Japenese encephalitis JE vaccine

[SUMAN-SAJAN]

Japenese encephalitis JE vaccine

JE is a mosquito borne arboviral infection predominant cause of viral encephalitis in Asia .

Children below 15 years are predominantly affected ;most of JE infection develope subclinical rather than overt symptoms.

serious outcomes in the surviors include- paralysis , coma , neuroparalysis .

Prevalence

Disease mainly occur in the rural areas.


VACCINATION IS SINGLEMOST IMPORTANT CONTROL MEASURE

JE-vaccine -GCC inj. has proven ot protective against JE.
It is purified preparation of the inactivated JE virus derived from the mice which is artificially inoculated with Nakayama strain.


IMMUNISATION SCHEME

Primary immunisation consist of :
3 doses of 1 ml for persons > 3 years of age at an interval of 0/1-2 wks/1year

3 doses of 0.5 ml for persons < 3 years of age at an interval of 0/1-2 wks/1year

Booster
At the age of 6 years and 12 years


Contraindications

cardiovascular diseases
fever
renal diseases
hepatic diseases
hypersensitivity
convulsion
pregnancy


Side effects

local redness
swelling
pain
fever
chills
headache
lassitude



Precautions

- shake well before use
- once freezed do not use
- not to be given for children less than 1 year


DOSAGE AND ADMINISTRATION

CHILDREN <3 YRS- 0.5 ml subcutaneous
CHILDREN.3 yrs and adult - 1.0 ml subcutaneous



ADMINISTRATION

primary immunisation
1st and 2nd dose : 2 injections at the interval of 1-2 weeks
3rd dose : after 1 year

Booster :
one dose at 6 years and 12 years




sUmAn sajan

[Mati]

Dear Suman,

That's good job! Keep posting (useless to say that: you are doing it and definitely you have more posts than mine).

Japanese Encephalitis (JE), a viral arthropod borne infectious disease, is dangerous one which can be prevented with vector (culex: mainly) control and vaccines. Human is not a normal host for the life cycle of this virus and is a dead end host! The disease is prevalent in our Terai region. However, a Western Doctor practicing in Nepal has said he had one case of JE from Kathmandu valley (from periphery of Kathmandu valley where paddy fields are ). I don't the details of the patient i.e migration status, traveling history, pets and etc. The disease starts from the ending/last segment of rainy season/monsoon. We can say from the end of Shrawan or from Bhadra and takes height somewhere during the time of Dashain Festival. As we know like malaria, it will affect and make victims of poors in Terai.

There is no specific treatment for this disease so far. It is only supportive measures we can do. The prevalence of this disease is of bimodal way: children and elderly. The mortality can go as high as to 30%-40%. In many cases, we need ICU set up.

Few weeks earlier, I have been in touch one of the leading epidemiologist of Nepal who is, of course, was in touch with the Ministry of Health. This year we have been suffering from the JE vaccine shortage! The financial aid for the vaccine has been very much delayed due to red tapism. The vaccines produced by the companies have been all reserved by INDIA because India need a lot more vaccines. Therefore, even if we get money by now it is already too late to buy vaccine and there are no vaccines in the market duet high demand as well as India reserving it. So, Nepal has what was left in her stock and last year's remaining which is not adequate of course!!! Therefore, there is high chance that Nepal can have JE upsurge this year!!! It is already rainy season, let's see.

Let's hope there will be less case fatality this year. Nepal has already been successful to reduce case fatality rate by vaccines as well as preventive measures.

Best wishes,
mati

[Ajay]

On this context, i would like to give some important facts regarding JE in Nepal .

• First case was detected in 1978
• Now 24 districts of terai are affected
• 12.5 million people are at risk
• Annually there are 1000-3000 cases with 200-400 mortality
• > 50% of the diseases are children(1-15 yrs)
• Male:female ratio- 1.3:1
• High risk districts: Kanchanpur, Kailali, Bardia, Banke, Dang, Rupandehi, Parsa, Sunsari, Morang, Jhapa
• 3 referral labs for the diagnosis: National Public Health Lab teku; Vector Borne Research and Training Centre, Hetauda; BPKIHS

Source: Annual Report, Department of Health Services 2061/62

[Mati]

Excellent,

About two months ago there was a workshop on "Research possibilities on Infectious Diseases of Nepal mainly on Japanese Encephalitis, Avian Influenza and Malaria". It was jointly organized by Nepal Health Research Council (NHRC) and Department of Health Services (Teku). I was there.

Two leading Tropical medicine experts from Oxford University were in Nepal for that workshop. One of those has been doing research in Vietnam for decades and another is in Thailand. They are conducting some of the largest trials on Tropical Medicine. So they were to see, suggest and conduct the possible studies on the topic.

NHRC, I think, is going to conduct a trial in one of the above diseases soon. That's great! The present body of NHRC seems all set to work. Hope they will come up many such ideas in the future.

Best wishes,
mati

[SUMAN-SAJAN]

Mati dai and Ajay dai! thanks for ur valuable informations . Your post has added the glory to the post" Japanese encephalitis JE vaccine".

Thanks again.