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Japanese Encephalitis.

Definition of Disease...

JAPANESE ENCEPHALITIS VACCINE

The vaccine for Japanese encephalitis is currently available in the United States through most traveler's clinics. Travelers to Asia may receive the vaccine, but CDC recommends the vaccine only to those who work or have extensive visits during the transmission season to rural areas of the previously mentioned countries. The vaccine is recommended only for persons who will travel in rural areas for four weeks or more, except under special circumstances such as a known outbreak of Japanese encephalitis.

Risk of acquiring Japanese encephalitis is proportional to exposure to the mosquitos that breed chiefly in rural rice-growing and pig farming regions. Therefore, risk is low among the vast majority of persons whose itineraries are limited to cities or who will travel to the countryside only for short periods. These travelers do not require the vaccine. Older persons (> 55 years old) may be at higher risk for disease after infection and should be carefully considered for vaccination if they travel in areas of risk.

The vaccine is given in 3 doses on days, 0, 7, and 30 and protection can be expected 10 days following the last dose. A short course of vaccine can be given on days 0, 7 and 14, but this vaccination schedule is less effective than the longer course. Serious allergic side effects from the vaccine have been reported from up to 0.1% of vaccinees. These side effects can be delayed for several days after vaccination and consist of hives and dangerous swelling of the throat and mouth. Persons who have multiple allergies, especially to bee stings and various drugs, appear to be at higher risk for side effects and probably should not be vaccinated except under strict medical supervision. Close medical supervision should be available for persons receiving the vaccine for at least 48 hours after vaccination.

Fever and local reactions such as redness, swelling, and pain are reported in about 10% of those vaccinated. There is no information on the usefulness of this vaccine in children under 1 year old. In children and adults above 1 year old, the vaccine appears to be over 85% protective against the illness.

A booster dose may be required two years after the primary vaccination if the traveler is still at risk for infection.

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