Japanese EncephalitisImmunization Information

At Rite Aid, your total wellness is paramount. And part of reaching total wellness is shielding yourself from diseases like Japanese encephalitis (JE). The JE virus is the chief cause of vaccine-preventable encephalitis in the western Pacific and Asia. Depending on destination, duration of travel, season, and activities, the risk for JE varies, but is typically very low for those traveling to Asia.

People can become infected with JE virus when they are bitten by a mosquito infected with JE. The majority of infections in people are asymptomatic, or cause only mild symptoms. A small fraction of people who have contracted JE develop inflammation of the brain (encephalitis), with possible symptoms ranging from: high fever, sudden headache onset, tremors and convulsions, disorientation, and sometimes coma. About 20-30% of encephalitis cases lead to death. About 30%-50% of encephalitis survivors continue to have neurologic, cognitive, or psychiatric symptoms even after the acute infection is over.

JE has no specific treatment. Treatment is based on symptoms, and hospitalization for supportive care and observation is generally required. Preventing mosquito bites and getting vaccinated are the best protective measures one can take to avoid Japanese encephalitis.

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How does Japanese Encephalitis spread?

  • JE virus is transmitted to humans via the bite of infected mosquitoes (Culex species), particularly Culex tritaeniorhynchus.
  • Japanese encephalitis is spread via a cycle that includes mosquitoes and vertebrate hosts, typically wading birds and pigs. People are incidental or "dead-end" hosts, since they typically don't develop high enough concentrations of Japanese encephalitis virus in their blood to infect feeding mosquitoes.
  • Japanese encephalitis virus transmission typically happens in rural, agricultural areas, especially those known for rice production or production of other crops that use flooding for irrigation. Such conditions can occur near urban centers in some areas of Asia.
  • Japanese encephalitis virus transmission is seasonal in temperate areas of Asia. Disease in humans typically peaks in summer and fall seasons. In the tropics and subtropics, transmission can occur all year, often peaking in the rainy season.

What are the symptoms of Japanese Encephalitis?

Ninety nine percent of people infected with Japanese encephalitis will NOT develop clinical illness. In the less than 1% of people who do develop symptoms, the incubation period (time from infection until illness) is usually 5-15 days. Headache, fever, and vomiting are often the initial symptoms. Symptoms that may develop over the next few days include: weakness, neurological symptoms, mental status changes and movement disorders. Among children, seizures are common.

What is the Japanese Encephalitis vaccine?

There is currently only one JE vaccine licensed for use in the United States. IXIARO is an inactivated cell culture vaccine approved for people aged 2 months and older to prevent Japanese encephalitis. IXIARO is given as a two-dose series, with doses given 28 days apart. The last dose should be given at least 1 week before travel. For persons aged 17 years and older, a booster dose may be given if a person has received the two-dose primary vaccination series one year or more previously, and there is a continued risk for JE virus infection or potential for reexposure to JE virus.

Japanese encephalitis vaccine is recommended for those who plan to travel to and spend one month or more in locations where the virus is endemic, during the JE virus transmission season. This includes: recurrent travelers, long-term travelers, or expatriates who will spend most of their time in urban areas but are expected to visit endemic, rural, or agricultural areas during high risk season for JE virus transmission.

Vaccination for Japanese encephalitis should also be considered for:

  • Short term (less than 4 weeks) travelers to regions where JE virus is endemic during transmission season if they plan to travel beyond an urban area and their activities will heighten the risk of JE virus exposure. Examples of high risk activities include:
    • Spending substantial time outdoors in agricultural or rural areas, especially in the evening or at night
    • Participating in predominantly outdoor activities such as hiking, camping, biking, hunting, fishing, or farming
    • Staying in accommodations lacking screens, bed nets, or air conditioning
  • Travelers to an area with an active JE virus outbreak
  • Travelers who are uncertain of specific destinations, activities, or duration of stay in endemic areas

The vaccine is not recommended for those traveling short term to urban areas or for travel during times outside of well-defined Japanese encephalitis virus transmission season.