | | - Kirsty Hope
- New South Wales Department of Health, Sydney, NSW
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Kitro A, Imad HA, Pisutsan P, Matsee W, Sirikul W, Sapbamrer R, Rapheal E, Fernandez S, Cotrone TS, Farmer AR, Hunsawong T, Silachamroon U, Chatapat L, Olanwijitwong J, Salee P, Anderson KB, Piyaphanee W. Seroprevalence of dengue, Japanese encephalitis and Zika among long-term expatriates in Thailand. J Travel Med 2024; 31:taae022. [PMID: 38335250 DOI: 10.1093/jtm/taae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Travel to Southeast Asia increases the likelihood of acquiring mosquito-borne Flavivirus infections such as dengue (DENV), Japanese encephalitis (JEV) and Zika viruses (ZIKV). Expatriates are long-term travellers who have a higher risk of mosquito-borne illness at their destination country. The purpose of this study was to evaluate the seroprevalence of DENV, JEV and ZIKV infections and the determinants contributing to seropositivity among expatriates living in Thailand. METHODS A cross-sectional study was performed from December 2017 to February 2020. Expatriates from non-Flavivirus endemic countries were recruited. 5 mL of blood was collected for DENV 1-4, JEV and ZIKV antibody testing by plaque reduction neutralization test (PRNT50). Individuals with vaccination histories or diagnoses for dengue, Japanese encephalitis, yellow fever and tick-borne encephalitis were excluded. RESULTS Among 254 participants, most participants (83.1%) were male, the mean age was 65 years and the median duration of stay in Thailand was 6 years. Seroprevalence rate of any Flavivirus, non-specific DENV, DENV1-4, JEV and ZIKV were 34.3, 30.7, 20.5, 18.1, 18.9, 10.6, 4.7 and 2.8%, respectively. The presence of neutralizing antibodies against DENV1-4 positively correlates with the duration of stay in Thailand. DENV seropositivity was associated with living in urban areas (aOR 2.75, 95% CI 1.36-5.57). Expatriates were unlikely to have detectable anti-JEV antibodies regardless of time spent in a JEV-endemic area. No risk factors were identified that were significantly associated with JEV or ZIKV seropositivity. Only 48.4% received pre-travel counselling services, while only 18.9% visited a travel medicine specialist. CONCLUSIONS A high proportion (34.3%) of long-term expatriates living in Thailand were seropositive for flavivirus, mainly from dengue (30.7%). To minimize risk, travel medicine practitioners should provide adequate pre-travel health risk information on mosquito-borne flavivirus infection and offer advice on mosquito bite prevention strategies. Dengue vaccine might be considered in high-risk travellers such as long-term expatriate.
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Affiliation(s)
- Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Hisham Ahmed Imad
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Suita 565-0871, Japan
| | - Phimphan Pisutsan
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wasin Matsee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wachiranun Sirikul
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Center of Data Analytics and Knowledge Synthesis for Health Care, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Environmental and Occupational Medicine Excellence Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Erica Rapheal
- School of Public Health, University of Minnesota, Minnesota, MN 55414, USA
| | - Stefan Fernandez
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Thomas S Cotrone
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Aaron R Farmer
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Taweewun Hunsawong
- Department of Virology, US Army Medical Directorate of the Armed Force Research Institute of Medical Sciences, Bangkok 10400, Thailand
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Lapakorn Chatapat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Jutarmas Olanwijitwong
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Parichat Salee
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Kathryn B Anderson
- Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Microbiology and Immunology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Watcharapong Piyaphanee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Khan A, Riaz R, Nadeem A, Amir A, Siddiqui T, Batool UEA, Raufi N. Japanese encephlu emergence in Australia: the potential population at risk. Ann Med Surg (Lond) 2024; 86:1540-1549. [PMID: 38463109 PMCID: PMC10923274 DOI: 10.1097/ms9.0000000000001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Japanese encephalitis virus (JEV), an RNA virus transmitted by Culex mosquitoes, primarily cycles between aquatic birds and mosquitoes with pigs as amplifying hosts, posing a significant global encephalitis threat. The emergence and spread of the JEV in new epidemiological regions, such as recent cases in Australia and nonendemic areas like Pune, India, raise significant concerns. With an estimated 68 000 clinical cases and 13 600 to 20 400 deaths annually, JEV poses a substantial global health threat. The virus primarily affects children, with a case-fatality ratio of 20-30% and long-term neurological sequelae in survivors. The changing epidemiology, influenced by factors like bird migration, climate change, and increased urbanization, contributes to the geographic expansion of JEV. The recent outbreaks underscore the potential for the virus to establish itself in nonendemic regions, posing a threat to populations previously considered at low-risk. With limited treatment options and high rates of neurological complications, continued surveillance, traveler vaccination, and research into treatments are crucial to mitigate the impact of JEV on human health. The evolving scenario necessitates proactive measures to prevent and control the spread of the virus in both endemic and newly affected areas.
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Affiliation(s)
- Afsheen Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rumaisa Riaz
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdullah Nadeem
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Ayesha Amir
- Department of Surgery, Hamad Medical Corporation
| | - Tasmiyah Siddiqui
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Um e A. Batool
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nahid Raufi
- Department of Medicine, Kabul Medical University, Afghanistan
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Renard A, Pérez Lombardini F, Pacheco Zapata M, Porphyre T, Bento A, Suzán G, Roiz D, Roche B, Arnal A. Interaction of Human Behavioral Factors Shapes the Transmission of Arboviruses by Aedes and Culex Mosquitoes. Pathogens 2023; 12:1421. [PMID: 38133304 PMCID: PMC10746986 DOI: 10.3390/pathogens12121421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Arboviruses, i.e., viruses transmitted by blood-sucking arthropods, trigger significant global epidemics. Over the past 20 years, the frequency of the (re-)emergence of these pathogens, particularly those transmitted by Aedes and Culex mosquitoes, has dramatically increased. Therefore, understanding how human behavior is modulating population exposure to these viruses is of particular importance. This synthesis explores human behavioral factors driving human exposure to arboviruses, focusing on household surroundings, socio-economic status, human activities, and demographic factors. Household surroundings, such as the lack of water access, greatly influence the risk of arbovirus exposure by promoting mosquito breeding in stagnant water bodies. Socio-economic status, such as low income or low education, is correlated to an increased incidence of arboviral infections and exposure. Human activities, particularly those practiced outdoors, as well as geographical proximity to livestock rearing or crop cultivation, inadvertently provide favorable breeding environments for mosquito species, escalating the risk of virus exposure. However, the effects of demographic factors like age and gender can vary widely through space and time. While climate and environmental factors crucially impact vector development and viral replication, household surroundings, socio-economic status, human activities, and demographic factors are key drivers of arbovirus exposure. This article highlights that human behavior creates a complex interplay of factors influencing the risk of mosquito-borne virus exposure, operating at different temporal and spatial scales. To increase awareness among human populations, we must improve our understanding of these complex factors.
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Affiliation(s)
- Aubane Renard
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
| | - Fernanda Pérez Lombardini
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Mitsuri Pacheco Zapata
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Thibaud Porphyre
- Laboratoire de Biométrie et Biologie Évolutive, VetAgro Sup, Campus Vétérinaire de Lyon, 69280 Marcy-l’Etoile, France;
| | - Ana Bento
- Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA;
| | - Gerardo Suzán
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - David Roiz
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Benjamin Roche
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
| | - Audrey Arnal
- Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Institut de Recherche Pour le Développement (IRD), Centre National de la Recherche Scientifique (CNRS), Université de Montpellier, 34394 Montpellier, France; (A.R.); (D.R.); (B.R.)
- Fauna Silvestre y Animales de Laboratorio, Departamento de Etología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México (UNAM), Ciudad de México 04510, Mexico; (F.P.L.); (M.P.Z.); (G.S.)
