**7. Discussion**

The earlier reports have shown that the case fatality rate (CFR) is high in Nepal, and nation‐ wide it has ranged from 15% to 46% for the years 1978 to 1994 (Joshi et al., 1981). It has been proved that JE virus causes encephalitis in humans and abortion in pigs while no symptoms in other animals and birds. Mostly children aged five to fifteen is victimized than adults. About fifty percent of the JE survivors are left with neurological syndrome and damage to the organs (Joshi, 1983, Pradhan, Khatri et al., 1981, 1983).

**8. Conclusion**

vidual (Joshi et al., 2003).

**Acknowledgements**

**Author details**

**References**

quito repellants (Neopane Arpana, 2011).

Durga Datt Joshi and Jeevan Smriti Marg

[1] Annapurna National Daily News Paper 2011.

For the reduction of JE cases in Nepal mass vaccination programme should be carried out every year for children in high risk districts of JE. Except symptomatic treatment there is no specific treatment for Japanese encephalitis. There is a Japanese encephalitis vaccine pre‐ pared in Japan, China and Rusia. There are two types of vaccines one liquid and other freeze dried. Vaccination can be done subcutaneously two doses of 1 ml each above 3 years of age and 0.5 ml. For children upto 3 years of age at an interval of 7-14 days. Third doses should be given before one year. This will protect for 3 years in the endemic zone. One more boos‐ ter dose after 3 years has been recommended which will give life long immunity to an indi‐

Review on Japanese Encephalitis Outbreak Cases in Nepal During the Year 2011

http://dx.doi.org/10.5772/52422

69

To conclude, mosquito borne disease is on the rise. There are many methods for mosquito control and depending the situation, source reduction (e.g., removing stagnant water) biocontrol (e.g. importing natural predators such as dragonflies), trapping, using nets and us‐ ing pesticides can be helpful. In endemic areas, there should be spraying of insecticides every day. People should stay inside between dusk and dark if possible. When outdoors, wearing pants and long-sleeved shirts is a must. Exposed skin should be sprayed with mos‐

I would like to thank following staff of NZFHRC for their continuous help in preparing and translating notes and papers from Nepali to English language published in different media of Nepal on Japanese encephalitis; Ms. Minu Sharma, Ms. Meena Dahal, Dr. Anita Ale, Ms. Kabita Shahi, Ms. Indira Mainali during the year 2007 to 2011. This study was supported by

\*Address all correspondence to: ddjoshi@healthnet.org.np/joshi.durgadatt@yahoo.com

National Zoonoses and Food Hygiene Research Centre (NZFHRC), Kathmandu, Nepal

International Development Research Centre (IDRC), Ottawa, Canada.

The people in the districts are dying due to Japanese encephalitis, and it threatens to assume epidemic proportions. The government has just started its second round of vaccination un‐ der mass vaccination program for the disease, which should have been completed by 2006. Because of the delay in vaccination, the number of patients suffering from Japanese Ence‐ phalitis may increase and take an epidemic form.

The vaccine "anti JESA-14-14-2 live attenuated" is produced in China and that it was found to be above 98 percent effective in Chinese children (RSS, 2006). In Nepal, some two million people live in the Terai regions considered to be highly affected areas. In order to prevent the epidemic, more than three million doses of vaccines had been arranged during the year 2005.

Vaccination campaign against Japanese encephalitis has been started in Banke district from 26 July 2006. It is said that all 422,000 people above one year of age from Banke district were vaccinated in the campaign, which would continue until August 18, 2006. The full doze vac‐ cine has been provided by the district public Health office. According to the schedule, the campaign would remain until July 17, 2006 in Nepalgunj municipality and from July 27 to August 18, 2006 in 46 VDCs of the districts (JE vaccination report of Banke, 2006).

The reduction in case incidence of Japanese encephalitis, in some countries like China, Japan and Korea has been achieved by applying certain measures such as:


3.5 million of JE vaccine doses was procured by the Ministry of Health during the year 2006/2007. The vaccine is made in China by Chengdu Institute of Biological Product. This vaccine will be used in children under 15 years of age of 24 districts of JE risk and high-risk areas of Nepal.

In Nepal twenty-four districts of Terai are declared as JE prone disease area. About 12.5 mil‐ lion people in Nepal are in JE risk category. Children who are less than 15 years of age are more prone to suffer in case of a JE outbreak. In China, JE vaccination in childrens has shown 98.4% immunity which is very encouraging (EDCD and IPD, 2006). During the year 2007 about 35,00,000 doses of JE vaccine is going to be procured. So far about 5000 people died due to JE from the year 1978 to 2006. Every year 3000 to 4000 people yet risk and about 200-300 people die due to JE.
