Japanese Encephalitis Vaccine for Travellers

Japanese encephalitis is a virus and is common in rural areas in the Pacific Islands, Southeast Asia, and the Far East. . The virus is often found in birds and pigs and is spread by mosquitoes.

Japanese encephalitis can cause serious complications including inflammation of the brain. The risk of developing Japanese encephalitis is very low however you may need the vaccination if you are staying longer than a month. At least 6-8 weeks before you travel depending on where you plan to visit and other factors including your own health.

Fortunately, the risk for most travellers is quite low but higher in the areas where the disease is predominant and for those who plan to stay/live in the area for longer than a month it is quite important you are vaccinated.

People with Japanese encephalitis may only experience mild symptoms: a low grade fever with headache. In others it becomes a serious infection not least of which includes inflammation of the brain (encephalitis) which may cause permanent brain damage and is fatal in some cases.

They may experience neck stiffness, fever, seizures, and coma. Of those that survive, (around half) will have a permanent disability. It can also have a serious detrimental effect on an unborn child during pregnancy.

Common Symptoms of Japanese Encephalitis

• Mild, flu-like symptoms and in rare cases it spreads to the brain, which can be severe and sometimes life-threatening.
• Uncontrollable tremors/li>
• Seizures
• Paralysis or muscle weakness
• Loss of speech
• Mental confusion and agitation.

The people who survive Japanese encephalitis can take months to recover completely. Even when they finally recover, most have long-term health problems.

Causes of Japanese Encephalitis

People catch it from an infected mosquito carrying the disease. Japanese encephalitis is more common in areas particularly rice paddy fields and pig farms where pigs and wading birds are found and where there is a high mosquito population. It cannot be transmitted by other humans. Whilst the disease is most common in rural areas it is also found in urban areas too.

Areas at risk include:

Southeast Asia and the Far East however it is mainly a problem in rural farming areas. It particularly occurs more commonly in the rainy season when the mosquitoes are most active and varies from country to country.

• China, Korea and Japan, May to September.
• Thailand, Cambodia and Vietnam, March to October.
• Nepal and North India, September to December.
• Malaysia, Indonesia and the Philippines, it is common all year round.

What to Do Next

It is very important get the necessary vaccinations before you travel to remote and exotic places which can be dangerous and protecting yourself and knowing why, as well as making sure you have the required medicines and vaccines, can save you from long term health problems later. Some vaccines may not be required if you have immunity already; however this must be discussed and confirmed with the doctor/nurse prior to your trip.

The type of mosquito responsible for Japanese encephalitis is active between dusk and dawn. However the risk is highest for long stay travellers to rural areas, particularly as it is difficult to avoid mosquito bites. Sprays and nets should always be used to avoid being bitten at night.

Vaccination is the most effective way to protect against this disease. A link has also been identified between infection during pregnancy and babies born with birth defects.

Even babies from the age of 2 months can be given the vaccine. It is usually given as two injections; the second injection 28 days after the first. Babies between the ages of 2 and 36 months are given half the dose.

Full immunity takes a week to develop. Therefore the second course should be completed at least one week before departure meaning you need to be immunised well in advance of your travel date.

A booster dose may be needed even if you still go to at-risk area after 1 - 2 years. We can check if your level of protection is still adequate by a simple blood test. (Please see our fees and prices page for more information).

There is no evidence of risk from this vaccine if you are pregnant or breast-feeding. However, as a precaution it is usually only given if the risk of Japanese encephalitis is very high and cannot be avoided.

Additional precautionary measures you should take:

During the day, it would help to wear loose-fitting clothes that can cover most of your skin. Additionally, you should also use insect repellent lotion on your body after sunscreen block as well as spray your room before entering with insect spray if there is no window or door insect mesh covers.

You should also avoid being bitten by mosquitoes:

Vaccination is not completely reliable and you should also try to avoid mosquito bites when in an 'at-risk' area.

• Making sure you only sleep in rooms that have screens i.e. close-fitting gauze over windows and doors.
• Spray the bedroom with insecticide before dusk. It kills mosquitoes that enter the room during the day.
• An electric mat will vaporise insecticide overnight. Or alternatively use a burning mosquito coil.
• Please use mosquito nets impregnated with insecticide i.e. permethrin when sleeping outdoors or in an unscreened room. It should fall to the floor all around your bed and extra long so you can tuck under the mattress as well and have no holes. It should also be resprayed with insecticide every six months.
• The type of mosquito responsible for carrying this disease are most active during dusk and in the evening hours so if possible, avoid going out after sunset. If you do venture out then wear long-sleeved clothes, trousers and socks. Light colours are better, as they are less attractive to mosquitoes.
• Apply insect repellent to clothing or exposed skin. Diethyltoluamide (DEET) is safe and effective but take advice on the best repellent in the area you visit. 50% DEET- based insect repellents should be applied regularly (according to the manufacturers’ instructions). DEET is appropriate for use in pregnancy. If DEET is unsuitable then a proven alternative should be used instead. Don’t buy medicines on the internet as you have no guarantee it is safe or effective and may well be fake.

If you are planning a trip to countries including Burma, China, Cambodia, Thailand, India, Philippines, Nepal, Laos, Malaysia, Sri Lanka, and Indonesia, make sure you are vaccinated and employ the tips to repel mosquitoes to avoid infection with Japanese encephalitis.

We can help you get the correct recommended vaccines at an affordable price. (Please see our prices and fees page for more information). Our vaccines are consistently updated depending on the current requirements.

Vaccine Requirement

It is important to visit the doctor at least a couple of months before your trip as updates and changes do happen periodically. Vaccine requirement depends on your length of stay, any pre-existing health conditions, and your health generally. ur doctor will ensure that you are adequately covered and receive the necessary up-to-date vaccines and medicines for your protection.

You can feel confident that you are in safe hands. We work side by side with the health authorities to make sure we provide you with all the vaccines you need for safe travel.

Our clinic is registered and certified to administer Yellow Fever vaccines and will provide you with the necessary documentation for entry into certain countries that insist on it.

If you follow the correct advice and appropriate health cover which is recommended, including remote areas, your visit will be an uneventful and enjoyable one.

Our website provides the latest information on vaccine requirement and additional medications for the rest of the world. Check out the rest of the pages on this site to learn about the vaccines needed and additional medicines required for destinations abroad and to other areas of interest. An excellent website recommended is the Fitfortravel NHS website where you can get the latest and comprehensive information to keep you safe. Please see our prices and fees page for more information.

All information has been licensed under the Open Government Licence. http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/