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Japanese Encephalitis in Hong Kong: what you should know

You may know that we recently have the year’s first 2 cases of Japanese Encephalitis (JE) in Hong Kong. This happened in patients who have underlying diseases. They are still in the hospital. Both are regarded as local cases now. JE is a viral infection transmitted by being bitten by an infected mosquito, Culex, which is commonly present in Hong Kong. The reservoir of infection is usually in animals like pigs and wild birds, so that mosquitoes stinging infected animals will be infected and in turn infect the human beings they sting. Luckily in Hong Kong, no large animal farms are present and the city is very much urbanized, hence the disease is not common. Generally we have anywhere from 0-6 cases a year, usually between May to August. But one must remember that 50% of infected patients die (30%) or are left with serious neurological sequelae (20%). Countries around us, like mainland China, Thailand, Malaysia, Japan and Korea have the disease as endemic. 

 You are referred to the Government website/notice for clinical information and treatment: http://www.chp.gov.hk/files/pdf/letters_to_doctors_20170610.pdf 

Because it is a virus infection, treatment is largely supportive or symptomatic. No specific treatment is available. However a vaccine is available and can be given to infants as young as 9 months. Because the disease is very uncommon here, we will NOT recommend this vaccine to all children living in Hong Kong. But you should consider it if you may stay in surrounding Asian countries for longer than 2 weeks.

So in general we recommend the following to you and your children:

1. Avoid mosquito bites in the summer:

a. When out in the open or sun, apply mosquito repellents on exposed skin or at the edge of clothes near exposed skin: DEET up to 20% for children, higher for adults.

b. Wear long sleeves, trousers, socks, hats to minimize skin exposure. Mosquitos chase after heat and the smell of sweat.

c. Ultrasonic mosquito repellers, although not very effective, do not harm.

d. Clothes of light colour are less attractive to mosquitoes.

e. Use mosquito nets if applicable.

2. Vaccinate against JE if you live or will stay for more than 2 weeks in an endemic country around Hong Kong.

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