• 1.

    Fischer M, Lindsey N, Staples JE, Hills S, 2010. Japanese encephalitis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 59: 127.

    • Search Google Scholar
    • Export Citation
  • 2.

    Campbell GL, Hills SL, Fischer M, Jacobson JA, Hoke CH, Hombach JM, Marfin AA, Solomon T, Tsai TF, Tsu VD, Ginsburg AS, 2011. Estimated global incidence of Japanese encephalitis: a systematic review. Bull World Health Organ 89: 766774.

    • Search Google Scholar
    • Export Citation
  • 3.

    World Health Organization, 2005. Global Advisory Committee on Vaccine Safety, 9–10 June 2005. Wkly Epidemiol Rec 80: 242243.

  • 4.

    Liu ZL, Hennessy S, Strom BL, Tsai TF, Wan CM, Tang SC, Xiang CF, Bilker WB, Pan XP, Yao YJ, Xu ZW, Halstead SB, 1997. Short-term safety of live attenuated Japanese encephalitis vaccine (SA14-14-2): results of a randomized trial with 26,239 subjects. J Infect Dis 176: 13661369.

    • Search Google Scholar
    • Export Citation
  • 5.

    Yaïch M, 2009. Investing in vaccines for developing countries: how public-private partnerships can confront neglected diseases. Hum Vaccin 5: 368369.

    • Search Google Scholar
    • Export Citation
  • 6.

    Kumar R, Tripathi P, Rizvi A, 2009. Effectiveness of one dose of SA 14-14-2 vaccine against Japanese encephalitis. N Engl J Med 360: 14651466.

    • Search Google Scholar
    • Export Citation
  • 7.

    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.

    • Search Google Scholar
    • Export Citation
  • 8.

    Henderson A, Leake CJ, Burke DS, 1983. Japanese encephalitis in Nepal. Lancet 2: 359360.

  • 9.

    Joshi DD, 1995. Current status of Japanese encephalitis in Nepal. Southeast Asian J Trop Med Public Health 26 (Suppl 3): 3440.

  • 10.

    Pant GR, 2006. A serological survey of pigs, horses, and ducks in Nepal for evidence of infection with Japanese encephalitis virus. Ann N Y Acad Sci 1081: 124129.

    • Search Google Scholar
    • Export Citation
  • 11.

    Bista MB, Shrestha JM, 2005. Epidemiological situation of Japanese encephalitis in Nepal. J Nep Med Assoc 44: 5156.

  • 12.

    Zimmerman MD, Scott RM, Vaughn DW, Rajbhandari S, Nisalak A, Shrestha MP, 1997. Short report: an outbreak of Japanese encephalitis in Kathmandu, Nepal. Am J Trop Med Hyg 57: 283284.

    • Search Google Scholar
    • Export Citation
  • 13.

    Basnyat B, Zimmerman MD, Shrestha Y, Scott RM, Endy TP, 2001. Persistent Japanese encephalitis in Kathmandu: the need for immunization. J Travel Med 8: 270271.

    • Search Google Scholar
    • Export Citation
  • 14.

    Partridge J, Ghimire P, Sedai T, Bista MB, Banerjee M, 2007. Endemic Japanese encephalitis in the Kathmandu valley, Nepal. Am J Trop Med Hyg 77: 11461149.

    • Search Google Scholar
    • Export Citation
  • 15.

    Bhattachan A, Amatya S, Sedai TR, Upreti SR, Partridge J, 2009. Japanese encephalitis in hill and mountain districts, Nepal. Emerg Infect Dis 15: 16911692.

    • Search Google Scholar
    • Export Citation
  • 16.

    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.

    • Search Google Scholar
    • Export Citation
  • 17.

    Burke DS, Nisalak A, 1982. Detection of Japanese encephalitis virus immunoglobulin M antibodies in serum by antibody capture radioimmunoassay. J Clin Microbiol 15: 353361.

