Mini ReportThe Buzz on Japanese Encephalitis

50 HEALTHTODAY•December 2015/January 2016

Our Brains are at Risk!

Who is at risk of JE?According to the World Health Organization (WHO), there are nearly 68,000 clinical cases of JE every year, with more than 3 billion people in the 24 countries in the WHO South-East Asia and Western Pacific regions facing the risk of JE transmission. Children are most affected when it comes to this disease.1

In Asia, there are 30,000 to 50,000 cases reported each year, and 25-30% of these cases are fatal, while half the survivors suffer from severe nerve and brain-related problems.2

What are the symptoms of JE?Infected people rarely show symptoms. However, 1-in-250 infections can lead to a severe form of the disease.1

This person would experience rapid onset of high fever along with seizures, headache, disorientation and neck stiffness. Coma, spastic paralysis and even death may occur. If you suspect that you or a loved one has JE, see a doctor immediately.

Asia is famous for its friendly multicultural

people, delicious cuisines, magnificent architecture and more. On a darker

note, there is also Japanese Encephalitis – a uniquely Asian disease.

Words Lim Teck Choon

What exactly is Japanese Encephalitis?

Encephalitis is a condition, in which the brain becomes swollen usually due to infection.

Japanese Encephalitis (JE) is caused by a viral infection. The disease got its name from the fact that it was first documented in Japan in 1871.1

Mini ReportThe Buzz on Japanese Encephalitis

A community health message brought to you by

How does one catch JE?The JE virus can be transmitted from pigs and wading birds (such as egrets and herons) to humans. The Culex mosquito would carry the JE virus when it feeds on an infected animal. When the mosquito feeds on a person, it can pass the virus to that person.1

Like many mosquito-borne diseases, JE may be more prevalent during or after rainy seasons, especially in rural areas where people live close to animals that can host the JE virus.1

Humans cannot pass the virus to one another; they are considered dead end hosts.3

Will other animals be able to catch JE?Various domestic animals can also be infected by the JE virus.5 However, the World Organisation for Animal Health (OIE) published a technical card on JE which states that horses and donkeys are “dead end hosts” for the virus (they cannot spread the virus to people), while domestic animals such as dogs, cats and cattle “likely do not contribute to [the] spread [of JE]".6

How is JE treated?To date, there is no cure for JE. Treatment revolves around providing relief and stabilizing the symptoms.1 When it comes to JE, prevention is definitely the more preferable option to cure! HT

Why are pigs such a matter of concern when it comes to JE?This is because pigs can breed quickly and produce many offspring that are susceptible to JE. When infected, pigs also tend to develop high concentrations of the JE virus in their blood.4 This is why pig farms are set up as far away from towns and villages as possible, and pigs infected with JE have to be eliminated during an outbreak.

References: 1. World Health Organization. Japanese Encephalitis. Retrieved on Nov 3, 2015 from http://www.who.int/mediacentre/factsheets/fs386/en/ 2. See C Wong, et al. (2008). A decade of Japanese encephalitis surveillance in Sarawak, Malaysia: 1997–2006. Trop Med Int Health. Jan;13(1):52-5. doi: 10.1111/j.1365-3156.2007.01967.x. 3. Erlanger TE, Weiss S, Keiser J, Utzinger J, Wiedenmayer K. (2009). Past, present, and future of Japanese encephalitis. Emerg Infect Dis. Retrieved on Nov 3, 2015 from http://wwwnc.cdc.gov/eid/article/15/1/08-0311 4. Centers for Disease Control and Prevention. (2010). Japanese encephalitis vaccines: recommendations of the Advisory Commitee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 59, 2. 5. Vythilingam, I, et al. (1997). Abundance, parity, and Japanese encephalitis virus infection of mosquitoes (Diptera:Culicidae) in Sepang District, Malaysia. J Med Entomol. May;34(3):257-62. 6. World Organisation for Animal Health. Japanese Encephalitis. Retrieved on Nov 4, 2015 from http://www.oie.int/fileadmin/Home/eng/Animal_Health_in_the_World/docs/pdf/Disease_cards/JAPANESE_ENCEPHALITIS.pdf

Mini ReportThe Buzz on Japanese Encephalitis

52 HEALTHTODAY•December 2015/January 2016

Our Brains are at Risk!

When there is a reported outbreak of Japanese Encephalitis (JE) in your neighbourhood,

minimising your chances of being bitten by mosquitoes is one way to protect yourselves from the disease. • Air conditioning can help reduce

the chances of being bitten by mosquitoes.

• If you do not have air-conditioning, cover windows with close-fitting

gauze screens to keep mosquitoes out.

