Protecting you on your travels

Japanese encephalitis is a viral brain infection that’s spread through mosquito bites. It’s most common in rural areas in southeast Asia, the Pacific islands and the Far East, but is very rare in travellers. The risk is greater if you’re planning to go hiking or camping in these areas.

The virus is found in pigs and birds, and is passed to mosquitoes when they bite infected animals. It cannot be spread from person to person.

Japanese encephalitis causes headache, convulsions, encephalitis and meningitis. Most people will have a mild illness with no or few symptoms but for those with severe disease around 30% can develop permanent neurological problems and around 30% will die from the disease.

There’s currently no cure for Japanese encephalitis. Treatment involves supporting the functions of the body as it tries to fight off the infection.

The person usually needs to be admitted to hospital so they can be given fluids, oxygen and medication to treat any symptoms.

The best way to prevent Japanese encephalitis is to be vaccinated against the infection before you visit a part of the world where there’s a risk of catching it.

The vaccine, which is usually only available privately, gives protection against Japanese encephalitis in more than 9 out of 10 people who receive it.

Health Plus Pharmacy make the Japanese encephalitis vaccinations convenient and accessible for all the community in Cardiff and Pontypool. Book an appointment with your local Health Plus Pharmacist to keep you safe.

Check the risks of a country you’re travelling to on the TravelHealthPro website

About the Japanese encephalitis vaccination

The Japanese encephalitis vaccine is on the World Health Organization’s List of Essential Medicines.

IXIARO® is a vaccine most commonly used in the UK against the Japanese encephalitis virus. The vaccine causes the body to produce its own protection (antibodies) against this disease.

IXIARO® is used to prevent infection with the Japanese encephalitis virus (JEV). This virus is mainly found in Asia and is transmitted to humans by mosquitoes that have bitten an infected animal (like pigs). Many infected people develop mild symptoms or no symptoms at all.

In people who develop severe disease, Japanese encephalitis usually starts as a flu-like illness, with fever, chills, tiredness, headache, nausea, and vomiting. Confusion and agitation also occur in the early stage of disease.

IXIARO® should be given only to adults, adolescents, children and infants aged 2 months and older travelling to countries, where Japanese encephalitis is endemic or who are at risk through work.

Patient information leaflet IXIARO® (Japanese encephalitis vaccination)

Japanese encephalitis vaccination schedule

Health Plus Pharmacy provide a Japanese encephalitis vaccination which consists of two injections. You need to get the first dose ideally five weeks before you travel in order to be able to complete the course in time. The second dose needs to be administered 28 days after the first, so you need to allow plenty of time before you travel.

The Japanese encephalitis injection is given in the upper arm muscle (deltoid muscle).

Primary immunisation should be completed at least one week prior to potential exposure to Japanese encephalitis virus.

Once you have received both doses, you are protected against Japanese encephalitis for 12-24 months. After one year, you require a booster.

Please book early before you travel, to ensure that you get the Japanese encephalitis vaccination.

How effective is the Japanese encephalitis vaccination

The Japanese encephalitis vaccination are more than 90% effective. Randomized control trials on Japanese encephalitis vaccination have shown that a two-dose schedule provides protection for one year.

Who should have the Japanese encephalitis vaccination

It is recommended that adults aged from 18-65 years and older, adolescents, children and infants aged 2 months and older to be vaccinated with Japanese encephalitis vaccine:

• if travelling to a country where Japanese encephalitis is present and where the stay may be prolonged (e.g. more than four weeks)
• you’re visiting during the rainy season or there’s a year-round risk because of a tropical climate
• if at increased risk of exposure to the disease e.g. staying in or around rice growing areas
• you’ll be taking part in any activities that may increase your risk of becoming infected, such as cycling or camping
• if having prolonged periods outdoors in rural areas
• for shorter, but frequent trips to endemic areas
• if going to live in an endemic area.

People at increased risk for Japanese encephalitis

The people most at risk are those who live and work in rural areas, such as on pig farms and in rice fields, where the condition is widespread.

Around 75% of cases involve children under the age of 15.

Who cannot have the Japanese encephalitis vaccine

The Japanese encephalitis vaccine is not usually recommended for children less than 2 months old because it’s unclear how safe and effective it is for this age group.

You should not have the vaccine if you have had a severe allergic reaction (anaphylaxis) to it or any of its ingredients in the past.

There are limited amount of data from the use of the Japanese encephalitis vaccination in pregnant or breast-feeding women. As a precautionary measure, the use of IXIARO® during pregnancy or breast-feeding should be avoided.

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or speak to your local Health Plus Pharmacist  for advice before receiving this vaccine.

Extra precautions when travelling abroad

To protect yourself from Japanese encephalitis when travelling, you need to:

• focus on avoiding mosquito bites, especially around dusk when this mosquito is most active. Use of insect repellents, appropriate clothing and mosquito nets is recommended for those at risk
• sleeping in rooms with close-fitting gauze over the windows and doors – if you’re sleeping outside, use a mosquito net that’s been impregnated with insecticide
• covering up with long-sleeved tops, trousers and socks
• applying a good-quality insect repellent to exposed areas of skin

Avoiding travel to a Japanese encephalitis risk area

If you have a contraindication to the Japanese encephalitis vaccine or the risk of serious side effects is high, and there is a significant risk of contracting Japanese encephalitis  on your trip you are likely to be advised to cancel or change your travel plans. Healthcare practitioners are not obliged to administer Japanese encephalitis vaccine if they believe it unsafe to do so, or it is not required for your trip. If you have any medical conditions, it is best to seek travel advice before you book your trip.

If you have recently received the Japanese encephalitis vaccine and feel unwell please contact your GP or the 111 service if your GP practice is closed.

In a medical emergency, when someone is seriously ill and their life is at risk, dial 999.