ICMR-Vector Control Research Centre (Field Unit), Madurai, Tamil Nadu, India.
ICMR-Vector Control Research Centre, Medical Complex, Puducherry, India.
Indian J Med Res. 2022 Oct-Nov;156(4&5):588-597. doi: 10.4103/ijmr.IJMR_2606_19.
Japanese encephalitis (JE) is a leading cause of viral encephalitis in Southeast Asia. It is a serious public health issue in India, and cases have been emerging in newer areas of the country. Although vaccination efforts have already been initiated in the country since 2006 and later through the Universal Immunization Programme in 2011, still a significant reduction in the number of cases has to be achieved since an escalating trend of JE incidence has been reported in certain States such as Assam, Uttar Pradesh and West Bengal. Moreover, fresh cases of JE have been reported from certain pockets in Odisha as well. Despite the mass JE vaccination programme implemented in prioritized endemic zones in the country in 2011, a shift in the age group of JE virus (JEV) infection was noticed affecting the adult population in West Bengal. The recent detection of the circulation of genotype I (GI) in Gorakhpur, Uttar Pradesh and the co-circulation of GI and genotype III (GIII) in West Bengal are probably a warning signal for the public health personnel to strengthen the surveillance system in all endemic hotspots in the country. The abrupt emergence of JEV genotype V (GV) in China and Korea in 2009, after its first detection in Malaya in 1952, endemic countries have been cautioned to strengthen their surveillance, because GV has been suspected of getting dispersed efficiently in other parts of Asia. Moreover, the reduced protection efficiency of the JEV GIII-based vaccine against the JEV genotype V further warrants careful evaluation of the ongoing vaccination strategies in the endemic countries, anticipating the possible incursion of GV and its impact on future control strategies. In view of the above facts, the present communication reviews the current knowledge on the molecular epidemiology of JEV in India vis-a-vis the global scenario and discusses the future priorities in JEV research in India for effectively designing control strategies.
日本脑炎(JE)是东南亚病毒性脑炎的主要病因。在印度,它是一个严重的公共卫生问题,该国的新地区也出现了病例。尽管自 2006 年以来,该国已经开始通过 2011 年的全民免疫计划开展疫苗接种工作,但由于在某些邦(如阿萨姆邦、北方邦和西孟加拉邦)报告了 JE 发病率不断上升的趋势,因此仍然需要大幅减少病例数量。此外,奥里萨邦的某些地区也报告了 JE 的新病例。尽管该国在 2011 年在优先流行地区实施了大规模 JE 疫苗接种计划,但在西孟加拉邦,JE 病毒(JEV)感染的年龄组发生了变化,影响了成年人群。最近在北方邦戈勒克布尔和西孟加拉邦检测到基因型 I(GI)的循环,以及 GI 和基因型 III(GIII)的共同循环,可能是向公共卫生人员发出的加强全国所有流行热点监测系统的警告信号。2009 年,在中国和韩国首次检测到 JEV 基因型 V(GV)后,该病毒在马来亚的首次检测后突然出现,流行国家已被警告要加强监测,因为 GV 可能已在亚洲其他地区有效传播。此外,基于 JEV GIII 的疫苗对 JEV 基因型 V 的保护效率降低,进一步要求对流行国家正在进行的疫苗接种策略进行仔细评估,以预测 GV 的可能入侵及其对未来控制策略的影响。有鉴于此,本通讯审查了印度 JEV 的分子流行病学与全球情况的当前知识,并讨论了印度 JEV 研究的未来重点,以便有效设计控制策略。