Clinical Conversations: Japanese Encephalitis – A Practical Approach for GPs | Part two

Dr Bernard Hudson

writer

Dr Bernard Hudson

Microbiologist and Infectious Diseases Physician; Senior Staff Specialist, The Department of Microbiology and Infectious Diseases, Royal North Shore Hospital

Dr Bernard Hudson

 

It is likely that Japanese encephalitis will become endemic, and GPs will once again be at the forefront in diagnosis, future immunisation programmes and patient education. This disease is likely worsened due to climate change, migratory birds and feral pigs. Learn more about Japanese encephalitis in this podcast transcript from Associate Professor Bernie Hudson.

This is part two of a three part series.
Read part one
Read part three

Practice points

• It is likely that at the moment, the focus is going to be primarily on people that work in piggeries, or people that are in rural areas.
• The closer pigs are to the house, the more likely it is that the mosquitoes that bite them when they have a viremia will have easy access to you as a human to bite.
• Regarding insect repellents, the main ones have got DEET or picaridin or extract of oil of lemon eucalyptus. The citronella derivatives do not work very well.
• Avoid any stagnant water that could attract mosquitoes to breed in.
• Imojev® is a single-dose, live vaccine. JEspect® is a two-dose, killed vaccine schedule. The two vaccines are both highly immunogenic. There used to be an old one that was called Je-Vax®.
• It takes about fourteen days after the last dose generally for people to develop antibodies, but with an incubation period between five and fifteen days for Japanese encephalitis, you’d have to be very unlucky to catch it too soon for immunity.
• It’s generally recommended that boosters be given maybe a year later, but the reality is you can probably have them any time from a year onwards after you’ve had the vaccine.
• Imojev® is on a yellow fever vaccine virus shell and is a live viral vaccine, it can’t be given to immunosuppressed people.
• At the moment is that the vaccines are in short supply, and the Government will be rationing them specifically for the occupational health and safety of the people working in piggeries.
• Japanese encephalitis is basically going to be something that’s here to stay.

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Dr Bernard Hudson

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Dr Bernard Hudson

Microbiologist and Infectious Diseases Physician; Senior Staff Specialist, The Department of Microbiology and Infectious Diseases, Royal North Shore Hospital

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