Nice Googling OD. However this study looks at the incidence of the disease as opposed to the incidence of the disease in humans and the resulting deaths from same. The report I saw was probably from around the year 2000.OrangeDragon wrote:2012 data:
http://www.plosntds.org/article/info%3A ... td.0001678
heavy reading though...
Japanese Encephalitis Vaccine
- OrangeDragon
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the thing i keyed on was the incidence of the mosquito that carries the disease. a key factor in it's transmission, and as such your risk. as chewy pointed out, reporting on "reported cases" is going to have a lot of variance and be fairly inaccurate as a guide on your risk levels. too many variables like access to medical care, accuracy of diagnosis, accuracy of reporting [not out of the realm of possibility for the doctors here to be told to not report as much in fear of hurting tourist levels, and do all of those cheapo clinics report in?], and so on. best bet is to look at saturation of the virus and of the virus transmission source. sort of makes me want to go get a JE vaccine now honestly.
from that report, other than a few key areas, incidence of that specific mosquito was pretty low here. what i found surprising was, after i did an overlay with google maps to pin-point actual locations, PP is one of the medium-higher density areas.
from that report, other than a few key areas, incidence of that specific mosquito was pretty low here. what i found surprising was, after i did an overlay with google maps to pin-point actual locations, PP is one of the medium-higher density areas.
Last edited by Anonymous on Wed Apr 17, 2013 5:38 pm, edited 1 time in total.
Those who begin coercive elimination of dissent soon find themselves exterminating dissenters. Compulsory unification of opinion achieves only the unanimity of the graveyard.
Robert H. Jackson, West Virginia State Board of Education v. Barnette
Robert H. Jackson, West Virginia State Board of Education v. Barnette
Yes, but the key is to look at the incidence in humans. For example the disease may be hugely prominent in areas of Indonesia but as there are few pigs there to speak of it is being carried on other animals which are less likely to lead to transmission. The only thing that matters is the rate of humans infected which Chubacca gives above. My point is that even with figures far worse than the ones he gives the threat for normal foreigner activities here is not severe enough to warrant vaccination for me, in my view. Clearly the Australian government does not feel the same way about this as it has a full vaccination program in the affected areas. I am not, however, in the pay of the pharmaceutical companies (at least not since I worked for Pfizer many moons ago!).
- vladimir
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Slaughterhouses in the city, and chickens everywhere. Places like De Kastle and other up=market condominiums probably have to have a clause in the lease prohibiting chickens, LOL.OrangeDragon wrote:PP is one of the medium-higher density areas.
ירי ילדים והפצצת אזרחים דורש אומץ, כמו גם הטרדה מינית של עובדי ההוראה.
Absolutley - risks are low, however, doesn't mean it doesn't happen, - whilst living in Cambodia, I did see two cases of JE in foreigners, both coincidently Japanese, there are also case reports regarding tourists travelling to JE areas who have gone back to their home countries sick - including Cambodia, so it really is up to each individaul to make an informed choice, and do so satisfied that it is the right choice for them.Bosco wrote: My point is that even with figures far worse than the ones he gives the threat for normal foreigner activities here is not severe enough to warrant vaccination for me, in my view.
Some examples:
Journal of Travel Medicine Volume 18, Issue 6, pages 411–413, November/December 2011
Japanese Encephalitis in a Danish Short-Term Traveler to Cambodia
Anne M. Werlinrud MD1, Claus B. Christiansen MD, PhD2, Anders Koch MD, PhD, MPH1,*
Abstract
We present a recent case of Japanese encephalitis in a Danish male traveler to Cambodia, who we believe is the second Danish case within the last 15 years. Although both this and a number of other travel-related cases occurred in short-term travelers, change in vaccination recommendations is not recommended.
Japanese encephalitis (JE) affects more than 50,000 persons and causes 15,000 deaths per year, mostly in east and Southeast Asia.1 In endemic areas most cases occur among children. JE virus belongs to the flaviviridae family and is transmitted through a zoonotic cycle between culex mosquitoes, pigs, and water birds. Travelers to endemic areas are at risk of contracting JE and most western countries recommend vaccination in persons staying for longer periods (generally >4 wks) in rural, endemic areas. Yet, JE occurs very seldom among travelers from non-endemic countries.
We present a recent case of JE in a Danish male traveler to Cambodia, who we believe is the second Danish case within the last 15 years.
Med J Aust 2004; 181 (5): 269-270.
