Epidemiology of Japanese Encephalitis in Central India after Implementing Immunization

Abstract

Objective We report the epidemiology of Japanese encephalitis (JE) disease after the implementation of routine immunization in medium-endemic districts in the states of Maharashtra and Telangana in Central India.

Methods We investigated acute encephalitis syndrome (AES) patients hospitalized from October 2018 to September 2020. Field visits were also made to the residences of 262 AES cases, including 54 JE cases.

Results The overall case fatality ratio was 31%. Maharashtra state contributed 72% of JE and 67% of AES cases. The rural localities had a significantly higher number of JE cases than the urban areas. The occurrence of JE was reported year round, with most JE cases reported during the rainy season. Both AES and JE cases were reported mostly among children, with JE in 66% and non-JE AES in 70% of children.

Conclusion The JE disease continues to affect the population after routine immunization. Surveillance, prevention, and control need to be enhanced to achieve accelerated control.

Keywords

acute encephalitis syndrome - disease endemicity - epidemiological transition - risk estimation - routine immunization - vaccination impact

Authors' Contributions

B.V.T. planned and designed the study including the design, procedures, and questionnaires. P.S.D. and P.K. drafted the first version of the manuscript as per the input by B.V.T. along with the preparation of illustrations with continued guidance from B.V.T. Additional review, suggestions, and coordination of field activities were received from R.N., M.S.Q., and G.V.P. as the site investigators. Critical review inputs were received from S.J.T., P.R.D., U.W.N., and P.K.J. The other investigator colleagues of the study group also provided inputs and support during the study execution (V.P.B., G.N.S., R.G.D., M.J., A.V.R. D.J., V.K.G., J.J., R.V.G., V.C.S., A.K.N., M.T., P.R., B.P.S., M.P.K., and K.J.K.). S.S.R. guided, reviewed, and provided inputs on study design, data interpretation, and reporting of findings, and a critical review of the draft report and final manuscript. All manuscript authors including also the study group contributors reviewed and approved the final version of the manuscript.

Publication History

Received: 06 October 2023

Accepted: 12 January 2024

Article published online:
24 April 2024

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