JAPANESE ENCEPHALITIS VACCINE IN TRAVELERS - IS WIDER USE PRUDENT

Vaccination against Japanese encephalitis has been carried out extensi vely in many Asian countries for the past 20 years and is also increas ingly recommended for travellers to endemic areas. Although the curren tly available vaccine, manufactured from mouse brain, is generally con sidered to be highly effective and of low reactogenicity, approximatel y 50% of vaccinees report experiencing usually mild adverse effects fo llowing vaccination. Concern has been raised regarding potential neuro logical adverse effects but the incidence of such effects appears to b e very low (around 1 to 2.3 per 1 000 000 vaccinations). Routine vacci nation of all travellers to endemic areas is clearly not beneficial at this moment and use of the vaccine should remain restricted to person s spending a month or longer in endemic areas, especially rural areas, during the transmission season. However, when counselling individual travellers, it has to be kept in mind that the Possibility of Japanese encephalitis can never be ruled out completely when travelling to end emic areas, and that such an infection can prove disastrous for the in dividual concerned.