- International Joint Laboratory IRD/UNAM ELDORADO (Ecosystem, Biological Diversity, Habitat Modifications, and Risk of Emerging Pathogens and Diseases in Mexico), Merida 97205, Mexico
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Lau CL, Mills DJ, Mayfield H, Gyawali N, Johnson BJ, Lu H, Allel K, Britton PN, Ling W, Moghaddam T, Furuya-Kanamori L. A decision support tool for risk-benefit analysis of Japanese encephalitis vaccine in travellers. J Travel Med 2023; 30:taad113. [PMID: 37602668 DOI: 10.1093/jtm/taad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND During pre-travel consultations, clinicians and travellers face the challenge of weighing the risks verus benefits of Japanese encephalitis (JE) vaccination due to the high cost of the vaccine, low incidence in travellers (~1 in 1 million), but potentially severe consequences (~30% case-fatality rate). Personalised JE risk assessment based on the travellers' demographics and travel itinerary is challenging using standard risk matrices. We developed an interactive digital tool to estimate risks of JE infection and severe health outcomes under different scenarios to facilitate shared decision-making between clinicians and travellers. METHODS A Bayesian network (conditional probability) model risk-benefit analysis of JE vaccine in travellers was developed. The model considers travellers' characteristics (age, sex, co-morbidities), itinerary (destination, departure date, duration, setting of planned activities) and vaccination status to estimate the risks of JE infection, the development of symptomatic disease (meningitis, encephalitis), clinical outcomes (hospital admission, chronic neurological complications, death) and adverse events following immunization. RESULTS In low-risk travellers (e.g. to urban areas for <1 month), the risk of developing JE and dying is low (<1 per million) irrespective of the destination; thus, the potential impact of JE vaccination in reducing the risk of clinical outcomes is limited. In high-risk travellers (e.g. to rural areas in high JE incidence destinations for >2 months), the risk of developing symptomatic disease and mortality is estimated at 9.5 and 1.4 per million, respectively. JE vaccination in this group would significantly reduce the risk of symptomatic disease and mortality (by ~80%) to 1.9 and 0.3 per million, respectively. CONCLUSION The JE tool may assist decision-making by travellers and clinicians and could increase JE vaccine uptake. The tool will be updated as additional evidence becomes available. Future work needs to evaluate the usability of the tool. The interactive, scenario-based, personalised JE vaccine risk-benefit tool is freely available on www.VaxiCal.com.
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Affiliation(s)
- Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Helen Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Brian J Johnson
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Hongen Lu
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Kasim Allel
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Philip N Britton
- Department of Infectious Diseases and Microbiology, Children's Hospital Westmead, Westmead, NSW, Australia
- Child and Adolescent Health and Sydney ID, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Weiping Ling
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Tina Moghaddam
- School of Information Technology and Electrical Engineering, Faculty of Science, The University of Queensland, St Lucia, QLD, Australia
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Zhang X, Jin N, Tu A, Dong M, Shi T, Ren X, Liu S, Zhao X, Liu J, Wu Z, Li Y, Wu D, Wang H, Wang H, Hu Y, Zhang B, Wang W, Meng L. Adults in Northwest China experienced the largest outbreak of Japanese encephalitis in history 10 years after the Japanese encephalitis vaccine was included in the national immunization program: A retrospective epidemiological study. J Med Virol 2023; 95:e28782. [PMID: 37212323 DOI: 10.1002/jmv.28782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023]
Abstract
Mainland China included Japanese encephalitis (JE) vaccine in the national immunization program in 2008 to control the JE epidemic. However, Gansu province in Western China experienced the largest JE outbreak since 1958 in 2018. We conducted a retrospective epidemiological study to explore the causes of this outbreak. We found that adults aged ≥20 years (especially those in rural areas) were the main JE cases in Gansu Province, with a significant increase in the JE incidence in older adults aged ≥60 years in 2017 and 2018. In addition, JE outbreaks in Gansu Province were mainly located in the southeastern region, while the temperature and precipitation in Gansu Province were gradually increasing in recent years, which made the JE epidemic areas in Gansu Province gradually spread to the western of Gansu Province. We also found that adults aged ≥20 years in Gansu Province had lower JE antibody positivity than children and infants, and the antibody positivity rate decreased with age. In the summer of 2017 and 2018, the density of mosquitoes (mainly the Culex tritaeniorhynchus) in Gansu Province was significantly higher than in other years, and the genotype of JEV was mainly Genotype-G1. Therefore, in the future JE control in Gansu Province, we need to strengthen JE vaccination for adults. Moreover, strengthening mosquito surveillance can provide early warning of JE outbreaks and the spread of epidemic areas in Gansu Province. At the same time, strengthening JE antibody surveillance is also necessary for JE control.
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Affiliation(s)
- Xiaoshu Zhang
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Na Jin
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Aixia Tu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Maoxing Dong
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Tianshan Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaowei Ren
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shuyu Liu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaohong Zhao
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jianfeng Liu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Zhao Wu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Yixing Li
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dan Wu
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanyu Wang
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijun Wang
- Department of Immunization Program, Longnan Center for Disease Control and Prevention, Longnan, China
| | - Yukun Hu
- Department of Immunization Program, Pingliang Center for Disease Control and Prevention, Pingliang, China
| | - Bin Zhang
- Department of Immunization Program, Tianshui Center for Disease Control and Prevention, Tianshui, China
| | - Wenjun Wang
- Department of Immunization Program, Qingyang Center for Disease Control and Prevention, Qingyang, China
| | - Lei Meng
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
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Maamary J, Maddocks S, Barnett Y, Wong S, Rodriguez M, Hueston L, Jeoffreys N, Eden JS, Dwyer DE, Floyd T, Plit M, Kok J, Brew B. New Detection of Locally Acquired Japanese Encephalitis Virus Using Clinical Metagenomics, New South Wales, Australia. Emerg Infect Dis 2023; 29:627-630. [PMID: 36823673 PMCID: PMC9973708 DOI: 10.3201/eid2903.220632] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In the context of an emerging Japanese encephalitis outbreak within Australia, we describe a novel locally acquired case in New South Wales. A man in his 70s had rapidly progressive, fatal meningoencephalitis, diagnosed as caused by Japanese encephalitis virus by RNA-based metagenomic next-generation sequencing performed on postmortem brain tissue.
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Zhang F, Xu G, Zhang X, Li Y, Li D, Wang C, Guo S. Clinical characteristics and short-term outcomes of Japanese encephalitis in pediatric and adult patients: a retrospective study in Northern China. Front Neurol 2023; 14:1135001. [PMID: 37153674 PMCID: PMC10160806 DOI: 10.3389/fneur.2023.1135001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/21/2023] [Indexed: 05/10/2023] Open
Abstract
Objective The study aimed to compare the clinical characteristics and short-term outcomes of pediatric and adult Japanese encephalitis (JE) patients in order to find out the differences. Methods From August 2006 to October 2019, 107 patients (62 pediatric patients and 45 adult patients) with JE were enrolled. Clinical characteristics and short-term outcomes were analyzed. The short-term outcome of each patient was defined as a good outcome or poor outcome according to their Glasgow Coma Scale (GCS) scores (GCS > 8 vs. GCS ≤ 8) at discharge. Results As for acute complications, the incidence of pulmonary infection was higher in 25 adults (25/45, 55.6%) than in 19 children (19/62, 30.6%; P = 0.01). Upper gastrointestinal bleeding was more common in patients with pulmonary infection, with 10 of these patients experiencing the symptom (10/44, 22.7%) compared to only one patient without pulmonary infection (1/63, 1.6%; P = 0.001). The proportion of mechanical ventilation and admission to the intensive care unit (ICU) for supportive care was higher in patients with pulmonary infection than in patients without infection (P < 0.001, P = 0.008, respectively). The GCS scores at discharge in patients with pulmonary infection (7, 4-12.75) were lower than in patients without pulmonary infection (14, 10-14; P < 0.001). Although the GCS scores at the admission of children (9.5, 7-13) were similar to that of adults (7, 6-13), the GCS scores at the discharge of adults (7, 3.5-13) were lower than that of children (13, 10.75-14; P < 0.001). Conclusion The short-term outcome of JE was worse in adults. Pulmonary infection was correlated with a high incidence of upper gastrointestinal bleeding, mechanical ventilation, and ICU hospitalization in JE. Pulmonary infection is a prognostic predictor of short-term outcomes in patients with JE. Vaccination for adults should be initiated.
