“The word devastating does not cover it” – these are words from a mother whose son contracted Japanese Encephalitis whilst travelling in SE Asia in 2015 1.
With the chance of contracting Japanese Encephalitis less than 1 in 1,000 000 2, it is seen as a rare disease among travellers and travel health professionals. Yet, it is still a risk to certain travellers and can potentially cause lasting, life-altering symptoms.
In 2014/2016, there were 3 confirmed cases of Japanese Encephalitis diagnosed in British Travellers. One was acquired in Thailand, one in China, and one in either Thailand, Laos, or Cambodia 1.
The blog below will look at the disease, risks, and prevention for UK travellers.
Japanese Encephalitis (JE) is a virus that causes severe brain infection. It was first discovered in Japan in the 1800s 3 (hence the name). It has become endemic in East and Southeast Asia, with actual global numbers unknown. It is estimated that 68,000 clinical cases occur in the 24 countries endemic to JE.
Japanese Encephalitis is transmitted through mosquitoes. The mosquito feeds on a pig, duck, or other water-wading bird (which carries the virus) and then on a human, passing the virus to humans.
The species of JE-carrying mosquitoes predominantly feed during the night, between dusk and dawn. These mosquitoes breed in rural areas and flooded rice paddies but can be found in cities and urban locations 3.
Not all people will develop the Encephalitis (inflammation of the brain) part of the disease. Symptoms could be vague or flu-like, or the person could show no symptoms.
The incubation period can be between 5-15 days 3. If symptoms are experienced, they will be:
After a few days of these symptoms, others can occur:
If the disease progresses to more severe symptoms, these will be convulsions and altered consciousness.
30% of JE cases are fatal; for the survivors, 30 – 50 % of patients can be left with long-term neurological or psychiatric problems 3.
Japanese Encephalitis is normally diagnosed by a blood test or a sample of spinal fluid.
There is no specific treatment for JE; therapy will include :
Risk for UK Travellers
The risk is relevantly low for most travellers visiting Asia for short periods and predominantly in city or urban areas.
The risk varies on the following factors:
Destination − the following map shows the countries where there is a risk of JE map-japanese-encephalitis.png (9280×4800) (who.int)
Activities in destination − Any prolonged activity in rural areas. For Example, camping, hiking, trekking, biking, rafting, fishing, farming
Duration of trip − The longer you are in a high-risk area, the more likely you will be bitten by an infected mosquito.
Season—In some areas, JE is a risk all year round, but it is normally a higher risk in the rainy season, as mosquitos breed in areas with a lot of water.
Risk Factors for Japanese Encephalitis Among Travelers. (cdc.gov)
Book a video consultation with our Nurse Specialist, who will be able to assess your risk and give you advice on JE.
The Japanese Encephalitis vaccination is available for all travellers from 2 years of age upwards and consists of 2 doses, normally 28 days apart.
If a traveller is leaving before the 28th day, they may be able to receive the second dose on day 7 if they meet the correct criteria. Our Nurse Specialist will be able to discuss this further.
The JE vaccine offers protection for 2 years, with a booster after the 2nd year offering protection for 10 years.
Even if you are vaccinated against JE, you should still maintain good bite-prevention practices.
Bite Prevention is a must for all travellers visiting countries where mosquito-borne diseases are present.
Use Insect repellent when out and about, both in the day and in the evening. Ensuring you sleep under a mosquito net or/and in a sir conditioned room is available.
If working outside near farms or water, it may be a good idea to treat your clothes with an insecticide like Permethrin. You can also buy pretreated clothing. Wear long sleeves and long trousers if you are working in an area where JE and its hosts are present.
When travelling to certain parts of East and Southeast Asia, it’s important to be aware of the potential for Japanese Encephalitis (JE), even though it’s rare among UK travellers. This disease can have severe and life-altering symptoms, so understanding the risk factors is crucial. While the chances of getting JE are less than 1 in 1,000,000, the consequences of infection can be serious, with a high mortality rate and the possibility of long-term neurological damage.
To lower the risk, it’s important to consider preventative measures such as getting vaccinated and taking steps to prevent mosquito bites. The JE vaccine provides substantial protection and is recommended for travellers engaging in prolonged or rural activities. Using insect repellent, sleeping under mosquito nets, and wearing protective clothing can also help reduce the likelihood of infection.
Travelers should speak with our Nurse Specialist to assess their specific risks and get personalized advice. By taking these precautions, UK travellers can significantly lower their risk of contracting Japanese Encephalitis and ensure a safer travel experience in affected regions.
References:
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