Japanese encephalitis vaccine: is it being sufficiently used in travellers?
Catherine M Geraghty and James S McCarthy
Clinical record
A 32-year-old woman presented to the Royal Brisbane Hospital immediately on disembarking from a flight from Bangkok. She had a 5-day history of gastrointestinal symptoms, fever and altered mental state. She was a university graduate and had travelled for 2 months across south-east Asia before becoming unwell in Phnom Penh, Cambodia. Her illness began with mood elevation, hallucinations, muscle spasms and paraesthesiae, shortly after ingestion of a “herbal pizza” . Within 24 hours, nausea, vomiting and profuse watery diarrhoea ensued. Despite empirical treatment for bacterial gastroenteritis, symptoms progressed to lethargy with altered mental state.
The patient had been taking doxycycline for malaria prophylaxis, and had been vaccinated against viral hepatitis, tetanus, poliomyelitis and typhoid. She was aware of the availability of a Japanese encephalitis vaccine, but had been advised that it was not essential.
On presentation, the patient was drowsy and dehydrated, with a temperature of 38°C and tachycardia. There was peripheral leukocytosis (white cell count, 17.9 x 109 cells/L; reference range [RR], 4.0–11.0 x 109 cells/L) with dominant neutrophilia, as well as hyponatraemia, but renal function was preserved. Fever and lethargy persisted over 48 hours despite rehydration and regular paracetamol. Increasing obtundation and a fine tremor were observed. The patient complained of persistent headache, mild photophobia and neck discomfort. Her partner commented on her slow mentation, reduced concentration and personality change.
Investigations for malaria, typhoid, rickettsial disease and infectious diarrhoea were all negative. Magnetic resonance imaging of the brain detected no abnormalities. Cerebrospinal fluid (CSF) showed mononuclear pleocytosis (white cell count, 12 x 106 cells/L; 92% mononuclear cells [RR, < 5 x 106 mononuclears/L]), with mild elevation of protein level (0.62 g/L [RR, <0.45 g/L]), but was negative for herpes simplex virus by polymerase chain reaction. Flavivirus-specific IgM was detected in CSF and subsequently blood. The diagnosis of Japanese encephalitis was confirmed by a rise in titre of specific IgG in blood, from 80 (8 days after onset of illness) to 1280 (4 weeks after onset).
The fever resolved spontaneously by Day 4 after presentation, and the patient was discharged after 10 days. At the time of discharge, her level of alertness had improved, but global impairment of higher cognitive functioning and tremor persisted. After a period of convalescence of approximately 5 months, during which she was cared for by her partner, the patient was able to return to work.
A recent paper has hypothesised that due to the lack of specific diagnostic centres, vacc programs and surveillance systems in countries such as Cambodia, Laos and Myanmar, as well as increases in irrigated rice farming and enhanced pig rearing, that it is likely severe JE outbreaks will occur in the future in those countries (Ref Emerg Infect Dis. 2009 January; 15(1): 1–7.)vladimir wrote:Slaughterhouses in the city, and chickens everywhere. Places like De Kastle and other up=market condominiums probably have to have a clause in the lease prohibiting chickens, LOL.OrangeDragon wrote:PP is one of the medium-higher density areas.
Can debate this as long as the cows go home, so weigh up the risks and choose what you choose!
PS - the ganga smiley has disappeared!
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Thanks everyone for the info. I have not gotten any of the shots yet.
The vaccine most commonly given here in Canada is Ixario, and is given in two shots. Does anyone happen to know if that vaccine is commonly available in Phnom Penh? Lots of into seems to be related to a different 3 shot vaccine.
Cheers
The vaccine most commonly given here in Canada is Ixario, and is given in two shots. Does anyone happen to know if that vaccine is commonly available in Phnom Penh? Lots of into seems to be related to a different 3 shot vaccine.
Cheers
JESPECT/IXIARO should be available in the main clinics like SOS - is a two shot vaccine with the option of a booster after a year.
I think the Pasteur would stock the new generation Sanofi-Pasteur vaccine which is a one shot for adults and 2 shot for kids.
Not sure on what the costs are now!
I think the Pasteur would stock the new generation Sanofi-Pasteur vaccine which is a one shot for adults and 2 shot for kids.
Not sure on what the costs are now!
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Thanks chubacca, I think I will just get the IXIARO vaccine at the Pasteur Institut once I arrive in PP.
Cheers
Cheers
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