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Affiliation(s)
- Fangyuan Zhang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Guangyin Xu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
| | - Xiaoyu Zhang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yue Li
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
| | - Dong Li
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Chunjuan Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Chunjuan Wang
| | - Shougang Guo
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- *Correspondence: Shougang Guo
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9
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Preethi L, Alina MS, Chandran L, Asvin S, Jagadeesan M, Vijayakumar TM, Chitra V, Pandey AK, Reddy MM, Misra BR, Kant R, Bhukya PL, Deshpande GR, Abraham P, Sapkal G, Zaman K. Duration of Seroprotection of the live attenuated SA-14-14-2 Japanese encephalitis vaccine in children in India. J Travel Med 2022; 30:6887153. [PMID: 36495206 DOI: 10.1093/jtm/taac147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Acute encephalitis syndrome (AES) is a major public health concern in India and the Japanese Encephalitis (JE) Virus is the most common cause of viral encephalitis in Asia affecting children under the age of 15 years. In India, despite the introduction of the JE vaccine (SA-14-14-2) in the immunization programme, JE continues to account for 15-20% of AES cases to date. The present study evaluates the immunogenicity of live attenuated SA-14-14-2 JE vaccine in terms of persistence of the humoral response after two doses. METHODS A cross-sectional study was conducted among 266 children belonging to one of the JE endemic regions of Uttar Pradesh, India. Blood samples were taken from children (2-10 years) and grouped according to the duration (in years) after two doses of the vaccine (five groups with a class interval of two years). Informed written consent was obtained from the parents/guardians. All the samples collected were tested for the presence of anti-JEV-specific IgG antibodies by enzyme-linked immunosorbent assay (ELISA) and further confirmed by micro neutralization test (MNT) and immunofluorescence assays. RESULTS Of the 266 samples tested by ELISA for anti-JEV-specific IgG antibodies, 260 (97.74%) were negative and six (2.26%) were equivocal. The geometric mean immune status ratio across the five groups, 0-2 years (n = 59), 2-4 years (n = 73), 4-6 years (n = 65), 6-8 years (n = 48) and 8-10 years (n = 21) post two doses of SA-14-14-2 JE vaccine was 1.143, 1.059, 1.138, 1.075 and 1.130 respectively and the geometric mean titre (GMT) obtained from MNT across the five groups were 10.77, 8.400, 8.453, 9.517 and 9.674 respectively. CONCLUSION The study showed a decreasing trend of anti-JEV specific IgG antibody titers across the five groups based on the duration following two doses of SA-14-14-2 vaccine. The results emphasize the significance of booster doses of vaccine for children living in endemic areas.
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Affiliation(s)
- L Preethi
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - M S Alina
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - Lakshmi Chandran
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - S Asvin
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - M Jagadeesan
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - T M Vijayakumar
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - V Chitra
- Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - Ashok Kumar Pandey
- ICMR- Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), India
| | - Mahendra M Reddy
- ICMR- Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), India
| | - Brij Ranjan Misra
- ICMR- Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), India
| | - Rajni Kant
- ICMR- Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), India
| | - Prudhvi Lal Bhukya
- ICMR- National Animal Resource Facility for Bio-medical Research Hyderabad (ICMR-NARFBR, Hyderabad), India
| | | | - Priya Abraham
- ICMR- National Institute of Virology Pune (ICMR-NIV Pune), India
| | - Gajanan Sapkal
- ICMR- National Institute of Virology Pune (ICMR-NIV Pune), India
| | - Kamran Zaman
- ICMR- Regional Medical Research Centre Gorakhpur (ICMR-RMRC Gorakhpur), India.,ICMR- National Institute of Traditional Medicine Belagavi (ICMR-NITM Belagavi), India
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10
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Diptyanusa A, Herini ES, Indarjulianto S, Satoto TBT. Estimation of Japanese encephalitis virus infection prevalence in mosquitoes and bats through nationwide sentinel surveillance in Indonesia. PLoS One 2022; 17:e0275647. [PMID: 36223381 PMCID: PMC9555671 DOI: 10.1371/journal.pone.0275647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 09/11/2022] [Indexed: 11/26/2022] Open
Abstract
Indonesia belongs to endemic areas of Japanese encephalitis (JE), yet data regarding the true risk of disease transmission are lacking. While many seroprevalence studies reported its classic enzootic transmission, data related to the role of bats in the transmission of JE virus are limited. This current study aimed to identify the potential role of bats in the local transmission of the JE virus to aid the ongoing active case surveillance in Indonesia, in order to estimate the transmission risk. Mosquitoes and bats were collected from 11 provinces in Indonesia. The detection of the JE virus used polymerase chain reaction (PCR). Maps were generated to analyze the JE virus distribution pattern. Logistic regression analysis was done to identify risk factors of JE virus transmission. JE virus was detected in 1.4% (7/483) of mosquito pools and in 2.0% (68/3,322) of bat samples. Mosquito species positive for JE virus were Culex tritaeniorhynchus and Cx. vishnui, whereas JE-positive bats belonged to the genera Cynopterus, Eonycteris, Hipposideros, Kerivoula, Macroglossus, Pipistrellus, Rousettus, Scotophilus and Thoopterus. JE-positive mosquitoes were collected at the same sites as the JE-positive bats. Collection site nearby human dwellings (AOR: 2.02; P = 0.009) and relative humidity of >80% (AOR: 2.40; P = 0.001) were identified as independent risk factors for JE virus transmission. The findings of the current study highlighted the likely ongoing risk of JE virus transmission in many provinces in Indonesia, and its potential implications on human health.
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Affiliation(s)
- Ajib Diptyanusa
- Doctoral Study Program of Health and Medical Sciences, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- World Health Organization Indonesia Country Office, Jakarta, Indonesia
| | - Elisabeth Siti Herini
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Soedarmanto Indarjulianto
- Department of Internal Medicine, Faculty of Veterinary Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tri Baskoro Tunggul Satoto
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- * E-mail:
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11
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Sahu RC, Suthar T, Pathak A, Jain K. Interventions for the Prevention and Treatment of Japanese Encephalitis. Curr Infect Dis Rep 2022; 24:189-204. [PMID: 36187900 PMCID: PMC9510552 DOI: 10.1007/s11908-022-00786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 11/04/2022]
Abstract
Purpose of Review Japanese encephalitis (JE), a clinical indication of JE virus–induced brain inflammation, is the most prevalent cause of viral encephalitis in the world. This review gives a comprehensive update on the epidemiology, clinical features, therapeutic trials and approaches for preventing the spread of JE. It also outlines the different JE vaccines used in various countries and recommendations for administration of JE vaccines. Recent Findings According to the WHO, annual incidence of JE is estimated to be approximately 68,000 cases worldwide. It is widespread across Asia–Pacific, with a potential for worldwide transmission. In endemic locations, JE is believed to affect children below 6 years of age, but in newly affected areas, both adults and children are at risk due to a lack of protective antibodies. Various vaccines have been developed for the prevention of JE and are being administered in endemic countries. Summary JE is a neuroinvasive disease that causes symptoms ranging from simple fever to severe encephalitis and death. Despite a vast number of clinical trials on various drugs, there is still no complete cure available, and it can only be prevented by adequate vaccination. Various nanotechnological approaches for the prevention and treatment of JE are outlined in this review.
Supplementary Information The online version contains supplementary material available at 10.1007/s11908-022-00786-1.
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12
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Sudjaritruk T, Kaewpoowat Q, Prasarakee C, Sarachai S, Taurel AF, Sricharoen N, Assawawongprom P, Saheng J, Harris R, Nealon J, Yoksan S. Seroepidemiological study of Japanese encephalitis virus in Chiang Mai: Immunity and susceptibility 28 years after introduction of a vaccination programme. PLoS Negl Trop Dis 2022; 16:e0010674. [PMID: 35913983 PMCID: PMC9371339 DOI: 10.1371/journal.pntd.0010674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/11/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Thailand has introduced a nationwide vaccination against Japanese encephalitis virus (JEV) into National Immunization Programme since the 1990’s. To improve the understanding of immunity and susceptibility of the population after 28 years of a vaccination programme, we conducted a JEV seroepidemiological study in a JEV-endemic area of Thailand.
Methods
An age-stratified, population-based, seroepidemiological study was conducted in Chiang Mai, Thailand–a northern Thai province where is an endemic area of Japanese encephalitis. Nine districts were chosen based on administrative definition: rural (n = 3); urban (n = 3); and peri-urban (n = 3). Within each district, eligible participants were randomly selected from 3 age groups: adolescents (10–20 years); adults (21–50 years); and older adults/elderly (≥51 years) by computer randomization. Plaque reduction neutralization tests (PRNT50 and PRNT90) were performed to measure neutralizing antibodies to JEV. To account for the cross-reactivity of JEV and other flaviviruses, JEV seroprotection was defined according to age, previous history of JEV vaccination, and PRNT50/PRNT90 levels of study participants.
Results
Overall, 279 adolescents, 297 adults, and 297 older adults/elderly were enrolled from nine districts. Age-stratified, protocol-defined, cluster-adjusted JEV seroprotection rates were 61% (95% CI: 48–73%), 43% (95% CI: 31–57%), and 52% (95% CI: 37–67%) for adolescents, adults, and older adults/elderly, respectively. Living in peri-urban districts, having a history of prior dengue virus infection, and previously receiving mouse brain-derived JEV vaccine were significantly associated with seroprotection to JEV in adolescents. Older age and male sex were associated with seroprotection for adults; and only male sex was the associated factor for older adults/elderly (P <0.05).
Conclusions
Approximately half of population living in a JEV-endemic area demonstrated seroprotection to JEV. Ongoing nationwide surveillance on JEV seropepidemiology is an important strategy to understand the evolving population-level immunity to JEV, and to help formulating the appropriate recommendations on JE immunization.
