Country Information updates: Japanese encephalitis vaccine recommendations

NaTHNaC has reviewed and updated the Japanese encephalitis (JE) country-specific information and vaccine recommendations

NaTHNaC with the UK Health Security Agency has recently reviewed the country-specific guidance for countries with a risk of JE transmission. Further information about how this guidance is developed is available on our country-specific rationale page.

The risk of contracting JE for most travellers is considered to be very low, especially for short-term travellers visiting urban areas. There is an increased risk for people who intend to live or travel for long periods of time in JE risk areas or during outbreaks and have rural trips. Certain activities, even during short trips where there is significant rural, outdoor or night-time exposure e.g. fieldwork or camping can increase the traveller's risk.

Revised country-specific information can be found on our Country Information pages and Outbreak Surveillance section.

Advice for travellers

Before you travel

• Read our Country Information to check the JE risk at your destination and for specific advice about other health risks.
• If JE is a risk at your destination(s), make an appointment with your healthcare provider to discuss whether vaccination is recommended based on your plans.
• Check Foreign, Commonwealth and Development Office (FCDO) country advice for safety and security information for your destination.

While you are away

Reduce your risk of all insect-spread illnesses, including JE, by following our insect and tick bite avoidance advice, including:

• As JE is spread by mosquitoes, which tend to bite outside at night and during twilight periods, take particular care during the night, especially around dawn and dusk.
• Wear long-sleeved tops and long trousers to reduce the risk of being bitten.
• Insect repellent should be applied after sunscreen and regularly reapplied after any activities, including swimming. 50% DEET (N, N-diethyl-m-toluamide) based insect repellents are the most effective repellents currently available and can be used if you are pregnant or breastfeeding and for children from two months of age. If DEET is unsuitable, alternative insect repellents containing Icaridin (Picaridin); Eucalyptus citriodora oil, hydrated, cyclized; or 3-ethlyaminopropionate should be used.

See our Mosquito bite avoidance for travellers video for more advice.

When you return

Fever and flu-like illness can occur due to a number of insect and tick-borne infections including JE, malaria, chikungunya and dengue. Get urgent medical advice and remember to tell your healthcare provider about every country you visited.

Advice for health professionals

• Check our Country Information to ascertain the JE risk at your traveller's destination.
• IXIARO® is licensed for immunisation against JE in adults and children from two months of age.
• The UKHSA 'green book' JE chapter, has a flowchart to help when deciding who might be suitable for JE vaccination.

Travellers with flu-like illness following recent travel abroad should be seen and assessed urgently for infections known to occur in the areas travelled.

JE should be suspected in individuals with symptoms who live in or have recently visited an area where JE is known to occur. Clinical advice should be sought in the first instance from a local microbiology, virology, or infectious disease consultant. Health professionals who suspect JE should send appropriate samples for testing (with full clinical and travel history) to the Rare and Imported Pathogens Laboratory, UK Health Security Agency (UKHSA).

There is no specific treatment for JE and treatment focuses on relieving symptoms often in intensive care. Long-term care for neurological complications may be needed.