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 vaccine

Price: £95 per dose

Doses per course: 2

Price per course: £190

Course: The course consists of one dose.

Who to get vaccinated:  You need to get the first dose ideally five weeks before you travel in order to be able to complete the course in time.

Course: The course consists of two doses. The second dose needs to be given ideally 28 days after the first. You are protected from seven days after the second dose.

Accelerated course: In special cases you can get a faster course where the first dose should be at least 2 weeks before you travel.

Boosters: The vaccine protects you for at least 12 months, so you need a booster 12-24 months later to remain protected after one year.

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

Side effects: The vaccine can cause side effects such as digestive problems, a high temperature and muscle pain. You may also notice soreness at the injection site.

Children: The Japanese encephalitis vaccine can be given from the age of two months.

Additional precautions: In addition to getting the vaccination you need to practise mosquito bite avoidance.

Risk if you contract Japanese encephalitis: Japanese encephalitis can cause severe complications, including brain damage and death. There is no cure for it.

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.

Which countries are affected by Japanese encephalitis?

Japanese encephalitis is found throughout Asia and beyond (see map).

Most cases occur in:

  • China
  • Myanmar (Burma)
  • Thailand
  • Vietnam
  • Cambodia
  • Laos
  • Nepal
  • India
  • Philippines
  • Sri Lanka
  • Malaysia
  • Indonesia

Despite its name, Japanese encephalitis is now relatively rare in Japan as a result of mass immunisation programmes.

Map adapted from Centers for Disease Control and Prevention.

Map adapted from Centers for Disease Control and Prevention. Yellow Book 2020. Chapter 4 Travel-Related Infectious Diseases. Japanese Encephalitis. June 2019

What is Japanese encephalitis?

Japanese encephalitis is a viral disease which, like malaria, is transmitted by mosquitoes. In many patients, Japanese encephalitis symptoms remain mild and the infection may even go unnoticed. However, in some cases, the virus causes severe symptoms and leads to serious complications.

Typical encephalitis symptoms include nausea and vomiting, seizures, headaches and confusion. The Japanese encephalitis virus affects the human brain and can lead to inflammation and swelling in the brain. In very severe cases, the infection can lead to brain damage.

There is no specific medication to treat and cure this type of encephalitis. Treatment usually focuses on relieving symptoms and supporting the immune system in its effort to fight the virus. A Japanese encephalitis vaccine provides medical protection for travellers at risk of catching the virus.

The World Health Organisation states, that there are roughly 70,000 new cases of Japanese Encephalitis worldwide each year. Half of these cases were in China, and around three quarters of all cases were children under the age of 15 years.

How serious is Japanese encephalitis?

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.

What are the symptoms of Japanese encephalitis?

Most people infected by the Japanese encephalitis virus have either no symptoms or mild short-lived symptoms, which are often mistaken for flu.

But around 1 in every 250 people who become infected with Japanese encephalitis develop more severe symptoms as the infection spreads to the brain.

This usually happens 5 to 15 days after infection.

Symptoms can include:

  • a high temperature (fever)
  • seizures (fits)
  • a stiff neck
  • confusion
  • the inability to speak
  • uncontrollable shaking of body parts (tremor)
  • muscle weakness or paralysis

Up to 1 in every 3 people who develop these more serious symptoms will die as a result of the infection.

In those who survive, these symptoms tend to slowly improve.

But it can take several months to make a full recovery, and up to half of those who do survive are left with permanent brain damage.

This can lead to long-term problems, such as tremors and muscle twitches, personality changes, muscle weakness, learning difficulties and paralysis in 1 or more limbs.

Treatment for Japanese encephalitis

There is no specific treatment. Severe illnesses are treated by supportive therapy which may include hospitalization, respiratory support, and intravenous fluids.

What should I do if I think a family member might have Japanese encephalitis?

You should get immediate medical advice if you have any of the symptoms of Japanese encephalitis and you have recently visited, or are still in, an area where the infection is found.

GOV.UK has information about who to contact when you need immediate medical help abroad.

If you're already back in the UK, see your GP.

Your GP or the healthcare professional treating you will ask about your symptoms, where you have been travelling, what you did on your trip and what vaccinations you have had.

If necessary, they may carry out a blood test to see if you have an infection.

Avoiding mosquito bites

Before you travel consider how you will protect yourself from mosquito bites during your trip. This involves:

  • using good quality insect repellents
  • wearing the right clothing to protect your skin from bites
  • using a mosquito net
  • reducing the number of mosquitos in and around your accommodation

You should also be aware of how to treat bites if they occur.

Treating mosquito bites

Scratching an itchy bite can damage the skin and may cause the bite to become infected. Reducing the itching can help to prevent this. Putting a cold cloth over the bite can help soothe the itch.

If you are aware that your skin reacts badly to bites, consider purchasing a bite relief cream or antihistamine tablets before you travel.

  • ‘Bite relief’ creams and ointments can be bought in pharmacies and supermarkets. They contain steroids (such as hydrocortisone 1%) or antihistamines and reduce the redness and itch when rubbed onto bites.
  • The itch from bites is reduced by taking a daily antihistamine tablet. You must discuss the suitability of taking these with your pharmacist, doctor or travel health advisor.

What are the side effects of the Japanese encephalitis vaccination

Like all medicines, this vaccine can have side effects, although not everybody gets them.


(affects 1 to 10 users in 100)

  • Nausea
  • Influenza like illness
  • Fever, other injection site reactions (e.g. redness, hardening, swelling, itching)


(affects 1 to 10 users in 1,000)

  • Vomiting
  • Skin rash
  • Changes in the lymph-nodes
  • Migraine (throbbing headache, often accompanied by nausea and vomiting and sensitivity to light)
  • Dizziness
  • Vertigo (spinning sensation)
  • Diarrhoea
  • Belly pain
  • Exces- sive sweating
  • Itching
  • Chills
  • General condition of feeling unwell
  • Musculoskeletal stiffness
  • Joint pain
  • Weakness
  • Abnormal laboratory liver test results (hepatic enzymes increased)


(affects 1 to 10 users in 10,000)

  • palpitations
  • rapid heartbeat
  • difficulty to breathe
  • ab- normal sensation of skin (for example pins and needles)
  • hives
  • skin redness
  • pain in leg or arm
  • platelet deficiency
  • nerve inflammation
  • limb swelling and ankle swelling
  • taste disturbance
  • swelling of eyelid
  • fainting

Patient information leaflet IXIARO® (Japanese encephalitis vaccination)

Monitoring safety of vaccines

In the UK, the safety of vaccines is monitored through the Yellow Card Scheme regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) and the Commission on Human Medicines.

Most reactions reported through the Yellow Card Scheme have been minor, such as redness and swelling at the injection site, rashes, fever and vomiting.

Additional side effects in children aged 2 months to < 3 years

In children aged 2 months to <3 years, the following side effects have been observed more frequently compared to children aged 3 years to <12 years, adolescents and adults:

Very common

  • Fever (28.9%)
  • Diarrhoea (11.8%)
  • Influenza like illness (11.2%)
  • Irritability (11.0%)


  • loss of appetite
  • vomiting
  • skin rash


  • cough

Where can i get the Japanese encephalitis vaccination near me?

You can get the Japanese encephalitis vaccination and other travel vaccinations at your local Health Plus Pharmacy in Grangetown, Llandaff in Cardiff and Torfaenin Pontypool, Wales.