Japanese encephalitis

JEV is typically found throughout Asia and the Pacific region, with historically a small number of notifications in far north Queensland, the Torres Strait and the Tiwi Islands in the Northern Territory.

At risk groups are:

• Laboratory workers who may be exposed to JEV
• Travellers spending 1 month or more in endemic areas during the JEV transmission season
• People who live or work on the outer islands of the Torres Strait.

Since February 2022, JE cases have been detected across several Australian states and territories.

While there have been no human cases of JE reported in WA, there has been evidence of prior JEV infection in feral pig samples collected in October 2022 in a remote area of northern Kimberley. Persons eligible for vaccination are encouraged to get vaccinated against JE now. See Prevention section below for further details.

Most people infected with JEV do not develop symptoms. However, in rare cases (less than 1% of infected people) encephalitis (swelling of the brain) may develop which can lead to death or long-term damage to the nervous system. Signs and symptoms of severe JE include headache, fever, convulsions, decreased consciousness (becoming drowsy or unresponsive), and disorders of the muscles, including paralysis.

Children under the age of 5 years and older people who are infected with JEV are at a higher risk of developing more severe illness, such as encephalitis. Infection during pregnancy can result in an increased risk of miscarriage and other complications.

The incubation period (i.e. the time from being bitten by an infected mosquito to developing symptoms to the disease) in humans is from 5 to 15 days.

If you are experiencing symptoms, especially if you have visited affected regions, please seek urgent medical assistance.

JEV infection is usually diagnosed by testing blood or spinal fluid samples. Under the Public Health Regulations 2017 (WA) JE is an urgently notifiable infectious disease in Western Australia (WA).

There is no specific treatment for JE. Treatment usually involves management of symptoms.

Taking steps to avoid mosquito bites is essential to protect yourself from JEV. Even if people are vaccinated, they should still use precautions to protect against mosquito bites, which will also protect them against other mosquito-borne diseases. No vaccine is 100% effective and the JE vaccine takes a few weeks to provide protection.

Ways to protect yourself from mosquito bites include:

• apply and regularly reapply an effective insect repellent on exposed skin, ensuring you follow the instructions on the label
• wear long, loose fitting clothing when outside
• use insecticide sprays, vapour dispensing units (indoors) and mosquito coils (outdoors) to clear rooms and repel mosquitoes from an area
• make sure accommodation, including tents, are properly fitted with mosquito nets or screens
• cover all windows, doors, vents and other entrances with insect screens
• remove any water-holding containers where mosquitoes may breed.

Effective mosquito repellents contain diethyltoluamide (DEET), picaridin, or oil of lemon eucalyptus (OLE).

Vaccination

The WA Department of Health is currently offering free JE vaccine to eligible persons in specific areas of the Kimberley. These areas are considered to be at highest risk of JEV transmission in WA.

Eligible persons currently include Kimberley residents who meet the following criteria:

• All residents of postcode 6740: including remote Aboriginal communities and suburbs/localities of Drysdale River, Kalumburu, Mitchell Plateau, Oombulgurri, Prince Regent River, and including Wyndham.
• All residents of postcode 6770: including remote Aboriginal communities and suburbs/localities of Mueller Ranges, Ord River, Purnululu, Sturt Creek, Tanami, and including Halls Creek.
• All residents of postcode 6765: including remote Aboriginal communities and suburbs/localities of Mount Hardman and including Fitzroy Crossing.
• Residents of remote areas of postcode 6728: including remote Aboriginal communities and suburbs/localities of Camballin, Meda, Kimbolton, King Leopold Ranges, St George Ranges (excluding Derby).
• All residents of postcode 6743: including remote Aboriginal communities and suburbs/localities of Cambridge Gulf, Durack, Gibb, Lake Argyle, Warmun, and including Kununurra.
• Persons living and/or working in an eligible postcode for at least a 30-day period who spend significant time outdoors (at least 4 hours per day), for unavoidable work, recreation, education or other essential activities. This excludes those working in the mining industry.
• People who work directly with mosquitoes, and indirectly through sentinel animal surveillance systems in the Kimberley and Pilbara regions e.g. environmental health officers, entomologists, environmental consultants involved in mosquito management, rangers and park staff, and depot workers.
• diagnostic and research laboratory workers who are likely to handle live JEV.

There is limited supply of JE vaccines worldwide. Eligibility for vaccines will continue to be expanded in stages to those at highest risk of JEV infection as more vaccine becomes available.

Proof of eligibility

• Bring evidence of primary residence in an eligible postcode e.g. driver’s licence, Medicare card, utilities bill, or similar.
• Employees need to get a letter from their employers and bring it to their vaccination appointment as proof of eligibility. A template JE vaccine eligibility letter employers can use is available here (DOC 59KB).

Types of vaccines

There are two vaccines available in Australia which are safe and effective for both adults and children.

• Imojev® – a single dose, live attenuated virus vaccine
• JEspect® (also known as Ixiaro) – a two dose, inactivated vaccine (given 28 days apart)

If you are pregnant or immunocompromised, please consult with your immunisation provider to ensure you receive the right vaccine.

Where to get vaccinated

To report an adverse event following immunisation, contact the Western Australian Vaccine Safety Surveillance System (external site), email wavss@health.wa.gov.au or phone (08) 6456 0208.

For more information about the JE vaccines, please refer to the Japanese encephalitis virus (JEV) vaccines | Australian Government Department of Health and Aged Care.

Further information

• 2023 WA JEV Vaccination Program Frequently Asked Questions (FAQs)
• Japanese encephalitis: Information for WA local government and industry
• Japanese encephalitis | Australian Government Department of Health and Aged Care
• Japanese encephalitis virus (JEV) Health alert | Australian Government Department of Health and Aged Care
• Japanese encephalitis virus (JEV) vaccines | Australian Government Department of Health and Aged Care