Dengue Virus and Japanese Encephalitis Virus Epidemiological Shifts in Nepal

This article report that there is an epidemiological shifts from high  burden Japanese Encephalitis (JE) in the past to Dengue Virus (DENV) infection at present in Nepal. This must be due to the introduction of JE vaccine. Initially, the Ministry of Health - Government of Nepal introduced  country- wide  JE mass vaccination successfully in phase - wise manner. Now, the mass vaccination is replaced with routine immunization through integration of this vaccine in National Immunation Program (NIP). As the key component of national JE control program, the country - wide laboratory based JE surveillance is going on. At this juncture, the publication of this article will provide a strong evidence for the policy makers to integrate and implement DENV laboratory surveillance in the country. This is also important to remember that an effective surveillance inplace will provide true epidemiological picture of the disease to Department of Health Service (DHS), Epidemiology and Disease Control Division (EDCD).      

 

Reference:

 

Am J Trop Med Hyg. 2013 April 3; 88(4): 677–680. doi: 10.4269/ajtmh.12-0436

 Abstract of the article

 

"We report on the changing epidemiology of two important flaviviruses in Nepal: Japanese encephalitis (JE) and dengue viruses. Morbidity and mortality in Nepal is in the thousands since JE was introduced in 1978. Nepal launched an extensive laboratory-based JE surveillance in 2004. Nepal experienced a remarkable reduction in disease burden after mass immunizations from 2005 to 2010, when 2,040 JE infections and 205 JE-related deaths were confirmed. With its emergence in 2006, dengue has become a significant challenge in the country, highlighted by a sudden outbreak in 2010 that resulted in 359 confirmed dengue infections. Currently, both viruses cocirculate in Nepal. Here, we document the remarkable expansion of dengue in Nepal, which urgently requires national surveillance to refine the burden and make recommendations regarding control and prevention programs. We believe that the use of existing JE surveillance network for integrated dengue surveillance may represent the most appropriate alternative."