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Affiliation(s)
- Tavitiya Sudjaritruk
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- * E-mail:
| | - Quanhathai Kaewpoowat
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanidapa Prasarakee
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Saowalak Sarachai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Natthanidnan Sricharoen
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jutamad Saheng
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rebecca Harris
- Vaccine Epidemiology and Modeling Department, Sanofi, Singapore
| | - Joshua Nealon
- Vaccine Epidemiology and Modeling Department, Sanofi, Singapore
| | - Sutee Yoksan
- Center for Vaccine Development, Institute of Molecular Biosciences, Mahidol University, Bangkok, Thailand
- Chulabhorn Research Institute, Bangkok, Thailand
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13
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Liu J, Jing W, Fang Y, He X, Chen G, Jia H, Wang J, Jing Z. The Infection of the Japanese Encephalitis Virus SA14-14-2 Strain Induces Lethal Peripheral Inflammatory Responses in IFNAR Deficiency Mice. Front Microbiol 2022; 12:823825. [PMID: 35310394 PMCID: PMC8928384 DOI: 10.3389/fmicb.2021.823825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 12/30/2021] [Indexed: 11/21/2022] Open
Abstract
The Japanese encephalitis virus (JEV) is a leading cause of mosquito-borne viral encephalitis worldwide. Clinical symptoms other than encephalitis, on the other hand, are substantially more prevalent with JEV infection, demonstrating the relevance of peripheral pathophysiology. We studied the peripheral immunopathogenesis of JEV using IFNAR deficient (IFNAR–/–) mice infected with the SA14-14-2 strain under the BSL-2. The body weight and survival rate of infected-IFNAR–/–mice decreased significantly. Infected-IFNAR–/–mice’s liver and spleen demonstrated obvious tissue damage and inflammatory cell infiltration. There was also extensive viral replication in the organs. IFN-α/β protein expression was dramatically elevated in peripheral tissues and serum, although the related interferon-stimulated genes (ISGs) remained low in the spleen and liver of infected-IFNAR–/–animals. Consistently, the differentially expressed genes (DEGs) analysis using RNA-sequencing of spleens showed inflammatory cytokines upregulation, such as IL-6, TNF-α, and MCP-1, and IFN-γ associated cytokine storm. The infiltration of macrophages and neutrophils in the spleen and liver of SA14-14-2-infected IFNAR–/– mice was dramatically elevated. However, there was no significant difference in tissue damage, viral multiplication, or the production of IFNα/β and inflammatory cytokines in the brain. Infection with the JEV SA14-14-2 strain resulted in a lethal peripheral inflammatory response and organ damage without encephalitis in IFNAR–/– mice. Our findings may help shed light on the peripheral immunopathogenesis associated with clinical JEV infection and aid in developing treatment options.
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Affiliation(s)
- Juan Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Wenxian Jing
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Yongxiang Fang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Xiaobing He
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Guohua Chen
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Huaijie Jia
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Jingyu Wang
- College of Veterinary Medicine, Northwest A&F University, Yangling, China
- *Correspondence: Jingyu Wang,
| | - Zhizhong Jing
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of Agriculture Ministry Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Zhizhong Jing,
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14
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Park SE. Importance of maintaining a high childhood vaccination rate and surveillance program against Japanese encephalitis in Korea. Clin Exp Pediatr 2022; 65:127-128. [PMID: 35176836 PMCID: PMC8898613 DOI: 10.3345/cep.2021.01557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/25/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Su Eun Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
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15
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Li X, Li J, Wu G, Wang M, Jing Z. Detection of Japanese Encephalitis by Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid: A Case Report and Literature Review. Front Cell Neurosci 2022; 16:856512. [PMID: 35250491 PMCID: PMC8892252 DOI: 10.3389/fncel.2022.856512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 12/28/2022] Open
Abstract
Japanese encephalitis (JE) is an acute viral central nervous system disease, although less than 1% of patients infected with Japanese encephalitis virus (JEV) result in JE, which has an extremely poor prognosis. The Routine detection methods for JEV are time-consuming or limited by hospital conditions, therefore, need the quicker and sensitive techniques to detect JEV. Here, we reported a 14-year-old female who was admitted to our hospital with a severe fever, progressively headache and unconsciousness. Based on the clinical presentation, Preliminary diagnosis on admission indicated central nervous system infection of suspected viral meningoencephalitis or autoimmune encephalitis. The patient's symptoms were unrelieved after being treated with empiric antiviral therapy. Magnetic resonance imaging (MRI) showed that the lesions were located in the bilateral thalamus, head of caudate nucleus, and right lenticular nucleus, so we had to consider the possibility of Flaviviruses infection. We sent the cerebrospinal fluid (CSF) for metagenomic next-generation sequencing (mNGS) immediately, subsequent result suggested the infection caused by JEV. Two days later the results of the serum agglutination test confirmed that virus immunoglobulin M antibody positive. After a week treatment with intravenous immunoglobulin (IVIG), meanwhile, the lumbar puncture was used to check the pressure and various indicators of the CSF again to evaluate the treatment effect, An decrease in the number of WBC indicates, protein and unique RNA reads that the previous experimental treatment was effective, accompany by temperature and consciousness of the patient was normalized. Two weeks after admission, the patient was transferred to the rehabilitation hospital, MR showed the lesions had disappeared completely after 2 months of follow-up. We believed that mNGS may be an effective method for rapid identification of JE.
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Affiliation(s)
- Xin Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jing Li
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Guode Wu
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
| | - Manxia Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
- *Correspondence: Manxia Wang
| | - Zhang Jing
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
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16
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Novel reverse genetics of genotype I and III Japanese encephalitis viruses assembled through transformation associated recombination in yeast: The reporter viruses expressing a green fluorescent protein for the antiviral screening assay. Antiviral Res 2022; 197:105233. [DOI: 10.1016/j.antiviral.2021.105233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/22/2021] [Accepted: 12/26/2021] [Indexed: 11/24/2022]
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17
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Japanese Encephalitis Virus NS1' Protein Interacts with Host CDK1 Protein to Regulate Antiviral Response. Microbiol Spectr 2021; 9:e0166121. [PMID: 34756071 PMCID: PMC8579942 DOI: 10.1128/spectrum.01661-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Type I interferon (IFN-I) is a key component of the host innate immune system. To establish efficient replication, viruses have developed several strategies to escape from the host IFN response. Japanese encephalitis virus (JEV) NS1', a larger NS1-related protein, is known to inhibit the mitochondrial antiviral signaling (MAVS)-mediated IFN-β induction by increasing the binding of transcription factors (CREB and c-Rel) to the microRNA 22 (miRNA-22) promoter. However, the mechanism by which NS1' induces the recruitment of CREB and c-Rel onto the miRNA-22 promoter is unknown. Here, we found that JEV NS1' protein interacts with the host cyclin-dependent kinase 1 (CDK1) protein. Mechanistically, NS1' interrupts the CDC25C phosphatase-mediated dephosphorylation of CDK1, which prolongs the phosphorylation status of CDK1 and leads to the inhibition of MAVS-mediated IFN-β induction. Furthermore, the CREB phosphorylation and c-Rel activation through the IκBα phosphorylation were observed to be enhanced upon the augmentation of CDK1 phosphorylation by NS1'. The abrogation of CDK1 activity by a small-molecule inhibitor significantly suppressed the JEV replication in vitro and in vivo. Moreover, the administration of CDK1 inhibitor protected the wild-type mice from JEV-induced lethality but showed no effect on the MAVS-/- mice challenged with JEV. In conclusion, our study provides new insight into the mechanism of JEV immune evasion, which may lead to the development of novel therapeutic options to treat JEV infection. IMPORTANCE Japanese encephalitis virus (JEV) is the main cause of acute human encephalitis in Asia. The unavailability of specific treatment for Japanese encephalitis demands a better understanding of the basic cellular mechanisms that contribute to the onset of disease. The present study identifies a novel interaction between the JEV NS1' protein and the cellular CDK1 protein, which facilitates the JEV replication by dampening the cellular antiviral response. This study sheds light on a novel mechanism of JEV replication, and thus our findings could be employed for developing new therapies against JEV infection.
