Key result
Four children developed laboratory-confirmed Japanese encephalitis within two weeks of receiving the live attenuated JE vaccine, though a causal link could not be definitively established.
Why the study?
Does the live attenuated Japanese encephalitis vaccine cause acute encephalitis in children?
Case Report (n=4)
No
Does the live attenuated Japanese encephalitis vaccine cause acute encephalitis in children?
Four cases of acute encephalitis temporally associated with live attenuated JE vaccination highlight the need for careful surveillance and vaccination timing outside of transmission seasons, though a causal link could not be definitively established.
Warrants continued post-vaccination encephalitis surveillance in children; leaves open causality and requires prospective studies.
BACKGROUND: Japanese encephalitis (JE) vaccination is the most effective measure for preventing JE disease. The live attenuated JE vaccine, which has shown good efficacy and safety, has been widely used in China. CASE PRESENTATIONS: We report four laboratory-confirmed JE cases detected in JE-endemic areas during the JE virus (JEV) transmission season, who all received a first dose of live attenuated JE vaccine within 2 weeks prior to the onset of illness. All cases presented with acute encephalitis and rapidly reduced consciousness. All cerebrospinal fluid (CSF) samples from the patients were positive for JEV-specific immunoglobulin M (IgM) antibodies, but viral isolation and polymerase chain reaction (PCR) detection of JEV were both negative. CONCLUSIONS: It is difficult to identify a causal link between the disease and the vaccination, as the source of positive CSF JEV IgM antibodies might be natural JEV infection or possibly due to a traumatic lumbar puncture. Our observations highlight the need for public health officers and doctors to consider reasonable vaccination policies during the JE season. In addition, continued surveillance as well as thorough investigation of any events that occur after JE vaccination is necessary.
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Jia et al. (2011) conducted a case report in Japanese encephalitis (n=4). Live attenuated Japanese encephalitis vaccine was evaluated on Laboratory-confirmed Japanese encephalitis. Four children developed laboratory-confirmed Japanese encephalitis within two weeks of receiving the live attenuated JE vaccine, though a causal link could not be definitively established.
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