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News Archives 17 November 2005

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• Report published on illness associated with foreign travel

Japanese encephalitis in India and Nepal – update

The outbreak of Japanese encephalitis (JE) that has been occurring in India and Nepal since July 2005 (1) is continuing. As of 10 November 2005, the World Health Organization Regional Office for South East Asia (SEARO) has reported just under 6000 cases in India and 2400 cases in Nepal (2).

In India, the outbreak has affected the northern state of Uttar Pradesh, where there have been 5737 suspected and confirmed cases reported, including 1334 deaths (case fatality rate [CFR] 23.3%), and the adjoining state of Bihar, where 360 cases and 64 deaths (CFR 17.8%) have been reported. Of the 5737 cases reported in Uttar Pradesh, 1116 had samples taken of which 413 (37%) were positive for JE virus.

In Nepal, as of 6 November 2005, 2398 cases including 271 deaths have been reported. The majority have been reported in Mid-western division but the highest number were reported in Kailali district in Central division. Of 1592 samples that have been tested in Nepal, 599 (38%) were positive for the JE virus. For more details on the distribution of cases in Nepal see the SEARO website at <http://w3.whosea.org/en/Section1226/Section2073.asp>.

The WHO is assisting the national authorities with technical support. Insect control measures have been intensified in India and a plan for immunising children aged between one and 12 years is being drawn up for 2006. The risk of JE for travellers who stay for short periods in urban areas is low. All travellers to endemic areas should be advised to practise insect bite avoidance measures, particularly between dusk and dawn, when mosquito vector is most active (3). Vaccination is not usually recommended for short visits to urban areas. Vaccine should be considered for those intending to stay for long periods in rural endemic regions during the main transmission season; for those whose planned activities will increase their risk; and for all long-term expatriates. More information on prevention of JE in travellers is available from the National Travel Health Network and Centre <http://www.nathnac.org/pro/factsheets/japanese_enc.htm>.

References

1. Health Protection Agency. Japanese encephalitis in India and Nepal. Commun Dis Rep Weekly [serial online] 2005 [cited 2005]; 15(38): News. Available at <http://www.hpa.org.uk/cdr/archives/2005/cdr3805.pdf>.
2. WHO Regional Office for South East Asia (SEARO). Immunization and vaccine development. Japanese encephalitis [online]. Available at <http://w3.whosea.org/en/Section1226/Section2073.asp>.
3. National Travel Health Network and Centre. Japanese encephalitis in India and Nepal: Clinical update 19 October 2005 [online]. Available at <http://www.nathnac.org/pro/clinical_updates/JE_india_nepal_191005.htm>.