Bellary, India achieves negligible case fatality due to Japanese encephalitis despite no vaccination: an outbreak investigation in 2004.

OBJECTIVE: To confirm the existence of the outbreak of suspected Japanese encephalitis, identify the source, to understand the circumstances due to which the outbreak was taking place and to suggest measures for its control. METHODS: The team visited Bellary from 4th to 10th Sept, 2004. The team interviewed the key persons and analyzed the records at District Surveillance Unit and Entomological Surveillance Unit and case records of suspected JE cases admitted in Encephalitis ward in Vijay Nagar Institute of Medical Sciences (VIMS). Eco-entomological survey was done in houses and surroundings of 3 randomly selected cases of Encephalitis in rural and urban areas of District Bellary. Their family members and neighbors were also asked for the awareness and presence of disease. Data was analyzed for epidemiological and clinical profiles. RESULTS: The suspected JE cases were being reported from end of June 2004. The cases were sporadic and out of 34 cases reported to VIMS (till 10th of September), 32 were from Bellary district and 2 were from adjoining Andhra Pradesh. Among these 32, 22 were from Bellary Taluk, which in turn were mainly concentrated (10 were reported) in urban Bellary. The case fatality rate was zero as no death was reported. Entomological surveillance (done by District Surveillance Unit) revealed a high outdoor presence of Culex tritaeniorhynchus as well as an indoor rising density of this mosquito from 2 per man hour catch in January to 22 in the month of August in the affected villages. On the contrary, the investigations on 7th and 8th September revealed high densities of An.subpictus and An. peditaenatus and nil of Culex species in the urban areas. Amplifier host of pigs and water birds were occasionally sighted in the area. CONCLUSION: A good community awareness of encephalitis, a prompt referral system and a good supportive treatment for the patients and a good surveillance system and response were observed. Very close proximity with amplifying hosts of pigs was avoided by the community, though piggeries were still not very far away (1-3 Km). These may explain the reduction in cases, deaths and disabilities due to this disease in this district over the years. Possibilities of mutant strain which is less virulent and/or a better immune status of at risk population may also need to be explored. The impact of the mass vaccination with SA 14-14-2, imported from China in Bellary during July, 2006 remains to be evaluated. This will further decrease the case load.

Serosurveillance for Japanese encephalitis, Akabane, and Aino viruses for Thoroughbred horses in Korea

Recent global warming trends may have a significant impact on vector-borne viral diseases, possibly affecting vector population dynamics and disease transmission. This study measured levels of hemagglutination-inhibition (HI) antibodies against Japanese encephalitis virus (JEV) and neutralizing antibodies against Akabane virus (AKAV) and Aino virus (AINV) for Thoroughbred horses in Korea. Blood samples were collected from 989 racehorses in several provinces, between October 2005 and March 2007. Sera were tested using either an HI assay or a virus neutralization test. Approximately half (49.7%; 492/989) of the horses tested were antibody-positive for JEV. The HI titer against JEV was significantly correlated with racehorse age (p < 0.05). Horses with an HI antibody titer of 1: 160 or higher accounted for 3.9% of the animals tested, indicating that vectors transmitting arthropod- borne viruses bit relatively few horses. In contrast, 3.8% (19/497) and 19.5% (97/497) of horse sera collected in March 2007 were positive against AKAV and AINV, respectively. The presence of antibodies against AKAV and AINV may indicate the multiplication of AKAV and AINV in these horses.

The seroprevalence of Japanese encephalitis virus in goats raised in Korea

Japanese encephalitis virus (JEV) causes a mosquitoborne viral zoonosis that is becoming increasingly important to public health in east and south Asia. Although JEV is primarily associated with reproductive failure in swine, JEV infection can cause fever and headache in humans and is associated with aseptic meningitis and encephalitis. The exact mode of transmission, including host range and possible source of viral amplification within livestock, is still not completely clear. This study consisted of a serological survey of JEV infection in goats. A total of 804 goat serum samples were collected from 144 farms in Korea between May 2005 and May 2006. The incidence of positive cases was 12.1% (97 out of 804 goats). The seroprevalence of JEV infection in the 144 farms screened was 31.3% (45/144), indicating that JEV infection is frequent in goat farms in Korea. In addition, three districts of Korea (mainly in the southern region) had a higher seroprevalence of JEV compared to other areas. The results suggest that goats could be monitored epidemiologically as a sentinel animal for JEV transmission in Korea.

