Challenges in the Management and Prevention of Japanese Encephalitis

  • Quanhathai KaewpoowatEmail author
  • Linda Aurpibul
  • Rommanee Chaiwarith


Japanese encephalitis (JE), a viral disease transmitted by Culex mosquitos, is one of the major global health threats with three billion of the world’s population living in at risk JE-endemic areas. Most JE infections are asymptomatic, but when clinical neuroinvasive disease does ensue, mortality can be as high as 30% with 20–30% permanent morbidity among survivors. The recommended confirmation test is JE IgM in CSF (preferred) or serum with limitations of dengue cross-reactivity and fair sensitivity.

Supportive treatment remains the mainstay of care for symptomatic JE infection. Several therapeutic agents have been explored, but most failed to demonstrate significant benefit. The vaccination, especially for children in endemic areas and for nonimmune travelers, remains the best method to prevent JE along with routine personal protective measures to avoid mosquito bites. The comprehensiveness of JE immunization programs varies greatly, dependent on national policymaking that often does not cover all endemic areas. Moreover, public and physician awareness remains low for JE vaccination in high-risk travelers. Gaps in knowledge, strategies, and resources for JE need to be addressed.


Japanese encephalitis Japanese encephalitis vaccine Travelers Management Prevention 



The authors acknowledge Dr. Bruce G. Weniger for his editorial advice and assistance.

Conflict of Interest

The authors have no conflicts of interest to declare.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Quanhathai Kaewpoowat
    • 1
    • 2
    Email author
  • Linda Aurpibul
    • 3
  • Rommanee Chaiwarith
    • 4
  1. 1.Division of Infectious Diseases and Tropical MedicineDepartment of Medicine, Chiang Mai UniversityChiang MaiThailand
  2. 2.Research Institute for Health Sciences, Chiang Mai UniversityChiang MaiThailand
  3. 3.Research Institute for Health Sciences, Chiang Mai UniversityChiang MaiThailand
  4. 4.Division of Infectious Diseases and Tropical MedicineMaharaj Nakorn Chiang Mai Hospital, Chiang Mai UniversityChiang MaiThailand

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