Asawapaithulsert Punyisa, Ngamprasertchai Thundon, Kitro Amornphat
Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
Vaccines (Basel). 2023 Nov 2;11(11):1683. doi: 10.3390/vaccines11111683.
Japanese encephalitis (JE) remains the cause of vaccine-preventable encephalitis in individuals living in endemic areas and international travelers. Although rare, the disease's high fatality rate emphasizes the need for effective immunization. This review aims to provide updated data on the JE burden between 2017 and 2023, vaccine acceptance, and vaccine strategies for travelers. We prospectively identified studies, using MEDLINE and PubMed, published through 2023. JE incidence has decreased in local populations and remains low among travelers from non-endemic countries. The local JE risk cannot be utilized to determine traveler risk. Adult travelers naïve to JEV infection or immunization may be at potentially higher risk. The JE vaccine acceptance rates among international travelers visiting JE endemic areas range from 0.2% to 28.5%. The cost of the vaccine and low risk perception could be barriers to JE vaccination. For travelers, an accelerated two-dose regimen of inactivated Vero cell JE vaccine (JE-VC) or a single dosage of live attenuated JE vaccine (JE-LV) may be an option. In conclusion, the JE burden among residents and travelers is lower, but the risk is not negligible. Practitioners should prioritize sharing knowledge, increasing awareness, and promoting vaccinations and preventive measures to reduce tourists' risk of JE along their journey.
日本脑炎（JE）仍然是生活在流行地区的个人和国际旅行者中可通过疫苗预防的脑炎病因。尽管这种疾病罕见，但其高死亡率凸显了有效免疫的必要性。本综述旨在提供2017年至2023年间日本脑炎负担、疫苗接受情况以及旅行者疫苗策略的最新数据。我们通过MEDLINE和PubMed前瞻性地确定了截至2023年发表的研究。当地人群中日本脑炎发病率有所下降，来自非流行国家的旅行者中发病率仍然较低。不能根据当地的日本脑炎风险来确定旅行者的风险。未感染过日本脑炎病毒（JEV）或未接种过疫苗的成年旅行者可能面临更高的潜在风险。前往日本脑炎流行地区的国际旅行者中，日本脑炎疫苗的接种率在0.2%至28.5%之间。疫苗成本和低风险认知可能是日本脑炎疫苗接种的障碍。对于旅行者来说，加速接种两剂次的灭活Vero细胞日本脑炎疫苗（JE-VC）或单剂次的减毒活日本脑炎疫苗（JE-LV）可能是一种选择。总之，居民和旅行者中的日本脑炎负担较低，但风险并非可以忽略不计。从业者应优先分享知识、提高认识并促进疫苗接种和预防措施，以降低游客在旅途中感染日本脑炎的风险。