• Use aerosol insecticide, electric mats or mosquito coil in the bedroom for added protection.

• If you are travelling outdoors (especially from dusk to dawn, when the Culex mosquito is the most active), wear long-sleeved clothing, trousers and socks. You can apply insect repellent on exposed skin.

• If your neighbourhood is infested with mosquitoes, make arrangements for neighbourhood mosquito control programmes (such as spraying) to take place as soon as possible.

Keep Mosquitoes Out!

Let’s take a closer look at how you can protect yourself and your loved ones from Japanese encephalitis. Words Lim Teck Choon

Keeping JE Out of Our Lives

Stop mosquitoes from breedingMosquitoes breed in areas of still or standing water, so removing these breeding areas would cut down the mosquito population around your home. • Identify spots around the

house that are potential mosquito breeding grounds (gully trap in sinks, air conditioner trays, flower pots, etc) and clean them regularly. Alternatively, you can pour some bleach or insecticide into the water.

• Containers, bowls, plates and other utensils that can collect water should either be covered or turned over when not in use.

• Discard all unwanted water-collecting containers, and always cover your dustbin.

• Keep your house and garden free from clutter and debris.

Mini ReportThe Buzz on Japanese Encephalitis The Buzz on Japanese Encephalitis

Who should get vaccinated? The JE vaccine is suitable for adults and children. The following people are recommended by US Centres for Disease Control and Prevention (CDC) to get the vaccine.

Locals• People who are living in areas

known to be JE ‘hot spots’. • Pig farmers and other people who

come into frequent close contact with pigs.

TravellersTravellers heading to JE ‘hot spots’ should be aware that certain activities can place them more at risk of catching JE. These activities include:• Spending a significant amount of

time outdoors in rural areas or plantations, especially during the evening or night.

• Taking part in outdoor activities such as camping, hiking, hunting, etc.

• Staying in accommodations that lack air conditioning, bed nets, screens and other means to reduce your chances of being bitten by mosquitoes.

The following travellers should get the JE vaccine:• Those who intend to spend a month

or longer in a destination where JE cases happen all year long.

• For travellers who intend to stay for less than a month, they should still get the vaccine if they plan to travel to rural areas or plantations, or if they intend to carry out the high-risk activities listed above.

• Those heading to a destination that currently experiences a JE outbreak.

• For travellers who are heading to a JE ‘hot spot’, but have not determined what their specific destination, activities or duration of stay, it is better safe than sorry to get the vaccine!

The JE vaccine is not necessary for short-term travellers whose destination is restricted to urban areas, or if there is no well-defined season of JE virus transmission during their visit. HT

Reference: Centers for Disease Control and Prevention. (2010). Japanese encephalitis vaccines: recommendations of the Advisory Commitee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 59, 17-18.

A community health message brought to you by

GET VACCINATEDThere are vaccines to protect you from JE, and it is definitely worth

giving this shot a shot!

Mini ReportThe Buzz on Japanese Encephalitis

54 HEALTHTODAY•December 2015/January 2016

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5. Who should not or cannot receive the vaccine?The specific groups of people who should not receive the JE vaccine may differ slightly from one brand of vaccine to another. You should consult your doctor for more information. Generally, though, you should notify your doctor before receiving the vaccination if you are pregnant, breastfeeding, or suffering from a medical condition that weakens the immune system.

A Shot against Japanese Encephalitis

1. What is the JE vaccine?There are several types of JE vaccines, and just like most vaccines, they are developed either from live but weakened JE virus (which will not cause the disease when injected into the body) or an inactive virus grown and cultivated in a laboratory.

2. How does the vaccine work?Like all vaccines, the JE vaccine triggers the body’s immune system to produce antibodies without actually causing the disease. Therefore, the next time the actual JE virus finds its way into the body, the immune system will produce the antibodies that will help protect the person from the disease.

4. Can children receive the vaccine?Depending on the specific type of vaccine, children after a certain age can safely receive it. Talk to a doctor for more information.

3. Is the vaccine really useful?Yes, it is. In a study conducted in Sibu between 1997 and 2006, it was found that the introduction of the JE vaccination reduced the incidence of JE from 9.8 per 100,000 population under 12 years old per year to 4.3 per 100,000.

Here are some answers to

commonly asked questions about

the vaccine. Words Lim Teck Choon

References: 1. Centers for Disease Control and Prevention. (2010). Japanese encephalitis vaccines: recommendations of the Advisory Commitee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 59, 7. 2. See C Wong, et al. (2008). A decade of Japanese encephalitis surveillance in Sarawak, Malaysia: 1997–2006. Trop Med Int Health. Jan;13(1):52-5. doi: 10.1111/j.1365-3156.2007.01967.x.