Japanese encephalitis: it's preventable
Japanese
encephalitis is a deadly disease that is caused by a virus
and transmitted by mosquitoes from infected animals, usually
pigs or wild birds. It occurs primarily in rural areas of South
and East Asia. Countries which have had major epidemics in the
past, but which have controlled the disease primarily by
vaccination, include China, Korea, Japan, Taiwan and Thailand.
Other countries such as Viet Nam, Cambodia, Myanmar, India,
Nepal, and Malaysia still have periodic epidemics. With a few
precautions, travelers to these areas should not have to worry
about contracting the disease. Although 30,000 to 50,000 cases
of Japanese encephalitis are reported annually, less than one
case per year is reported in U.S. civilians and military
personnel living in or traveling to Asia.
Most people who are infected with Japanese encephalitis show
only mild symptoms such as fever and a headache. More severe
infections can produce symptoms such as a stiff neck,
gastrointestinal problems, vomiting, confusion, tremors, stupor,
and coma. In about one out of every 200 cases, advance stages of
the illness cause inflammation of the brain, and more than half
of those cases end in permanent disability or death.
Since Japanese encephalitis is transmitted by mosquitoes, the
best way to avoid contracting the disease is to avoid being
bitten by mosquitoes. In tropical areas, the rainy season and
early dry season is the time when the disease is most likely to
be transmitted. In temperate areas, the critical time is during
the summer months. But regardless of the season, you should
avoid being outside during the dusk and dawn hours, when it's
cool and mosquitoes are most actively feeding. Also use mosquito
repellent and aerosol room insecticides. If your bedroom doesn't
have screens or air conditioning, the use of a mosquito net is a
must.
Don't worry about contracting Japanese encephalitis from another
person, even a health care worker who has treated someone with
the disease, because the disease is transmitted only by
mosquitoes, not from person to person.
You can get vaccinated against Japanese encephalitis, but in a
small number of cases there have been reports of serious
allergic side effects. About one in ten people who receive the
vaccine also experience chills, muscle pain, nausea, vomiting or
abdominal pain.
The National Center for Infectious Diseases does not recommend
the Japanese encephalitis vaccine for most travelers to Asia,
unless they will be spending more than a month in endemic areas
during the transmission season, and especially if their travel
will include rural areas. The Center does recommend the vaccine
for expatriates who plan to live in areas where Japanese
encephalitis is found.
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