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18
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An Advax-Adjuvanted Inactivated Cell-Culture Derived Japanese Encephalitis Vaccine Induces Broadly Neutralising Anti-Flavivirus Antibodies, Robust Cellular Immunity and Provides Single Dose Protection. Vaccines (Basel) 2021; 9:vaccines9111235. [PMID: 34835166 PMCID: PMC8618450 DOI: 10.3390/vaccines9111235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/16/2021] [Accepted: 10/19/2021] [Indexed: 01/24/2023] Open
Abstract
ccJE+Advax is an inactivated cell culture Japanese encephalitis (JE) vaccine formulated with Advax, a novel polysaccharide adjuvant based on delta inulin. This vaccine has previously shown promise in murine and equine studies and the current study sought to better understand its mechanism of action and assess the feasibility of single dose vaccine protection. Mice immunised with ccJE+Advax had higher serum neutralisation titres than those immunised with ccJE alone or with alum adjuvant. ccJE+Advax induced extraordinarily broad cross-neutralising antibodies against multiple flaviviruses including West Nile virus (WNV), Murray Valley encephalitis virus (MVEV), St Louis encephalitis virus (SLEV) and Dengue virus-1 and -2 (DENV-1 and -2). Notably, the DENV-2 cross-neutralising antibodies from ccJE+Advax immunised mice uniquely had no DENV-2 antibody-dependent infection enhancement (ADIE) activity, in contrast to high ADIE activity seen with DENV-1 cross-reactive antibodies induced by mbJE or ccJE alone or with alum adjuvant. JEV-stimulated splenocytes from ccJE+Advax immunised mice showed increased IL-17 and IFN-γ production, consistent with a mixed Th1 and Th17 response, whereas ccJE-alum was associated with production of mainly Th2 cytokines. In a mouse lethal challenge study against highly virulent JaTH160 JEV strain, ccJE+Advax conferred complete protection in a two-dose schedule with 50 ng of vaccine antigen and near complete protection after a single 200 ng dose of vaccine antigen. There is an ongoing lack of human vaccines against particular flaviviruses, including WNV, SLEV and MVEV. Given its ability to provide single-dose JEV protection and induce broadly neutralising antibodies devoid of ADIE activity, ccJE+Advax vaccine could be useful in situations where rapid protection is desirable, e.g., during a local outbreak or for use in travellers or armies requiring rapid deployment to JEV endemic regions.
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19
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Diptyanusa A, Herini ES, Indarjulianto S, Satoto TBT. The detection of Japanese encephalitis virus in Megachiropteran bats in West Kalimantan, Indonesia: A potential enzootic transmission pattern in the absence of pig holdings. INTERNATIONAL JOURNAL FOR PARASITOLOGY-PARASITES AND WILDLIFE 2021; 14:280-286. [PMID: 33898229 PMCID: PMC8056122 DOI: 10.1016/j.ijppaw.2021.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
The West Kalimantan province in Borneo island, Indonesia belongs to endemic area of Japanese encephalitis (JE) that accounts for approximately 30% of total cases yearly. As the presence of pig holdings is uncommon in West Kalimantan, another reservoir host might have played a role in the local transmission of JE virus in this area. Current study aimed to identify the potential role of bats in the local transmission of JE by performing molecular detection of JE virus in bats and mosquitoes using RT-PCR. Sample collection was performed in 3 districts in West Kalimantan, covering 3 different ecosystems: forest, coastal, and residential areas. Bat collection was performed using mist net and harp net, while mosquito collection was carried out using animal-baited trap and human landing collection. A total of 373 blood samples from bats were tested for JE virus, among which 21 samples (5.6%) showed positive results, mainly from Cynopterus brachyotis (lesser short-nosed fruit bat) found in residential areas. Out of 53 mosquito pools, 3 JE-positive pools of Culex tritaeniorhynchus and Cx. vishnui were collected at the same location as JE-positive bats. Current study showed the first evidence of JE virus detection in several species of Megachiropteran bats in Indonesia, demonstrated the potential role of frugivorous bats in local transmission of JE in West Kalimantan. More aggressive measures are required in JE risk mitigation, particularly in initiating JE vaccination campaign and in avoiding disruption of bats’ natural habitats through changes in land-use. First evidence of JE virus detection in Megachiropteran bats in Indonesia. Molecular detection of JE virus using RT-PCR instead of using antibodies. Collection of JE-positive bats and mosquitoes at the same site. Involvement of bats in JE transmission cycle in the absence of pig holdings.
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Affiliation(s)
- Ajib Diptyanusa
- Doctoral Study Program of Health and Medical Sciences, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia.,Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Elisabeth Siti Herini
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | | | - Tri Baskoro Tunggul Satoto
- Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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Ashraf U, Ding Z, Deng S, Ye J, Cao S, Chen Z. Pathogenicity and virulence of Japanese encephalitis virus: Neuroinflammation and neuronal cell damage. Virulence 2021; 12:968-980. [PMID: 33724154 PMCID: PMC7971234 DOI: 10.1080/21505594.2021.1899674] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Thousands of human deaths occur annually due to Japanese encephalitis (JE), caused by Japanese encephalitis virus. During the virus infection of the central nervous system, reactive gliosis, uncontrolled inflammatory response, and neuronal cell death are considered as the characteristic features of JE. To date, no specific treatment has been approved to overcome JE, indicating a need for the development of novel therapies. In this article, we focused on basic biological mechanisms in glial (microglia and astrocytes) and neuronal cells that contribute to the onset of neuroinflammation and neuronal cell damage during Japanese encephalitis virus infection. We also provided comprehensive knowledge about anti-JE therapies tested in clinical or pre-clinical settings, and discussed recent therapeutic strategies that could be employed for JE treatment. The improved understanding of JE pathogenesis might lay a foundation for the development of novel therapies to halt JE. Abbreviations AKT: a serine/threonine-specific protein kinase; AP1: activator protein 1; ASC: apoptosis-associated speck-like protein containing a CARD; ASK1: apoptosis signal-regulated kinase 1; ATF3/4/6: activating transcription factor 3/4/6; ATG5/7: autophagy-related 5/7; BBB: blood-brain barrier; Bcl-3/6: B-cell lymphoma 3/6 protein; CCL: C-C motif chemokine ligand; CCR2: C-C motif chemokine receptor 2; CHOP: C/EBP homologous protein; circRNA: circular RNA; CNS: central nervous system; CXCL: C-X-C motif chemokine ligand; dsRNA: double-stranded RNA; EDEM1: endoplasmic reticulum degradation enhancer mannosidase alpha-like 1; eIF2-ɑ: eukaryotic initiation factor 2 alpha; ER: endoplasmic reticulum; ERK: extracellular signal-regulated kinase; GRP78: 78-kDa glucose-regulated protein; ICAM: intercellular adhesion molecule; IFN: interferon; IL: interleukin; iNOS: inducible nitric oxide synthase; IRAK1/2: interleukin-1 receptor-associated kinase 1/2; IRE-1: inositol-requiring enzyme 1; IRF: interferon regulatory factor; ISG15: interferon-stimulated gene 15; JE: Japanese encephalitis; JEV: Japanese encephalitis virus; JNK: c-Jun N-terminal kinase; LAMP2: lysosome-associated membrane protein type 2; LC3-I/II: microtubule-associated protein 1 light chain 3-I/II; lncRNA: long non-coding RNA; MAPK: mitogen-activated protein kinase; miR/miRNA: microRNA; MK2: mitogen-activated protein kinase-activated protein kinase 2; MKK4: mitogen-activated protein kinase kinase 4; MLKL: mixed-linage kinase domain-like protein; MMP: matrix metalloproteinase; MyD88: myeloid differentiation factor 88; Nedd4: neural precursor cell-expressed developmentally downregulated 4; NF-κB: nuclear factor kappa B; NKRF: nuclear factor kappa B repressing factor; NLRP3: NLR family pyrin domain containing 3; NMDAR: N-methyl-D-aspartate receptor; NO: nitric oxide; NS2B/3/4: JEV non-structural protein 2B/3/4; P: phosphorylation. p38: mitogen-activated protein kinase p38; PKA: protein kinase A; PAK4: p21-activated kinase 4; PDFGR: platelet-derived growth factor receptor; PERK: protein kinase R-like endoplasmic reticulum kinase; PI3K: phosphoinositide 3-kinase; PTEN: phosphatase and tensin homolog; Rab7: Ras-related GTPase 7; Raf: proto-oncogene tyrosine-protein kinase Raf; Ras: a GTPase; RIDD: regulated IRE-1-dependent decay; RIG-I: retinoic acid-inducible gene I; RIPK1/3: receptor-interacting protein kinase 1/3; RNF11/125: RING finger protein 11/125; ROS: reactive oxygen species; SHIP1: SH2-containing inositol 5ʹ phosphatase 1; SOCS5: suppressor of cytokine signaling 5; Src: proto-oncogene tyrosine-protein kinase Src; ssRNA = single-stranded RNA; STAT: signal transducer and activator of transcription; TLR: toll-like receptor; TNFAIP3: tumor necrosis factor alpha-induced protein 3; TNFAR: tumor necrosis factor alpha receptor; TNF-α: tumor necrosis factor-alpha; TRAF6: tumor necrosis factor receptor-associated factor 6; TRIF: TIR-domain-containing adapter-inducing interferon-β; TRIM25: tripartite motif-containing 25; VCAM: vascular cell adhesion molecule; ZO-1: zonula occludens-1.
