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Japanese Encephalitis and International Travel.

Japanese encephalitis UE) is a flaviviral infection of the central nervous system.The Japanese encephahtis virus UEV) is transmitted to man through mosquito bites. Japanese encephalitis has long been endemic in Southeast Asia and in the Western Pacific regions. It is a zoonotic disease that infects man as an incidental host. The ratio of overt disease to inapparent infection varies from 1 :300 to 1 : 1000. Culicine mosquitoes, notably Culex tritaeniorhynchus, are the main vector. Rice fields are their principal breeding place, and pigs are iniportant amplifying hosts. Other vertebrate hosts include bovines, horses and possibly birds. Most JE patients come from areas where there are rice fields and pigs. In countries where JE has been present for many years, annual peaks of disease cycles have been irregular. In hot tropical regions, there is no apparent seasonal pattern as is the case in Tamil Nadu (India), Sri Lanka, and Malaysia. In contrast, seasonal incidences ofJE occur in northern moderate regions, such as in Chiang Mai Valley (Thailand), the northern part of Vietnam, Shan State ofBurma, and in northeastern India. Outbreaks have been associated with rainfall or irrigation and floods.The following factors are involved in the changing epidemiology ofJE in many countries: 1.