New Vaccine Development Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986) / Chapter Skim
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Appendix D-6: The Prospects for Immunizing Against Japanese Encephalitis Virus
Appendix D-6: The Prospects for Immunizing Against Japanese Encephalitis Virus
Pages 223-240
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detection of Japanese encephalitis virus (JEV) IgM antibodies in cerebrospinal fluid (CSF)
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Louis encephalitis virus in the Americas, West Nile encephalitis virus in Southwest Asia and Africa, and Murray Valley encephalitis virus in AustraliaJ. Preliminary analysis of the nucleotide sequence of JEV (Fournier, personal communication, 1986)
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When brain tissues from fatal cases are examined by immunohistochemical techniques, the earliest detectable host response is extravascular migration of mononuclear phagocytes (Johnson et al., 1985~. These cells, accompanied by T-lymphocytes, cluster around infected (antigen-bearing)
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Rates have remained low in Japan, but in 1982 the southwestern provinces of Korea were struck by the first major epidemic there in 12 years, involving almost 3,000 children (attack rates 5 to 10 per 100,000 in affected provinces)
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Potential target areas include Japan, China, Thailand, Korea, Vietnam, Kampuchea, Laos, Malaysia, Indonesia, the Philippines, Nepal, northern India, and Sri Lanka. To simplify the calculations, the potential target population is considered to be the entire birth cohort of all countries in affected regions (see Table D-6.41.
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Laos - Assumes rates similar to northern Thailand. Malaysia - Lam, personal communication, 1985; Okuno, 1978.
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* Vaccine preventable illness is defined as that portion of the disease burden that could be prevented by immunization of the entire target population (at the anticipated age of administration)
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The principal vector species of JE are common rice-field-breeding mosquitoes present in huge numbers throughout Asia; no practical vector control measures are available or are likely to be available in the near future. Because these species feed largely at night, window screens and mosquito nets probably are useful devices for limiting, but not eliminating, exposure.
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A bivalent vaccine, consisting of equal parts of the Nakayama strain and the Beijing strain, was shown to induce satisfactory levels of neutralizing antibodies to all known JEV strains (Fukai, 1983~. This bivalent Biken inactivated mouse brain vaccine is currently undergoing controlled field testing in northern Thailand.
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The 2-8 vaccine strain was developed from the 12-1-7 strain by ultraviolet irradiation and passage in adult mice. The resultant live vaccine was shown to have a protective eff icacy of 87 percent in a trial involving 500,000 horses, but only 50 percent of 8,000 children inoculated with this vaccine developed neutralizing antibody.
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As noted in previous sections, several different types of reportedly efficacious JE vaccines have been developed and administered to large numbers of humans; feasibility of vaccine construction is not an issue. However, none of the existing vaccines is ideal; significant problems still exist regarding vaccine safety, cost, and the requirement for booster immunizations.
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1985a. Kinetics of Japanese encephalitis virus immunoglobulin M and G antibodies in human serum and cerebrospinal fluid.
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1977. Intranasal infection of monkeys with Japanese encephalitis virus: Clinical response and treatment with a nuclease-resistant derivative of poly (I)
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I Comparison of viremia following peripheral inoculation of Langat and Japanese encephalitis viruses.
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1979. Japanese encephalitis virus in mosquito salivary glands.
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Pp. 198-204 in Viral Diseases in South-East Asia and the Western Pacific, J.S.
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