Japanese encephalitis
Japanese encephalitis virus (JEV) is a flavivirus related to dengue, yellow fever, and West Nile viruses that can be spread by some (but not all) types of mosquitoes.
Japanese encephalitis (JE) is a rare, severe manifestation of infection with JEV, occurring in many parts of Southeast Asia and China. In recent years the disease has extended beyond its traditional boundaries with cases occurring in eastern Indonesia, Papua New Guinea, the Torres Strait, and mainland Australia.
Signs and symptoms
The majority of people (about 99%) infected with JEV have no symptoms or mild symptoms. Those that do develop symptoms may experience a fever and headache, or abdominal pain and vomiting in children. Severe disease may be characterised by an acute encephalitis (inflammation of the brain), with sudden onset of high fever and chills, severe headache, neck stiffness, disorientation, convulsions, paralysis, and coma. Of these severe cases, approximately one-third die, and one-third are left with permanent disabilities.
Transmission
JEV can only be spread by the bite of an infected mosquito. Mosquitoes become infected after they bite infected pigs or wading birds. After a person is bitten by an infected mosquito, it usually takes 5 to 15 days for the first symptoms to appear. JEV does not spread directly between people and cannot be acquired by eating meat from an infected animal.
Treatment
There is no specific treatment. Treatment usually involves management of the symptoms.
Prevention
JEV infection is preventable through vaccination and avoidance of mosquito bites.
Vaccination
The Communicable Disease Network Australia has prioritised vaccination for people who are at high- risk of exposure to JEV.
JEV vaccination is recommended and available at no cost*, for the following at risk groups:
- people who live or work in the local government areas listed below and who are at risk of mosquito bites:
- Aurukun
- Balonne
- Burke
- Carpentaria
- Cook
- Doomadgee
- Goondiwindi
- Hope Vale
- Kowanyama
- Lockhart River
- Mapoon
- Mornington
- Napranum
- North Burnett
- Northern Peninsula Area
- Pormpuraaw
- Quilpie
- South Burnett
- southwest area of Toowoomba Regional Council (surrounding and including Millmerran)
- Torres Strait
- Weipa Town
- Western Downs
- Wujal Wujal
- people who work at, live near or have a planned visit to:
- a piggery, including farm workers and their families (including children aged 2 months and older) living at the piggery, transport workers, veterinarians and others involved in the care of pigs
- a pork abattoir or pork rendering plant
- pig doggers and hunters
- personnel who work directly with mosquitoes through their surveillance (field or laboratory based) or control and management such as:
- environmental health officers and workers (urban and remote)
- entomologists
- diagnostic and research laboratory workers who may be exposed to the virus
*Ask your vaccination provider if a consultation fee applies
**Costs will apply. Ask your vaccination provider for details.
You will find a full list of JEV vaccine service providers on the Queensland Health Immunisation clinic finder map.
Personal protection
Personal protection measures can reduce the risk of you and your family getting bitten by mosquitoes. These include:
- Avoiding mosquitoes when they are most active, particularly at dusk and dawn.
- Covering up with light-coloured, loose-fitting clothing with long sleeves, long trousers, socks, and covered footwear when outside.
- Using an effective insect repellent on exposed skin and reapplying within a few hours, following the manufacturer's instructions. The best mosquito repellents contain Diethyl Toluamide (DEET), Picaridin or Oil of Lemon Eucalyptus (also known as PMD; p-menthane-3,8 diol).
- Repellents containing less than 10 per cent DEET or picaridin are considered safe for children, however, the use of topical repellents is not recommended for infants under 3 months of age. To protect infants less than 3 months of age, it is best to use physical barriers, such as having the child wear long, loose-fitting clothing or using nets on prams and cots. Young children should not apply repellents themselves. Repellents should be applied to the hands of a carer first, and then applied evenly to the child's exposed skin.
- Using insecticide sprays, vapour dispensing units (indoors), or mosquito coils (outdoors) to repel or kill mosquitoes.
- Ensuring that flyscreens in your home, tent or caravan are in good condition so mosquitoes cannot enter.
- Using mosquito-proof tents when camping.
- Using mosquito nets when sleeping unless accommodation is air conditioned or has mosquito screens on doors and windows.
To stop mosquitoes breeding on your property, remove any standing water or water-holding containers or empty and wipe out the container, wherever possible.
Help and assistance
If you are in an emergency situation call 000
Get qualified health advice 24/7 for the cost of a local call, 13 HEALTH (13 43 25 84)
For further information, please contact your local doctor, community health centre or nearest public health unit. Travel vaccines need to be considered in your specific travel itinerary. Immunisation needs should be discussed with your doctor or travel medical centre at least 6 weeks before you travel. For further advice on travel vaccinations, visit the Australian Government's Smart Traveller website.
Other resources
- Having a vaccination what to expect fact sheet
- Barmah Forest virus fact sheet
- Kunjin virus disease fact sheet
- Ross River virus fact sheet
- Mosquito-borne disease prevention when travelling
- Mosquito-borne diseases after a storm, flood or cyclone
- Japanese encephalitis | The Australian Immunisation Handbook
- Translated factsheets on what you need to know about Japanese encephalitis
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One Health:
One Health is a collaborative, multisectoral approach which recognises the interconnection between people, animals, plants, and their shared environment. Queensland Health is committed to the ongoing collaboration across agencies, sectors and disciplines to achieve optimal health outcomes by addressing the interconnected challenges linking the health of people, domestic animals and wildlife.
Japanese encephalitis can also affect animals with reproductive losses in pigs and encephalitis (inflammation of the brain) in horses. For more information on animal health guidance review the animal health resources below.
References
Australian Technical Advisory Group on Immunisation (ATAGI). (2018). Australian Immunisation Handbook, Australian Government Department of Health, Canberra
Department of Health. (2022). Japanese Encephalitis
Heymann, D.L. (2015). Control of Communicable Diseases Manual, 20th edition. Washington, DC: American Public Health Association.
World Health Organization. (2019). Japanese Encephalitis Fact Sheet