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Affiliation(s)
- Usama Ashraf
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, Hubei, P. R. China.,The Cooperative Innovation Center for Sustainable Pig Production, Huazhong Agricultural University, Wuhan, Hubei, P. R. China
| | - Zhen Ding
- Department of Preventive Veterinary Medicine, College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang, Jiangxi, P. R. China.,Key Laboratory for Animal Health of Jiangxi Province, Nanchang, Jiangxi, P. R. China
| | - Shunzhou Deng
- Department of Preventive Veterinary Medicine, College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang, Jiangxi, P. R. China.,Key Laboratory for Animal Health of Jiangxi Province, Nanchang, Jiangxi, P. R. China
| | - Jing Ye
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, Hubei, P. R. China.,The Cooperative Innovation Center for Sustainable Pig Production, Huazhong Agricultural University, Wuhan, Hubei, P. R. China
| | - Shengbo Cao
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, Hubei, P. R. China.,The Cooperative Innovation Center for Sustainable Pig Production, Huazhong Agricultural University, Wuhan, Hubei, P. R. China
| | - Zheng Chen
- Department of Preventive Veterinary Medicine, College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang, Jiangxi, P. R. China.,Key Laboratory for Animal Health of Jiangxi Province, Nanchang, Jiangxi, P. R. China
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Carro SD, Cherry S. Beyond the Surface: Endocytosis of Mosquito-Borne Flaviviruses. Viruses 2020; 13:E13. [PMID: 33374822 PMCID: PMC7824540 DOI: 10.3390/v13010013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/16/2020] [Accepted: 12/19/2020] [Indexed: 02/06/2023] Open
Abstract
Flaviviruses are a group of positive-sense RNA viruses that are primarily transmitted through arthropod vectors and are capable of causing a broad spectrum of diseases. Many of the flaviviruses that are pathogenic in humans are transmitted specifically through mosquito vectors. Over the past century, many mosquito-borne flavivirus infections have emerged and re-emerged, and are of global importance with hundreds of millions of infections occurring yearly. There is a need for novel, effective, and accessible vaccines and antivirals capable of inhibiting flavivirus infection and ameliorating disease. The development of therapeutics targeting viral entry has long been a goal of antiviral research, but most efforts are hindered by the lack of broad-spectrum potency or toxicities associated with on-target effects, since many host proteins necessary for viral entry are also essential for host cell biology. Mosquito-borne flaviviruses generally enter cells by clathrin-mediated endocytosis (CME), and recent studies suggest that a subset of these viruses can be internalized through a specialized form of CME that has additional dependencies distinct from canonical CME pathways, and antivirals targeting this pathway have been discovered. In this review, we discuss the role and contribution of endocytosis to mosquito-borne flavivirus entry as well as consider past and future efforts to target endocytosis for therapeutic interventions.
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Affiliation(s)
| | - Sara Cherry
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
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23
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Adults with severe Japanese encephalitis: a retrospective analysis of 9 cases in Linyi, China. Neurol Sci 2020; 42:2811-2817. [PMID: 33169192 PMCID: PMC7652048 DOI: 10.1007/s10072-020-04867-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/27/2020] [Indexed: 01/17/2023]
Abstract
Objective Japanese encephalitis (JE) is a critical problem of public health worldwide; however, there is limited data about the clinical features and indicators of outcome in adults with severe Japanese encephalitis. Methods The clinical manifestations and laboratory study on brain neuroimaging of patients with severe JE were statistically analyzed retrospectively. All patients were followed up for 6 months after discharge. The patients were grouped into good outcome and poor outcome according to the results of the follow-up. Results This retrospective study consists of 9 adults with severe JE, including 5 cases with poor outcome, defined as the modified Rankin Scale (mRS) scores of greater than or equal to 4 points, and remained ventilator dependent. Typical clinical manifestations of JE include fever (100%), altered consciousness (100%), headache (66.7%), flaccid weakness (66.7%), and status epilepticus (44.4%). Serological examination revealed that a higher percentage of neutrophils and a lower percentage of lymphocytes at admission may be associated with a poor outcome. Abnormal neuroimaging of the thalamus (85.7%), hippocampal (71.4%), midbrain (28.6%), and basal ganglia (14.3%) was found. 42.9% of patients left severe irreversible disability, and the most prominent were mental symptoms (71.4%) and memory or understanding disorder (57.1%). Conclusion Our data suggest that respiratory failure is one of the important causes of early death. Serologic examination, coma, and status epilepticus may indicate a poor outcome for severe JE. Additionally, the hippocampus is the second most common lesion in the adults with severe JE. A large-scale clinical trial is required to further confirm these conclusions. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-020-04867-8.
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Pierson TC, Diamond MS. The continued threat of emerging flaviviruses. Nat Microbiol 2020; 5:796-812. [PMID: 32367055 DOI: 10.1038/s41564-020-0714-0] [Citation(s) in RCA: 454] [Impact Index Per Article: 113.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/27/2020] [Indexed: 12/18/2022]
Abstract
Flaviviruses are vector-borne RNA viruses that can emerge unexpectedly in human populations and cause a spectrum of potentially severe diseases including hepatitis, vascular shock syndrome, encephalitis, acute flaccid paralysis, congenital abnormalities and fetal death. This epidemiological pattern has occurred numerous times during the last 70 years, including epidemics of dengue virus and West Nile virus, and the most recent explosive epidemic of Zika virus in the Americas. Flaviviruses are now globally distributed and infect up to 400 million people annually. Of significant concern, outbreaks of other less well-characterized flaviviruses have been reported in humans and animals in different regions of the world. The potential for these viruses to sustain epidemic transmission among humans is poorly understood. In this Review, we discuss the basic biology of flaviviruses, their infectious cycles, the diseases they cause and underlying host immune responses to infection. We describe flaviviruses that represent an established ongoing threat to global health and those that have recently emerged in new populations to cause significant disease. We also provide examples of lesser-known flaviviruses that circulate in restricted areas of the world but have the potential to emerge more broadly in human populations. Finally, we discuss how an understanding of the epidemiology, biology, structure and immunity of flaviviruses can inform the rapid development of countermeasures to treat or prevent human infections as they emerge.
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Affiliation(s)
- Theodore C Pierson
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, the National Institutes of Health, Bethesda, MD, USA.
| | - Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA.
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Mao X, Zhou H. The spatiotemporal distribution of Japanese Encephalitis cases in Yunnan Province, China, from 2007 to 2017. PLoS One 2020; 15:e0231661. [PMID: 32287313 PMCID: PMC7156086 DOI: 10.1371/journal.pone.0231661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/27/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Japanese encephalitis (JE) is a vector-borne disease with a high prevalence in Yunnan Province, China. However, there has been a lack of a JE epidemic systematic analysis, which is urgently needed to guide control and prevention efforts. METHODS This study explored and described the spatiotemporal distribution of JE cases observed among two different age groups in Yunnan Province from 2007 to 2017. The epidemiological features and spatial features were analyzed according to basic statistics, ArcGIS software (version 9.3; ESRI, Redlands, CA) and SPSS software (version 20; IBM Corp., Armonk, New York). RESULTS Overall, the whole province had a high incidence of JE. The annual incidence rates in 2007 and 2017 were 1.668/100,000 and 0.158/100,000, respectively. The annual mortality was under 0.095/100,000 for these years. Although the whole province was in danger of JE, the Diqing autonomous prefecture and the Lijiang autonomous prefecture had no JE cases recorded for over 10 years. The JE cases were reported by hospitals located in 60 counties of 14 municipalities. The top ten areas with the most JE cases were Kunming City, Zhaotong City, Jinghong City, Wenshan City, Mangshi City, Pu'er City, Baoshan City, Dali City, Chuxiong City, and Gejiu City. The incidence declined smoothly, with a peak occurring from June to September, which accounted for 96.1% of the total cases. Children whose age was equal or less than 10 years old (LEQ10) still maintained a high frequency of JEV infection, and a large number of cases were reported in August, despite the Expanded Program on Immunization (EPI), which was established in April 2008. There was no difference in the quantity of cases between the two groups (t = -0.411, P>0.05); additionally, the number of JE cases among patients LEQ10 were significantly greater than those among patients older than 10 years (GTR10). Further analysis using local indicators of spatial association (LISA) revealed that the distribution of JE exhibited a high-high cluster characteristic (Z = 2.06, P<0.05), which showed that Jinghong City, Guangnan County, Yanshan County, Funing County, and Mengzi City were hot spots for the JE epidemic. CONCLUSIONS Although the EPI was established in 2008 and the incidence of JE declined smoothly in Yunnan Province, there was no difference in the number of cases between the two age groups, which reveals that the EPI has been conducted with a low level success. In the context of limited vaccine supply capacity, we should strengthen the implementation of the children's immunization program before strengthening other immunization programs.
