Division of Vector-Borne Infectious Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Fort Collins, CO 80521, USA.
MMWR Recomm Rep. 2010 Mar 12;59(RR-1):1-27.
This report updates the 1993 recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the prevention of Japanese encephalitis (JE) among travelers (CDC. Inactivated Japanese encephalitis virus vaccine: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1993;42[No. RR-1]). This report summarizes the epidemiology of JE, describes the two JE vaccines that are licensed in the United States, and provides recommendations for their use among travelers and laboratory workers. JE virus (JEV), a mosquito-borne flavivirus, is the most common vaccine-preventable cause of encephalitis in Asia. JE occurs throughout most of Asia and parts of the western Pacific. Among an estimated 35,000-50,000 annual cases, 20%-30% of patients die, and 30%-50% of survivors have neurologic or psychiatric sequelae. No treatment exists. For most travelers to Asia, the risk for JE is very low but varies on the basis of destination, duration, season, and activities. JE vaccine is recommended for travelers who plan to spend a month or longer in endemic areas during the JEV transmission season and for laboratory workers with a potential for exposure to infectious JEV. JE vaccine should be considered for 1) short-term (<1 month) travelers to endemic areas during the JEV transmission season if they plan to travel outside of an urban area and will have an increased risk for JEV exposure; 2) travelers to an area with an ongoing JE outbreak; and 3) travelers to endemic areas who are uncertain of specific destinations, activities, or duration of travel. JE vaccine is not recommended for short-term travelers whose visit will be restricted to urban areas or times outside of a well-defined JEV transmission season. Two JE vaccines are licensed in the United States. An inactivated mouse brain--derived JE vaccine (JE-VAX [JE-MB]) has been licensed since 1992 to prevent JE in persons aged >or=1 year traveling to JE-endemic countries. Supplies of this vaccine are limited because production has ceased. In March 2009, an inactivated Vero cell culture-derived vaccine (IXIARO [JE-VC]) was licensed for use in persons aged >or=17 years. JE-MB is the only JE vaccine available for use in children aged 1-16 years, and remaining supplies will be reserved for use in this group.
本报告更新了疾病预防控制中心免疫实践咨询委员会（ACIP） 1993 年关于旅行者预防日本脑炎（JE）的建议（CDC。灭活日本脑炎病毒疫苗：免疫实践咨询委员会（ACIP）的建议[ACIP]。MMWR 1993；42[No. RR-1]）。本报告总结了 JE 的流行病学，描述了美国许可的两种 JE 疫苗，并为旅行者和实验室工作人员使用这些疫苗提供了建议。日本脑炎病毒（JEV）是一种蚊媒黄病毒，是亚洲最常见的可通过疫苗预防的脑炎病因。JE 发生在亚洲大部分地区和西太平洋部分地区。在估计的 35000-50000 例年度病例中，20%-30%的患者死亡，30%-50%的幸存者有神经或精神后遗症。目前尚无治疗方法。对于大多数前往亚洲的旅行者来说，JE 的风险非常低，但目的地、持续时间、季节和活动会有所不同。JE 疫苗推荐给计划在 JEV 传播季节在流行地区停留一个月或更长时间的旅行者以及有接触传染性 JEV 风险的实验室工作人员。JE 疫苗应考虑用于：1）在 JEV 传播季节短期（<1 个月）前往流行地区的旅行者，如果他们计划前往城市地区以外旅行，并且面临增加的 JEV 暴露风险；2）前往正在发生 JE 暴发的地区的旅行者；3）对特定目的地、活动或旅行时间不确定的前往流行地区的旅行者。JE 疫苗不推荐给那些访问仅限于城市地区或明确的 JEV 传播季节以外时间的短期旅行者。美国有两种 JE 疫苗获得许可。一种由灭活鼠脑衍生的 JE 疫苗（JE-VAX [JE-MB]）自 1992 年起获准用于预防前往 JE 流行国家的年龄>或=1 岁的旅行者的 JE。由于生产已经停止，这种疫苗的供应有限。2009 年 3 月，一种由灭活 Vero 细胞培养衍生的疫苗（IXIARO [JE-VC]）获准用于年龄>或=17 岁的人群。JE-MB 是唯一可用于 1-16 岁儿童的 JE 疫苗，剩余的供应将保留给该组使用。
