Japanese Encephalitis: Travel Advice

Japanese Encephalitis (JE) is a virus that is transmitted by mosquito bites. It is most commonly found in Asia and the western Pacific, so if you plan to travel to a location in one of those areas, you may want to consider getting the vaccine for JE and learning the preventative measures.

For most travelers, it is unlikely you will be bitten by an infected mosquito. However, if you plan to travel within Japanese Encephalitis’s common transmission locations for longer than four weeks, such as if you plan to move there as an expatriate, it is worth your time to learn more about this disease.

While the chance of you getting infected is relatively low, for a slim ratio of the population who do become infected, they may develop severe symptoms such as headache, convulsions, encephalitis, meningitis, permanent neurological problems, and even death.

To put your mind at ease, we have gathered this guide to Japanese Encephalitis for those traveling long term in Asia, the Pacific Islands, and the Far East. We’ll teach you not only what the disease is and how it’s spread, but steps you can take to prevent it and which travel insurance options you have. And don’t forget to check out our article on the 14 most common diseases while traveling abroad!

In Which Countries Can I Catch Japanese Encephalitis When Traveling?

Japanese Encephalitis is most commonly transmitted in southeast Asia, the Far East, and the Pacific Islands. Mosquitos with this virus are most often in rural areas apart from the tourist locations of travelers. Travelers and expats visiting countries within these regions have low risk of infection.

Japanese Encephalitis is usually spread in areas with these types of characteristics:

• Agricultural areas
• Rice cultivation areas
• Flood irrigation

This chart lists the countries where travelers are at risk of catching Japanese Encephalitis and the transmission season in each.

This is a simplified version of a chart about Japanese Encephalitis made by the CDC.

When and How Encephalitis is Spread

Japanese Encephalitis is first found in pigs and birds, then spread to mosquitoes who bite those infected animals. Humans catch this virus when they are bitten by an infected mosquito. Humans, however, are dead-end hosts, meaning they cannot spread it to other humans.

This virus is usually spread seasonally, with peak transmission happening in the summer and fall months.

Who is at Risk of Getting Encephalitis?

Travelers or expats planning to travel or move to one of the countries in Asia or the western Pacific may be at extremely low risk of getting Japanese Encephalitis. The risk may be higher depending on your destination, the duration of your stay, the season, and your activities.

Your risk may be higher if you plan to:

• Visit the area for 4 weeks or longer, such as for expatriates moving to Asia
• Spend extended periods of time in rural areas
• Have regular, short trips to endemic areas
• Move to an endemic region
• Tour or stay near a rice growing area
• Travel during the summer when mosquitos are more common
• Visit a tropical or subtropical area (mosquitoes spread the virus all year long in these climates)

Japanese Encephalitis Explained Simply

Japanese Encephalitis is a viral infection transferred to people from mosquitos. Once caught, it can transition into Encephalitis if it spreads to the brain and causes inflammation. This is a deadly condition. Children, the elderly, and people with weak immune systems are at the greatest risk.

About 1 in 4 cases of Japanese Encephalitis is fatal, but the rest recover with often long-term effects.

Japanese Encephalitis Travel Vaccine

There is a 2 dose Japanese Encephalitis vaccine. If you are an expatriate moving to regions where JE is spread, or if while traveling to these regions you plan to visit rural areas, hike, camp, or stay in places without AC, screens, or bed nets, it is recommended you consider getting this vaccine. 

This vaccine is recommended to travelers who:

• Plan to move to an area where Japanese Encephalitis is transmitted
• Spend a month or more in an area with Japanese Encephalitis
• Travel regularly to areas with Japanese Encephalitis

How to Avoid Japanese Encephalitis When Traveling Abroad

If you plan to travel to regions where Japanese Encephalitis is spread, it is best you prepare ahead of time by securing international health insurance, getting the JE vaccine, and learning safety precautions you can take while in the region.

A few things you can do while traveling to prevent Japanese Encephalitis:

• Sleep in rooms with close-fitting gauze over the windows and doors
• If you plan to sleep outside, use a mosquito net impregnated with insecticide (learn how to use mosquito nets correctly)
• Wear long-sleeved shirts, pants, and socks
• Use high-quality insect repellent
• Use air-conditioning if available
• Don’t let mosquitoes lay eggs in or near water by weekly emptying, scrubbing, covering, or throwing away items (both inside and outside) that carry water
• Keep mosquitos out of your hotel or lodging
• Treat your clothing and gear with permethrin

What happens if a Tourist Gets Sick Abroad With Japanese Encephalitis?