Outdoor resting preference of Culex tritaeniorhynchus, the vector of Japanese encephalitis in Warangal and Karim Nagar districts, Andhra Pradesh.

BACKGROUND & OBJECTIVES: Entomological investigations were carried out in Warangal and Karim Nagar districts of Andhra Pradesh during viral encephalitis outbreak in July 2003. METHODS: Adult mosquito collections in outdoor were done using sweep cage method and in indoor with the help of aspirator tube and flash light. Larval collections were done by dipping method. JE virus positivity was tested by IgM capture ELISA test. RESULTS: Outdoor collections revealed presence of Culex tritaeniorhynchus, Cx. bitaeniorhynchus and Cx. gelidus and in indoor collections--Cx. quinquefasciatus, Cx. tritaeniorhynchus, An. vagus and An. subpictus. In the outdoor collections Cx. tritaeniorhynchus was predominant (96.3% of total collection). Three samples out of 55 serum samples from human cases and five from contacts showed the presence of antibodies against JE virus. INTERPRETATION & CONCLUSION: Cx. tritaeniorhynchus, a known vector of JE is predominant in outdoors and playing a main role in JE transmission in this area. Vector control aimed at the outdoor resting population might limit virus circulation in the mosquito vertebrate host cycle and prevent human infection.

Venereal transmission of Japanese encephalitis virus in Culex bitaeniorhynchus mosquitoes.

Experiments were conducted in the laboratory on C. bitaeniorhynchus to determine the possible role of males in maintaining or sustaining the Japanese encephalitis virus activity in nature. It was found that infected males are capable of passing on the virus to female mosquitoes while mating. The occurrence of phenomenon of venereal transmission of this virus may have epidemiological importance.

Virus isolation from wild-caught mosquitoes during a Japanese encephalitis outbreak in Kerala in 1996.

Out of 5357 wild-caught mosquitoes in 163 pools tested for virus using antigen capture ELISA and an insect-bioassay (inoculation into Toxorhynchites splendens larvae and identification by IFA using JE virus-specific monoclonal antibody), 16 flavivirus isolations were made of which 12 (75%) were identified as JE virus. Of the 12 JE virus isolations, 7 were from Culex tritaeniorhynchus, 3 from Mansonia uniformis and 1 each from Ma. indiana and Anopheles subpictus. Four isolations from Mansonia species for the first time reported here are noteworthy.

Japanese encephalitis virus is an important cause of encephalitis among children in Penang.

This study was carried out to determine if Japanese encephalitis virus is an important causative agent of viral encephalitis among pediatric admissions in Penang, Malaysia. 195 children with CNS symptoms and 482 children with non-specific febrile illness admitted into the Pediatric Ward of Penang Hospital during a 16 month period were entered into the study. The presence in serum of cerebrospinal fluid (csf) of Japanese encephalitis virus (JEV) specific IgM was determined by an IgM capture ELISA and cytomegalovirus (CMV) specific IgM was determined using a commercially available kit (Behringwerke AG). It was determined that 5 of 13 children with a discharge diagnosis of viral encephalitis had JEV specific IgM in csf, indicating that 38.5% of the viral encephalitis cases was due to JEV. One of the non-JEV cases was found to have mumps virus specific IgM in csf, while no etiology was determined for the other cases. It was also determined that 4 of the 195 (2.1%) cases with CNS symptoms had IgM to CMV, suggesting CMV may be an agent of encephalopathy in children in Penang. Other viruses found to be associated with CNS symptoms in children admitted into our study were measles and herpes simplex virus. A viral etiology was confirmed for 13 or the 195 cases (6.7%). We also screened 482 non-specific febrile cases for IgM to JEV and to dengue viruses and found that 2 (0.4%) had IgM specific for JEV and 9 (1.9%) had IgM specific for dengue virus.

First isolation of Japanese encephalitis virus from the mosquito, Culex tritaeniorhynchus Giles, 1901 (Diptera: Culicidae) in Gorakhpur district, Uttar Pradesh.

A strain of Japanese encephalitis (JE) virus has been isolated from a pool of female mosquitoes of C. tritaeniorhynchus, using C. bitaeniorhynchus cell line. This is the first report of JE virus isolation from mosquitoes in Gorakhpur district of Uttar Pradesh, north India.

Isolation of Japanese encephalitis virus from Culex pseudovishnui Colless, 1957 (Diptera: Culicidae) in Goa.

