Volume 88, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephalitis (JE) and dengue viruses. Morbidity and mortality in Nepal is in the thousands since JE was introduced in 1978. Nepal launched an extensive laboratory-based JE surveillance in 2004. Nepal experienced a remarkable reduction in disease burden after mass immunizations from 2005 to 2010, when 2,040 JE infections and 205 JE-related deaths were confirmed. With its emergence in 2006, dengue has become a significant challenge in the country, highlighted by a sudden outbreak in 2010 that resulted in 359 confirmed dengue infections. Currently, both viruses cocirculate in Nepal. Here, we document the remarkable expansion of dengue in Nepal, which urgently requires national surveillance to refine the burden and make recommendations regarding control and prevention programs. We believe that the use of existing JE surveillance network for integrated dengue surveillance may represent the most appropriate alternative.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Sohn YM, , 2000. Japanese encephalitis immunization in South Korea: past, present, and future. Emerg Infect Dis 6: 1724. [Google Scholar]
  2. Kyle JL, Harris E, , 2008. Global spread and persistence of dengue. Annu Rev Microbiol 62: 7192.[Crossref] [Google Scholar]
  3. WHO, 2009. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization. [Google Scholar]
  4. Gubler DJ, Meltzer M, , 1999. Impact of dengue/dengue hemorrhagic fever on the developing world. Adv Virus Res 53: 3570.[Crossref] [Google Scholar]
  5. EDCD, 2005. Annual Report: 2002 and 2003. Nepal: Epidemiology and Disease Control Division (EDCD), Department of Health Services, Ministry of Health and Population, Kathmandu. [Google Scholar]
  6. Bista MB, Shrestha JM, , 2005. Epidemiological situation of Japanese encephalitis in Nepal. JNMA J Nepal Med Assoc 44: 5156. [Google Scholar]
  7. WHO, 2003. WHO-Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases. Geneva: World Health Organization. [Google Scholar]
  8. Wierzba TF, Ghimire P, Malla S, Banerjee MK, Shrestha S, Khanal B, Sedai TR, Gibbons RV, , 2008. Laboratory-based Japanese encephalitis surveillance in Nepal and the implications for a national immunization strategy. Am J Trop Med Hyg 78: 10021006. [Google Scholar]
  9. Malla S, Thakur GD, Shrestha SK, Banjeree MK, Thapa LB, Gongal G, Ghimire P, Upadhyay BP, Gautam P, Khanal S, Nisaluk A, Jarman RG, Gibbons RV, , 2008. Identification of all dengue serotypes in Nepal. Emerg Infect Dis 14: 16691670.[Crossref] [Google Scholar]
  10. Pandey BD, Morita K, Khanal SR, Takasaki T, Miyazaki I, Ogawa T, Inoue S, Kurane I, , 2008. Dengue virus, Nepal. Emerg Infect Dis 14: 514515.[Crossref] [Google Scholar]
  11. Malla S, Ghimire P, Dumre S, Khanal SP, Subedi BK, Wierzba TF, , 2005. A First Report of Dengue Fever Cases in Nepal. Health Action in Nepal: Health Newsletter. Available at: http://www.who.int/hac/crises/npl/sitreps/2005/Nepal_Health_Action_Issue_III.pdf. Accessed May 1, 2012. [Google Scholar]
  12. Innis BL, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke CH, , 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40: 418427. [Google Scholar]
  13. WHO, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment and Control. Geneva: World Health Organization. [Google Scholar]
  14. Bista MB, Banerjee MK, Shin SH, Tandan JB, Kim MH, Sohn YM, Ohrr HC, Tang JL, Halstead SB, , 2001. Efficacy of single-dose SA 14-14-2 vaccine against Japanese encephalitis: a case control study. Lancet 358: 791795.[Crossref] [Google Scholar]
  15. Ohrr H, Tandan JB, Sohn YM, Shin SH, Pradhan DP, Halstead SB, , 2005. Effect of single dose of SA 14-14-2 vaccine 1 year after immunisation in Nepalese children with Japanese encephalitis: a case-control study. Lancet 366: 13751378.[Crossref] [Google Scholar]
  16. Tandan JB, Ohrr H, Sohn YM, Yoksan S, Ji M, Nam CM, Halstead SB, , 2007. Single dose of SA 14-14-2 vaccine provides long-term protection against Japanese encephalitis: a case-control study in Nepalese children 5 years after immunization. Vaccine 25: 50415045.[Crossref] [Google Scholar]
  17. WHO, 2011. World Health Organization Country Office for Nepal. National Immunization Programme: Routine Immunization. Available at: http://www.nep.searo.who.int/EN/Section4/Section29/Section89.htm. Accessed May 1, 2012. [Google Scholar]
  18. Tripathi P, Kumar R, Tripathi S, Tambe JJ, Venkatesh V, , 2008. Descriptive epidemiology of dengue transmission in Uttar Pradesh. Indian Pediatr 45: 315318. [Google Scholar]
  19. WHO, 2007. Outbreak Investigation in Nepal. South East Asia Regional Office, New Delhi, India: World Health Organization. Available at: Accessed May 14, 2012. [Google Scholar]
  20. Gautam I, Dhimal MN, Shrestha SR, Tamrakar AS, , 2009. First record of Aedes aegypti (L.) vector of dengue virus from Kathmandu, Nepal. Journal of Natural History Museum 24: 156164. [Google Scholar]

Data & Media loading...

  • Received : 19 Jul 2012
  • Accepted : 21 Nov 2012
  • Published online : 03 Apr 2013

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error