    • Search Google Scholar
    • Export Citation
  • 18.

    World Health Organization, 2008. WHO-Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases. Report No: WHO/V&B/03.01. Available at: http://whqlibdoc.who.int/hq/2003/WHO_V&B_03.01.pdf. Accessed June 2, 2011.

    • Search Google Scholar
    • Export Citation
  • 19.

    Andrus JK, Banerjee K, Hull BP, Smith JC, Mochny I, 1997. Polio eradication in the World Health Organization South-East Asia Region by the year 2000: midway assessment of progress and future challenges. J Infect Dis 175 (Suppl 1): S89S96.

    • Search Google Scholar
    • Export Citation
  • 20.

    World Health Organization Regional Office for South-East Asia, 2011. Malaria Situation in SEAR Countries: Nepal. Available at: http://www.searo.who.int/EN/Section10/Section21/Section340.htm. Accessed February 15, 2011.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Estimation of the Impact of a Japanese Encephalitis Immunization Program with Live, Attenuated SA 14-14-2 Vaccine in Nepal

View More View Less
  • Child Health Division, Ministry of Health and Population, Kathmandu, Nepal; Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia; Programme for Immunization Preventable Diseases, World Health Organization, Kathmandu, Nepal; Kanti Children's Hospital, Kathmandu, Nepal; National Public Health Laboratory, Kathmandu, Nepal; Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Walter Reed/Armed Forces Research Institute of Medical Sciences Research Unit Nepal, Kathmandu, Nepal
Restricted access

Wider availability of the live, attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine has facilitated introduction or expansion of immunization programs in many countries. However, information on their impact is limited. In 2006, Nepal launched a JE immunization program, and by 2009, mass campaigns had been implemented in 23 districts. To describe the impact, we analyzed surveillance data from 2004 to 2009 on laboratory-confirmed JE and clinical acute encephalitis syndrome (AES) cases. The post-campaign JE incidence rate of 1.3 per 100,000 population was 72% lower than expected if no campaigns had occurred, and an estimated 891 JE cases were prevented. In addition, AES incidence was 58% lower, with an estimated 2,787 AES cases prevented, suggesting that three times as many disease cases may have been prevented than indicated by the laboratory-confirmed JE cases alone. These results provide useful information on preventable JE disease burden and the potential value of JE immunization programs.

Author Notes

* Address correspondence to Susan L. Hills, Arboviral Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521. E-mail: shills@cdc.gov

Financial support: The Bill & Melinda Gates Foundation provided financial support for this evaluation through a grant to the US Centers for Disease Control and Prevention.

Authors' addresses: Shyam Raj Upreti, Child Health Division, Ministry of Health and Population, Kathmandu, Nepal, E-mail: drshyam@hotmail.com. Kristen Janusz, Marc Fischer, and Susan L. Hills, Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: kbjanusz@aol.com, mfischer@cdc.gov, and shills@cdc.gov. W. William Schluter, Programme for Immunization Preventable Diseases, World Health Organization, Kathmandu, Nepal, E-mail: schluterw@wpro.who.int. Ram Padarath Bichha, Kanti Children's Hospital, Kathmandu, Nepal, E-mail: drrpbichha@gmail.com. Geeta Shakya, National Public Health Laboratory, Kathmandu, Nepal, E-mail: geetanphl@yahoo.com. Brad J. Biggerstaff, Office of the Director, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, E-mail: bbiggerstaff@cdc.gov. Murari Man Shrestha and Tika Ram Sedai, Programme for Immunization Preventable Diseases, World Health Organization, Kathmandu, Nepal, E-mails: Shresthamu@searo.who.int and Sedait@searo.who.int. Robert V. Gibbons, US Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, E-mail: Robert.Gibbons@afrims.org. Sanjaya Shrestha, Walter Reed Armed Forces Research Institute of Medical Sciences Research Unit, Nepal, E-mail: shresthask@afrims.org.

Save