Prolonged Detection of Japanese Encephalitis Virus in Urine and Whole Blood in a Returned Short-term Traveler

Huang, G Khai Lin; Tio, Shio Yen; Caly, Leon; Nicholson, Suellen; Thevarajan, Irani; Papadakis, Georgina; Catton, Mike; Tong, Steven Y C; Druce, Julian

Japanese encephalitis is a rare infection in travelers, with only 79 cases among travelers or expatriates from nonendemic countries reported to the Centers from Disease Control and Prevention from 1973 to 2015 [13] . Vaccination to JEV is generally only recommended to travelers who intend to spend 1 or more months in endemic areas during the transmission season, although consideration may be given to short-term travelers who may be at increased risk of exposure or who plan to travel to an area with an ongoing outbreak [13] . A further notable aspect of our case is acquisition of JEV following shortterm travel to an area that would not normally be considered high risk. Interestingly, in a 2009 review on JEV in travelers, more than half of 21 cases were acquired after short-term travel [14] . Given the improved tolerability of modern vaccine preparations and the potentially devastating consequences of infection, it has been suggested that current vaccination recommendations should be revised to offer vaccination to a broader range of travelers [14] . A short-term traveler who visits JEV endemic areas should be informed about the risk of disease, potential outcomes, and the risks and benefits of JEV vaccination.