A strain of Japanese encephalitis virus was isolated from a pool of 54 female C. pseudovishnui Colless, 1957. The mosquitoes were collected in August 1988 during the period of epidemic of JE. This is the first report of isolation of JE virus from mosquitoes in Goa in the western coastal belt of peninsular India. In view of this isolation, C. pseudovishnui acquires greater importance, even though its density and relative prevalence during the current study was found to be far lower than C. tritaeniorhynchus.

Studies on Japanese encephalitis vectors in Indonesia.

Entomologic surveys indicated that JE vectors in Indonesia are Cx. tritaeniorhyncus and Cx. gelidus. In most study areas, the former were predominant among all the culicine mosquitoes. The seasonal abundance of the two JE vector species was correlated significantly with the rainfall. The virus activity was parallel to the seasonal fluctuation of the vectors suggesting that the transmission of the disease would depend on the population dynamics of the vectors.

A longitudinal study of Japanese encephalitis in suburban Bangkok, Thailand.

A one-year study of Japanese encephalitis (JE) in a small focus of transmission was conducted in suburban Bangkok in 1985. Monthly data were collected on weather, vector density, sentinel pig and chick JE antibody seroconversions, and epidemiology as related to human JE cases. The primary vector species were found to be Culex gelidus and Culex tritaeniorhynchus; from which one isolate each was obtained in March and June, respectively. Pig JE antibody seroconversion peaked in April (the hottest month), with secondary peaks following in July and December. Chick seroconversions were found only in June and July. Human cases (7) in the primary focus occurred from May-July, and started 2 months following the finding of the first JEV isolate in mosquitoes and 1 month following mass JEV seroconversion in pigs. Overall, the attack rate in the focus (0.83/10(5] was greater than 4 times that of the rest of Bangkok (0.19/10(5]. Attack rates were highest in 0-9 and 10-19 year-old groups, respectively. Indications are that JEV is transmitted to humans in Bangkok at least 10 out of 12 months per year, but that cases are concentrated in the May to July period.

Intense transmission of Japanese encephalitis virus to pigs in a region free of epidemic encephalitis.

Epidemic Japanese encephalitis recurs annually in the northern provinces of Thailand, but in the southern provinces cases of human encephalitis are rare. We investigated transmission of Japanese encephalitis virus (JEV) to pigs in southern Thailand. Blood specimens from one hundred young pigs at abattoirs in three southern provinces were tested for JEV hemagglutination inhibiting (HAI) antibodies. Seventy-four percent were positive. Ten seronegative sentinel pigs were placed at five locations in one southern province. Seven of the ten pigs developed JEV HAI and JEV IgM ELISA antibodies within two weeks of placement. JEV was isolated from all seven seroconverting sentinel pigs from blood specimens collected 3 to 11 days after placement. Fifteen light-trap mosquito collections at the five locations all included known JEV vectors, some in large numbers. We conclude that there is intense transmission of JEV to pigs in southern Thailand despite the rare occurrence of human encephalitis in the same region.

Correlation of population indices of female Culex tritaeniorhynchus with Japanese encephalitis viral activity in Kapuk, Indonesia.

Nineteen consecutive monthly light trap collections of mosquitoes were made between October 1978 and April 1980 in Kapuk, Indonesia. Kapuk is a small suburb of Jakarta where pigs are raised in close proximity to rice paddies which are breeding sites for Culex tritaeniorhynchus. Japanese encephalitis (JE) virus is believed to be endemic and has been recovered from mosquitoes and pigs in the area on several occasions. A total of 18,435 female Cx. tritaeniorhynchus were allocated to 359 pools of approximately 50 per pool. Virus isolations were attempted in both Vero and BHK-21 cells and agents producing cytopathic effect were identified in a micro-neutralization test. Nineteen strains of JE were recovered from the 359 pools of Cx. tritaeniorhynchus tested. The light trap index of female Cx. tritaeniorhynchus (X) and the relative frequency of pools positive for JE (Y) for each month of the study were plotted and correlation coefficients (r) calculated after transforming the mosquito population data logarithmically and the relative frequencies of isolation by arcsine square root. The close fit of the data (p less than 0.001) to an inverse linear model (1/y = a + b log10X) suggests a close dependence of JE viral activity on the population dynamics of Cx. tritaeniorhynchus. Three additional strains of JE were recovered from other Culex spp. at the same study site. One strain each was isolated from individual pools of Cx. gelidus, Cx. vishnui and Cx. fuscocephala. Cx. tritaeniorhynchus was more frequently infected with JE than the other species tested.