Prevention, Control and Vaccination of Japanese Encephalitis 

Japanese encephalitis is a zoonotic disease that is transmitted by the vector mosquito that mainly belongs to Culex vishnui group. Transmission cycle maintained in the nature by JE virus animal reservoirs such as pigs and water birds. Man is the dead end host, meaning JE is not transmitted from one infected person to another. Areas Where close interaction between pigs, birds and Humans were found common in outbreak. JE vectors reproduce in large bodies of water. Rich in aquatic vegetation such as rice fields.

                          

Objectives:

1. Strengthening early diagnosis and rapid case management in PHC, COCs and hospitals through training of medical and nursing personnel.
2. IEC to raise community awareness to promote early case notification, personal protection, isolation of the host amplifier, etc
3. Vector control primarily measures fogging during outbreaks, spraying of spaces in animal dwellings, and anti-larval operation when feasible
4. Development of indigenous vaccines that will be safe and standard. Vaccination for high-risk populations, especially children under 15 years of age.

Main areas are:

1. Strengthening of public health measures.
2. Establishment of pediatric intensive care units in 60 district hospitals.
3. Establish PMRs in 10 different medical colleges in 5 states
4. Supply of drinking water, sanitation in rural areas and neighborhoods
5. Establishment of District Rehabilitation and Counseling Centers for 60 identified districts.
6. Improvement of the nutritional status of children in endemic areas.
7. ASHA involvement to assist in early referral of cases of encephalitis.

Prevention and Control of JE

1. The JE vaccination campaign was launched in 2006
2. Most sensitive districts were covered in Uttar Pradesh, Karnataka  and Assam
3. Reorientation training course on JE case management.
4. Diagnostic facilities have been strengthened to 50 sentries and 13 Apex Referral Laboratories.
5. Guidelines on JE case management and prevention and control.
6. A vector-borne disease surveillance unit (VBDSU) and a JE the sub-office was established at BRD Medical College, Gorakhpur, Uttar Pradesh

JE vaccination

1. Out of six vector-borne diseases, JE is the only one disease against which vaccination is available. This is the most effective preventive tool available by JE. Two doses of SA-14-14-2 live attenuated JE vaccines are recommended under routine immunization.
2. 234 JE endemic districts from 21 states covered under the JE vaccination campaign
3. 37 new districts identified in 2018 for JE vaccination campaign in children from 1 to 15 years
4. 31 districts in 3 states, ie Assam, Uttar Pradesh and West Bengal in 2018 have been covered for adult vaccination

Strengthening of critical care services

1. The intervention resulted in a 42% decrease in case mortality rate in cases of AES / JE of 18.6% in 2013 to 10.8% in 2018.
2. Early referral of AES / JE cases: a strengthen early referral services, provisions have been made to incentivize ASHA with Rs.300 / - case for AES / JE referenc cases to the upper center.
3. Establishment of pediatric ICUs (PICUs) 31 PICUs have been made functional in identified districts.

References 

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