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Affiliation(s)
- Xianghua Mao
- Yunnan Provincial Center of Arbovirus Research, Pu’er, Yunnan, China
- Yunnan Institute of Parasitic Diseases, Pu’er, Yunnan, China
| | - Hongning Zhou
- Yunnan Institute of Parasitic Diseases, Pu’er, Yunnan, China
- * E-mail:
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26
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Nath B, Vandna, Saini HM, Prasad M, Kumar S. Evaluation of Japanese encephalitis virus E and NS1 proteins immunogenicity using a recombinant Newcastle disease virus in mice. Vaccine 2020; 38:1860-1868. [PMID: 31955960 DOI: 10.1016/j.vaccine.2019.11.088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 01/04/2023]
Abstract
Japanese encephalitis (JE) is the most important cause of acute encephalitis syndrome (AES). Japanese encephalitis virus (JEV), the prototype member of the JE serocomplex, belongs to the genus Flavivirus. The immunogenic proteins envelope (E) and non-structural protein 1 (NS1) of JEV are widely explored for the development of vaccines and diagnostics against JEV. However, there are underlying concerns such as the risk of reversion of live-attenuated vaccines to high virulence, the incomplete inactivation of pathogens in inactivated vaccines and partial vaccine coverage. Newcastle disease virus (NDV) is an efficient viral vaccine vector to express several human and animal immunogenic proteins. In the present study, we have developed a recombinant NDV (rNDV), individually expressing the E and NS1 proteins of JEV (rNDV-Ejev and rNDV-NS1jev). The recovered rNDV-Ejev and rNDV-NS1jev were characterized in 9-day-old SPF embryonated chicken eggs and in cell culture. The vaccination of rNDV-Ejev and rNDV-NS1jev showed effective immunity against JEV upon intranasal immunization in BALB/c mice. The rNDVs vaccination produced effective neutralization antibody titers against both NDV and JEV. The cytokine profiling of the vaccinated mice showed an effective Th1 and Th2 mediated immune response. The study also provided an insight that E, when used in combination with NS1 could reduce the efficacy of only E based immunization in mice. Our results suggested rNDV-Ejev to be a promising live viral vectored vaccine against JEV. This study implies an alternative and economical strategy for the development of a recombinant vaccine against JEV.
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Affiliation(s)
- Barnali Nath
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
| | - Vandna
- Center for Medical Biotechnology, M.D. University, Rohtak 124001, Haryana, India
| | - Hari Mohan Saini
- Center for Medical Biotechnology, M.D. University, Rohtak 124001, Haryana, India
| | - Minakshi Prasad
- College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar 125004, Haryana, India
| | - Sachin Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India.
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Amat C, Bellanger A, Bozon F, Léger R, Gbaguidi-Haore H, Marguet P. Current practice of French health professionals regarding Japanese encephalitis vaccination. Med Mal Infect 2019; 49:602-606. [DOI: 10.1016/j.medmal.2019.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/07/2018] [Accepted: 03/08/2019] [Indexed: 11/16/2022]
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Affiliation(s)
- Stewart Sell
- Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY, USA
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Yakass MB, Franco D, Quaye O. Suppressors of Cytokine Signaling and Protein Inhibitors of Activated Signal Transducer and Activator of Transcriptions As Therapeutic Targets in Flavivirus Infections. J Interferon Cytokine Res 2019; 40:1-18. [PMID: 31436502 DOI: 10.1089/jir.2019.0097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Flaviviruses cause significant human diseases putting more than 400 million people at risk annually worldwide. Because of migration and improved transportation, these viruses can be found on all continents (except Antarctica). Although a majority of the viruses are endemic in the tropics, a few [West Nile virus (WNV) and tick-borne encephalitis virus (TBEV)] have shown endemicity in Europe and North America. Currently, there are vaccines for the Yellow fever virus, Japanese encephalitis virus, and TBEV, but there is no effective vaccine and/or therapy against all other flaviviruses. Although there are intensive efforts to develop vaccines for Zika viruses, dengue viruses, and WNVs, there is the need for alternative or parallel antiviral therapeutic approaches. Suppressors of cytokine signaling (SOCS) and protein inhibitors of activated signal transducer and activator of transcription (STATs; PIAS), both regulatory proteins of the Janus kinase/STAT signaling pathway, have been explored as therapeutic targets in herpes simplex and vaccinia viruses, as well as in cancer therapy. In this review, we briefly describe the function of SOCS and PIAS and their therapeutic potential in flaviviral infections. [Figure: see text].
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Affiliation(s)
- Michael Bright Yakass
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | | | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
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Flourishing Japanese Encephalitis, Associated with Global Warming and Urbanisation in Asia, Demands Widespread Integrated Vaccination Programmes. Ann Glob Health 2019; 85. [PMID: 31373473 PMCID: PMC6676921 DOI: 10.5334/aogh.2580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Connor BA, Hamer DH, Kozarsky P, Jong E, Halstead SB, Keystone J, Mileno MD, Dawood R, Rogers B, Bunn WB. Japanese encephalitis vaccine for travelers: risk-benefit reconsidered. J Travel Med 2019; 26:5487229. [PMID: 31073616 DOI: 10.1093/jtm/taz037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Bradley A Connor
- Department of Medicine, Weill Cornell Medical College and the New York Center for Travel and Tropical Medicine, NY, USA
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, and Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Phyllis Kozarsky
- Department of Medicine and Infectious Diseases, Emory University (Emerita), Atlanta, GA, and Time Solutions, Chesapeake, VA, USA
| | - Elaine Jong
- Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Scott B Halstead
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jay Keystone
- Tropical Disease Unit, Division of Infectious Disease, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Maria D Mileno
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School of Brown University, and Brown Medicine, Brown Physicians, Inc., The Miriam Hospital, Providence, RI, USA
| | | | - Bonnie Rogers
- North Carolina Occupational Safety and Health Education and Research Center, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - William B Bunn
- Division of Neurology, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, and Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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Chen KC, Lin YF, Huang AC, Gao JY, Lin CW, Lien JC. Molecular interaction of the antiviral compound CW‑33 and its analogues with the NS2B‑NS3 protease of the Japanese encephalitis virus. Int J Mol Med 2019; 43:2024-2032. [PMID: 30816489 PMCID: PMC6443346 DOI: 10.3892/ijmm.2019.4113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/07/2019] [Indexed: 11/06/2022] Open
Abstract
In a previous study from our group, a novel compound, namely CW‑33 (ethyl 2‑(3',5'‑dimethylanilino)‑4‑oxo‑4,5‑dihydrofuran‑3‑carboxylate) was identified that exhibited antiviral activity for Japanese encephalitis virus (JEV). The viral NS2B‑NS3 serine protease serves an important role in cytoplasmic cleavage events that occur during viral polyprotein maturation. The inhibition of viral RNA and protein syntheses was responsible for the antiviral activities of the novel furanonaphthoquinone derivatives that were discovered for the prevention of JEV infection. Consequently, the present study examined the molecular docking simulation of JEV protease with compound CW‑33 and its analogues, and developed quantitative structure‑activity relationship (QSAR) models to assess the potential antiviral activities of these compounds with regard to JEV. Molecular docking simulation indicated the potential ligand‑protein interactions associated with the antiviral activities of these compounds. According to the results of the QSAR models, the secondary amine group was an important moiety required for compound bioactivity, which enabled the formation of hydrogen bonding with the residue Glu155. Furthermore, the aromatic ring mapping of the phenyl moiety of each compound was predicted to form a π‑cation interaction with residue Arg76, whereas the hydrophobic feature represented by the ethyl moiety exhibited hydrophobic contacts with residue Glu74. Finally, the hydrophobic substituents in the meta‑position of the phenyl ring further contributed to the efficacy of the antiviral activity. These results unravel the structural characteristics that are required for binding of CW‑33 to the JEV protease and can be used for potential therapeutic and drug development purposes for JEV.
