RooseveltG

Our local travel clinic recommended Japanese Encephalitis vaccine boosters (we had injections in 2010 for Southeast Asia) at $288 a pop!

We will be in mostly touristed northern India for 3 weeks. We are taking malaria prophylaxis but wonder if others are being vaccinated for Japanese Encephalitis.

Roosevelt G.

arjones22

I have a trip coming up in November. My physician also recommended the malaria prophylaxis, and is giving me an Rx for Cipro, just in case. He did not recommend the Japanese Encephalitis vaccine, although I did get a diphtheria-tetanus-pertussis booster.

Kathie

JE vaccines are typically only recommended if you are staying in rural farming areas for 6 weeks or more. Is there a current outbreak somewhere you will be visiting?

I always print out the cdc recommendations (as those are the guidelines they should be following) and carry them with me. Then if I get a recommendation that doesn't fit with the guidelines, I pull them out as ask what makes them recommend that vaccine.

Some for-profit travel clinics recommend vaccines or medications that are not recommended by the cdc just because it adds to their bottom line. Unless there is some specific reason to get the vaccine, I'd "just say no" and I'd warn others about the clinic.

RooseveltG

It was a university clinic. I agree that it is probably not necessary for our kind of trip.

Roosevelt G.

kikiv

We leave to India in October for 28 days and will be in some rural areas. We had all of the recommended shots and will be taking Malarone but opted not to have the JE vaccine.

Kathie

Roosevelt why did the provider recommend the JE vaccine? Did you ask?

foggybridges

I am going to northern India for 2 weeks, got my first (of 2) Hep A shots, as well as the oral Typhoid booster, was told that I wouldn't need the JE shot either.

RooseveltG

I think the travel nurse was just working off a list. We are not going to be immunized for JE. I think you have to be in rural areas for prolonged periods to be worried about it.

Roosevelt G.

Leslie_S

Can I ask if anyone (Kathie?) knows the answer to this -- when they say only necessary for pronlonged stays in rural areas is the "prolonged" just because your odds are greater that you'll come across a mosquito carrying JE the longer you're in that area? It is true that there will be a greater opportunity but if that area does have JE carrying mosquitos you could be unlucky and get bitten on day 1 instead of day 10 or day 42...no?

Kathie

It does have to do with probabilities. JE is a disease carried by pigs and ducks, so you need a farming area where both are present. JE is infrequent enough that the proportion of mosquitos carrying it is very low. But if there is an outbreak in the area, you would want to get the vaccine.

JE is a vaccine that has more side effects than most, so not only do you have to balance the likelihood of contracting JE, but also balance the side effects of a vaccine meant to prevent a rare infection.

So yes, it would be possible (though extremely unlikely) that you could get bitten on day 1 of your stay in a farming area and contract JE. It is carried by mosquitoes that are most active at dawn and dusk, so staying in air-conditioned rooms or using bed nets will also help prevent bites. And of course, one should always use repellant as there are a number of mosquito-borne illnesses in the area - Malaria, Dengue and JE.

Leslie_S

I guess the additional incentive to get the JE vax if you're going to a rural area is the potential for a very negative outcome if you do contract it. Not to be a fear-monger but the fact that there's no treatment and "The case-fatality ratio is approximately 20%–30%. Among survivors, 30%–50% have serious neurologic, cognitive, or psychiatric sequelae" freaks me out a little bit! Although it does sound like the odds of getting it as a short-term traveler are minute.

Kathie

Yes, especially if you are conscientious about applying repellants, and if you are staying in an air-conditioned rooms. If you are doing volunteering work on a farm and sleeping in a hut, the risk is different.