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Japanese Encephalitis

Victorian man dies after contracting Japanese encephalitis in Phuket, Thailand

Melissa Cunningham, The Age 23/6/17

Photo: Frank Greenaway

A Victorian man visiting Thailand has died from the rare and potentially fatal virus Japanese encephalitis.  

The man in his 60s had visited Phuket for 10 days in early May and began to feel lethargic on day eight.

Japanese encephalitis occurs in China, south-east Asia and Indonesia. 
Symptoms, which include headaches, a fever, convulsions and focal neurological signs, appear between five and 10 days after being infection. 

After returning home he struggled to stay awake and was admitted to hospital a few days later in a confused state.
He was eventually admitted to the intensive care unit, where he died. It’s believed the man was from Shepparton in the state’s north. 

Japanese encephalitis can cause a brain infections and is fatal in about 20 to 30 per cent of cases. It can cause long-term neurological complications in up to half of cases. 

Experts say the virus cannot be passed from person to person. Although the mosquitoes capable of carrying the virus exist in Victoria, there was minimal risk that the virus would spread because the virus needed to multiply in pigs. Royal Melbourne Hospital doctor Steven Tong, who treated the man, said mosquitoes carry the virus and the risk of catching it overseas is “very low” but varied based on destination, duration of travel, season and activities. 

 “Japanese encephalitis is predominantly contracted in Asian countries,” Dr Tong said. 

“The virus is maintained in a cycle involving mosquitoes and vertebrate hosts, mainly pigs and wading birds. People can be infected when bitten by an infected mosquito but most people are asymptomatic or display only mild symptoms.” Dr Tong said only a small percentage of infected persons develop inflammation of the brain also known ass encephalitis. “The symptoms include sudden onset of headache, high fever, disorientation, coma, tremors and convulsions,” he said. 

“About one in four cases of encephalitis are fatal.”

He said figures suggested that for travellers to endemic areas such as Thailand, the risk is about one in a million to one in 500,000 travellers that those who travel to those areas will get Japanese encephalitis.
The most recent national tourism statistics from the Australian Bureau of Statics revealed more than 620,000 Australians travel to Thailand each year. 

Dr Wong urged any Australians travelling to Asian countries to discuss getting the vaccination for the disease and other health risks with their general practitioner. 
He also urged people to always use insect repellent when travelling abroad. 

It remains unclear how the man caught the disease. There were no reports he had contact with animals or travelled to rural regions in Thailand, but he had been bitten by mosquitoes a number of times.

The last known case of Japanese encephalitis in Australia was in 2015 when another Victorian man aged 45 returned with the disease after a trip to Bali. Australians travelling anywhere in south-east Asia should take precautions, including vaccination and the use of insect repellent. The first ever outbreak of Japanese encephalitis in Australia occurred in the remote outer islands of the Torres Strait in 1995, with three cases – two of them fatal.

For more information visit betterhealth.vic.gov.au/health/healthyliving/travel-immunisation

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