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Affiliation(s)
| | - Yu-Fong Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung 40402
| | - An-Cheng Huang
- Department of Nursing, St. Mary's Junior College of Medicine, Nursing and Management, Yilan 26647
| | | | - Cheng-Wen Lin
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung 40402,Department of Biotechnology, Asia University, Taichung 41354,Professor Cheng-Wen Lin, Department of Medical Laboratory Science and Biotechnology, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan, R.O.C., E-mail:
| | - Jin-Cherng Lien
- School of Pharmacy,Department of Medical Research, Hospital of China Medical University, Taichung 40402, Taiwan, R.O.C,Correspondence to: Professor Jin-Cherng Lien, School of Pharmacy, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan, R.O.C., E-mail:
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Analysis of the Full Economic Cost for Japanese Encephalitis Under Different Risk Scenarios for Business Travelers to Asia. J Occup Environ Med 2019; 61:16-20. [DOI: 10.1097/jom.0000000000001474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Samy AM, Alkishe AA, Thomas SM, Wang L, Zhang W. Mapping the potential distributions of etiological agent, vectors, and reservoirs of Japanese Encephalitis in Asia and Australia. Acta Trop 2018; 188:108-117. [PMID: 30118701 DOI: 10.1016/j.actatropica.2018.08.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/11/2018] [Accepted: 08/12/2018] [Indexed: 12/15/2022]
Abstract
Japanese encephalitis virus (JEV) is a substantial cause of viral encephalitis, morbidity, and mortality in South-East Asia and the Western Pacific. World Health Organization recognized Japanese Encephalitis (JE) as a public health priority in demands to initiate active vaccination programs. Recently, the geographic distribution of JEV has apparently expanded into other areas in the Pacific islands and northern Australia; however, major gaps exist in knowledge in regard to its current distribution. Here, we mapped the potential distribution of mosquito vectors of JEV (Culex tritaeniorhynchus, Cx. pseudovishnui, Cx. vishnui, Cx. fuscocephala, Cx. gelidus), and reservoirs (Egretta garzetta, E. intermedia, Nycticorax nycticorax) based on ecological niche modeling approach. Ecological niche models predicted all species to occur across Central, South and South East Asia; however, Cx. tritaeniorhynchus, E. garzetta, E. intermedia, and N. nycticorax had broader potential distributions extending west to parts of the Arabian Peninsula. All predictions were robust and significantly better than random (P < 0.001). We also tested the JEV prediction based on 4335 additional independent human case records collected by the Chinese Information System for Disease Control and Prevention (CISDCP); 4075 cases were successfully predicted by the model (P < 0.001). Finally, we tested the ecological niche similarity among JEV, vector, and reservoir species and could not reject any of the null hypotheses of niche similarity in all combination pairs.
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Lindquist L. Recent and historical trends in the epidemiology of Japanese encephalitis and its implication for risk assessment in travellers. J Travel Med 2018; 25:S3-S9. [PMID: 29718434 DOI: 10.1093/jtm/tay006] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 01/17/2018] [Indexed: 01/30/2023]
Abstract
Japanese encephalitis is a major disease in many countries in Asia often visited by both leisure and non-leisure travellers. Although reported cases of Japanese apoptosis (JE) in travellers are relatively few, there are indications that both the number of cases might be underreported and that changes in the epidemiological situation in these parts of Asia may increase the risk, especially non-leisure travellers. Although JE mainly is considered a rural disease urban cases are seen the large economic growth and urbanization of previously rural areas in many for JE high-endemic areas may further add to the risk for JE, especially for business travellers, when visiting newly established peri-urban areas. This review will address these dynamic and unpredictable risks for JE and discuss its possible implications for the traveller.
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Affiliation(s)
- Lars Lindquist
- Karolinska Institutet, Karolinska University Hospital, SE 141 86 Huddinge, Sweden; Clinic for Infectious Diseases Huddinge I63; SE 141 86 Huddinge, Sweden
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36
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Amicizia D, Zangrillo F, Lai PL, Iovine M, Panatto D. Overview of Japanese encephalitis disease and its prevention. Focus on IC51 vaccine (IXIARO ®). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E99-E107. [PMID: 29938245 DOI: 10.15167/2421-4248/jpmh2018.59.1.962] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/24/2018] [Indexed: 01/30/2023]
Abstract
Japanese encephalitis (JE) is a vector-borne disease caused by the Japanese encephalitis virus (JEV). JEV is transmitted by mosquitoes to a wide range of vertebrate hosts, including birds and mammals. Domestic animals, especially pigs, are generally implicated as reservoirs of the virus, while humans are not part of the natural transmission cycle and cannot pass the virus to other hosts. Although JEV infection is very common in endemic areas (many countries in Asia), less than 1% of people affected develop clinical disease, and severe disease affects about 1 case per 250 JEV infections. Although rare, severe disease can be devastating; among the 30,000-50,000 global cases per year, approximately 20-30% of patients die and 30-50% of survivors develop significant neurological sequelae. JE is a significant public health problem for residents in endemic areas and may constitute a substantial risk for travelers to these areas. The epidemiology of JE and its risk to travelers have changed, and continue to evolve. The rapid economic growth of Asian countries has led to a surge in both inbound and outbound travel, making Asia the second most-visited region in the world after Europe, with 279 million international travelers in 2015. The top destination is China, followed by Thailand, Hong Kong, Malaysia and Japan, and the number of travelers is forecast to reach 535 million by 2030 (+ 4.9% per year). Because of the lack of treatment and the infeasibility of eliminating the vector, vaccination is recognized as the most efficacious means of preventing JE. The IC51 vaccine (IXIARO®) is a purified, inactivated, whole virus vaccine against JE. It is safe, well tolerated, efficacious and can be administered to children, adults and the elderly. The vaccination schedule involves administering 2 doses four weeks apart. For adults, a rapid schedule (0-7 days) is available, which could greatly enhance the feasibility of its use. Healthcare workers should inform both short- and long-term travelers of the risk of JE in each period of the year and recommend vaccination. Indeed, it has been shown that short-term travelers are also at risk, not only in rural environments, but also in cities and coastal towns, especially in tourist localities where excursions to country areas are organized.
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Affiliation(s)
- D Amicizia
- Department of Health Sciences, University of Genoa, Italy
| | - F Zangrillo
- Department of Health Sciences, University of Genoa, Italy
| | - P L Lai
- Department of Health Sciences, University of Genoa, Italy
| | - M Iovine
- Department of Health Sciences, University of Genoa, Italy
| | - D Panatto
- Department of Health Sciences, University of Genoa, Italy
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Jelinek T, Cromer MA, Cramer JP, Mills DJ, Lessans K, Gherardin AW, Barnett ED, Hagmann SHF, Askling HH, Kiermayr S, Kadlecek V, Eder-Lingelbach S, Taucher C, Dubischar KL. Safety and immunogenicity of an inactivated Vero cell_derived Japanese encephalitis vaccine (IXIARO ®, JESPECT ®) in a pediatric population in JE non-endemic countries: An uncontrolled, open-label phase 3 study. Travel Med Infect Dis 2018; 22:18-24. [PMID: 29549036 DOI: 10.1016/j.tmaid.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Young travelers to South-East Asia may be at risk for Japanese encephalitis (JE). METHODS IXIARO® (0.25 ml or 0.5 ml, depending on age) were administrated to 100 travelers aged ≥ 2 months to < 18 years. Solicited AEs were collected for 7 days after each injection, unsolicited adverse events (AEs) for a total of 7 months. JE neutralizing antibodies were assessed in 64 subjects. RESULTS The most common solicited local AEs were redness (3/12 subjects), induration and tenderness (both 1/12) with 0.25 ml IXIARO®, and tenderness (44/88) and pain (22/88) with 0.5 ml IXIARO®. Common solicited systemic AEs were diarrhea (2/12) and loss of appetite (1/12) with 0.25 ml IXIARO® and muscle pain (27/88) and excessive fatigue (10/88) with 0.5 ml IXIARO®. In total, up to day 56, AEs were reported by 10/12 (83.3%) of subjects who received the 0.25 ml dose and 67/88 (76.1%) of those vaccinated with the 0.5 ml dose. All subjects (62/62; 100%) developed protective levels of JE neutralizing antibodies by Day 56 and 31/34 (91.2%) retained protective titers at Month 7. CONCLUSIONS IXIARO® was generally well tolerated in children, with an overall AE profile similar to adults. IXIARO® was highly immunogenic in both dose groups.
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Affiliation(s)
- Tomas Jelinek
- Berlin Center for Travel & Tropical Diseases, Berlin and Institute of Medical Microbiology, Immunology and Hygiene, University of Cologne, Germany
| | | | | | - Deborah J Mills
- Dr. Deb - The Travel Doctor, Brisbane, Queensland, Australia
| | | | | | - Elizabeth D Barnett
- Boston Medical Center, Section of Pediatric Infectious Diseases, Boston, MA, USA
| | - Stefan H F Hagmann
- Bronx - Lebanon Hospital Center, Division of Pediatric Infectious Diseases, New York, NY, USA
| | - Helena H Askling
- Karolinska Institutet, Dept. of Medicine, Unit for Infectious Diseases, Solna, Sweden
| | - Sigrid Kiermayr
- Valneva Austria GmbH, Campus Vienna Biocenter, Vienna, Austria
| | - Vera Kadlecek
- Valneva Austria GmbH, Campus Vienna Biocenter, Vienna, Austria
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