If you are a digital nomad moving to Asia or the Pacific Islands, we recommend you invest in your health by getting an international health insurance plan. Not only can it bring you peace of mind while on your trip, but in the event you are infected, you will have coverage to get the care you need.

Pacific Prime is a leading expert on international insurance you can feel confident turning to when your need arises. To see which plans are available to you in the country you will soon be traveling to, check out the health insurance plans available in Asia and Australasia.

Is Encephalitis Contagious?

Encephalitis is not contagious between humans. You can only be infected by an infected animal, most often a mosquito.

However, Tuberculosis and Meningococcal Disease can be caught from other humans while traveling.

Common Symptoms of Japanese Encephalitis

Most cases of Japanese Encephalitis may not present any symptoms at all, and mild cases may show brief symptoms that are similar to the flu. About 1 in 250 people may develop extreme symptoms if the infection spreads to the brain causing seizures, confusion, limited ability to speak, or paralysis.

Symptoms usually become apparent 5 to 15 days after the date of infection.

Extreme symptoms include:

• A fever
• Headache
• Vomiting
• Seizures, especially among children
• A stiff neck
• Confusion
• The inability to speak
• Body tremors
• Weak muscles or paralysis
• The development of encephalitis

A third of patients who develop severe symptoms will die. Of those who survive, it will take a long time to fully recover, up to several months. Half of those who do survive will be left with permanent brain damage.

Some long-lasting effects of Encephalitis include:

• Tremors
• Muscle twitches
• Muscles weakness
• Learning Disabilities
• Personality changes
• Paralysis in 1 or more limbs
• Neurological problems
• Movement disorders

Common Treatments for Japanese Encephalitis

There is no specific treatment for Japanese Encephalitis. However, the CDC says that when treating Encephalitis hospitalization and close observation is usually required. Treating and supporting the complications that come because of JE will determine the main plan of care.

Conclusion

If you are an expat or a traveler going to the Pacific Islands, the Far East, or Western Asia, you will be entering the region where Japanese Encephalitis is spread. While most people are at low risk for being infected, if you plan to be there for an extended period of time and/ or to visit rural areas, you will want to prepare.

Reading this article is a first step in learning the right preventative measures you can take to protect yourself. Wearing long-sleeved clothing, using a strong insect repellent, planning ahead to sleep in mosquito free areas or learning how to use a mosquito net will all help limit the chances of catching the virus.

Ease your mind now against the possibility of a medical emergency by selecting a health insurance plan. There are long-term care plans available or even short-term health insurance plans.

Taking these precautions and securing a plan in case you do get sick in any way while away from home can help you relax. Not only will you have less stress, but you will feel calm enough to get back to what matters most: enjoying your international adventure and exploring the world!

To ensure you are fully prepared, read about the 14 most common diseases caught when traveling.

Sources

Japanese Encephalitis. (2019). CDC. https://www.cdc.gov/japaneseencephalitis/index.html

Japanese encephalitis. (2017, October 23). Nhs.uk. https://www.nhs.uk/conditions/japanese-encephalitis/#:~:text=Japanese%20encephalitis%20is%20a%20viral

Japanese Encephalitis – Chapter 4 – 2020 Yellow Book | Travelers’ Health | CDC. (2019, June 24). Wwwnc.cdc.gov. https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/japanese-encephalitis

Japanese Encephalitis | Disease Directory | Travelers’ Health | CDC. (2018). Cdc.gov; CDC.gov. https://wwwnc.cdc.gov/travel/diseases/japanese-encephalitis

Team, H. T. H. (n.d.). Japanese Encephalitis – Fit for Travel. Www.fitfortravel.nhs.uk. Retrieved March 7, 2023, from https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/japanese-encephalitis#:~:text=The%20risk%20for%20most%20travellers

The Basics of Encephalitis. (n.d.). WebMD. https://www.webmd.com/a-to-z-guides/understanding-encephalitis-basics

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Jantra Jacobs

Senior Copywriter at Pacific Prime

Jantra Jacobs is a Senior Copywriter at Pacific Prime with over 10 years of writing and editing experience. She writes and edits a diverse variety of online and offline copy, including sales and marketing materials ranging from articles and advertising copy to reports, guides, RFPs, and more.

Jantra curates and reports on the results of Pacific Prime’s monthly newsletters, as well as manages Pacific Prime’s Deputy Global CEO’s LinkedIn posts. Complemented by her background in business writing, Jantra’s passion for health, insurance, and employee benefits helps her create engaging content - no matter how complex the subject is.

Growing up as a third-culture kid has given her a multicultural perspective that helps her relate to expats and their families while 8 years of working remotely have given her unique insight into hybrid work arrangements and enthusiasm for employee benefits.

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