**8. Protection**

The control of JE is based mainly on three measures: mosquito control, avoiding human exposure and immunization. Mosquito control has failed to be an effective measure and suffers from the lack of research into new pesticides. Avoiding complete exposure from infected mosquitoes is not practically possible. Accordingly, immunization is the only effective method for long-term protection. To prevent JE, it is crucial to apply a large scale vaccination for the human population in JE prone areas [Tiwari *et al*., 2012]. There are many groups of vaccines [Table 3] which are presently in use such as purified, formalin-inactivated mouse brain derived and cell culture derived live attenuated vaccine [Lin *et al*., 2013]. Several vaccines are still in different stages of development such as DNA vaccines, recombinant virus based/chimeric vaccines [Li *et al*., 2013]. In most countries, the currently available vaccine for use is an inactivated vaccine derived from mouse brain, which is manufactured in many regional countries, but it is costly, involves three doses, needs boosting at quite frequent intervals, may be less effective due to antigenic variation and gives rise to a number of vaccine related adverse reactions [Yun *et al*., 2013].


There are several side effects of JE vaccination. Side effects which are mainly seen after vaccination are redness, swelling and tenderness. Rarely systematic adverse reactions are also seen after vaccination like headache, myalgia, abdominal pain and skin rash. Some recipients of the vaccine had very rare major neurological side effects [Sohn *et al*., 2000]. To avoid some of the adverse reactions, vero cell grown inactivated vaccines are being examined and some of them are currently in clinical trials. Live attenuated vaccines seem to offer good hope; some of the advantages are that these provide long lasting immunity and are very sensitive. Currently, the only potential vaccine is the Chinese SA 14-14-2 strain [Verma *et al.,* 2012]. Protein-protein interaction is essential for various cellular functions and impeding such interactions using synthetic composites is a very noteworthy idea for formulation of new pharmaceuticals [Haridas *et al.*, 2013].

## **9. Conclusion**

**7. Treatment**

10 Trends in Infectious Diseases

**8. Protection**

reactions [Yun *et al*., 2013].

Currently there is no therapy for JE [Saxena *et al*., 2009]. Presently, chemotherapy during JE is mainly supportive and not targeted towards JEV specifically. Interferon therapy has not proved to be a great success [Tiwari *et al*., 2012]. Naturally occurring compounds such as arctigenin, a phenylpropanoid and rosmarinic acid, which is a phenolic compound found in many *Labiatae* provide protection to mice against JEV GP78 by noticeably decreasing JEV induced neuronal apoptosis, activation of microglial cells, active caspase activity and induction

An *in vivo* study has shown that minocycline reduces neuronal apoptosis, activation of microglial cells, active caspase activity, proinflammatory mediators and viral titer on later stages after infection. Another compound, N-methylisatin-β-thiosemicarbazone derivative is known to inhibit JEV replication completely *in vitro*. Glucosidase inhibitors of the endoplasmic reticulum such as N-nonyl-deoxynojirimycin, which block the trimming step of N-linked glycosylation, have been shown to eliminate the production of many endoplasmic reticulumbudding viruses, including dengue type-II and JEV. Another recent study carried out in mice using RNA interference showed that a single intracranial organization of lentiviruses deliv‐ ering short hairpin RNA or lipid-complexed small interfering RNA (siRNA) either before or after the viral challenge was sufficient to provide protection against lethal encephalitis. From the study it was clear that by precise drug design of the conserved site, a single siRNA treatment could suppress viral infection across species, thus enhancing the treatment of acute

The control of JE is based mainly on three measures: mosquito control, avoiding human exposure and immunization. Mosquito control has failed to be an effective measure and suffers from the lack of research into new pesticides. Avoiding complete exposure from infected mosquitoes is not practically possible. Accordingly, immunization is the only effective method for long-term protection. To prevent JE, it is crucial to apply a large scale vaccination for the human population in JE prone areas [Tiwari *et al*., 2012]. There are many groups of vaccines [Table 3] which are presently in use such as purified, formalin-inactivated mouse brain derived and cell culture derived live attenuated vaccine [Lin *et al*., 2013]. Several vaccines are still in different stages of development such as DNA vaccines, recombinant virus based/chimeric vaccines [Li *et al*., 2013]. In most countries, the currently available vaccine for use is an inactivated vaccine derived from mouse brain, which is manufactured in many regional countries, but it is costly, involves three doses, needs boosting at quite frequent intervals, may be less effective due to antigenic variation and gives rise to a number of vaccine related adverse

of proinflammatory mediators in the brains of the infected animals.

viral infections with overlapping clinical symptoms [Ghosh *et al*., 2009].

JE is a neurological disease caused by a mosquito-borne JEV. Unlike smallpox and polio, JEV cannot be completely eradicated because of its enzootic nature of transmission. Ever since its discovery, JEV has continued to expand its activity into new regions, while many JE vaccines have been made commercially available in different parts of the world. Concern about its spread has been emphasized by the recent emergence and spread of JEV in northern Australia, making it a major concern for global public health. Currently, prevention of infection with most arboviruses relies primarily on efforts to control vector populations by spraying repel‐ lents, wearing protective clothing and reducing breeding places.

One of the most important research areas is the development of an ideal JE vaccine: one that is nontoxic, less expensive and more effective and that provides life-long protection with a single dose. The development of such a vaccine will be greatly aided by a expanding our knowledge of JEV replication and pathogenesis at the molecular level, which has now become technically possible with the use of infectious JEV SA14-14-2 cDNA technology. This technol‐ ogy also has huge potential for developing JEV SA14-14-2 as a vaccine vector to deliver foreign gene(s), as has already been accomplished with infectious YFV 17D cDNA technology.
