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Objectives: To investigate the distribution and prevalence of Japanese encephalitis virus (JEV) antibody (as evidence of past infection) in northern Victoria following the 2022 Japanese encephalitis outbreak, seeking to identify groups of people at particular risk of infection; to investigate the distribution and prevalence of antibodies to two related flaviviruses, Murray Valley encephalitis virus (MVEV) and West Nile virus Kunjin subtype (KUNV). Study design: Cross‐sectional serosurvey (part of a national JEV serosurveillance program). Setting: Three northern Victorian local public health units (Ovens Murray, Goulburn Valley, Loddon Mallee), 8 August – 1 December 2022. Participants: People opportunistically recruited at pathology collection centres and by targeted recruitment through community outreach and advertisements. People vaccinated against or who had been diagnosed with Japanese encephalitis were ineligible for participation, as were those born in countries where JEV is endemic. Main outcome measures: Seroprevalence of JEV IgG antibody, overall and by selected factors of interest (occupations, water body exposure, recreational activities and locations, exposure to animals, protective measures). Results: 813 participants were recruited (median age, 59 years [interquartile range, 42–69 years]; 496 female [61%]); 27 were JEV IgG‐seropositive (3.3%; 95% confidence interval [CI], 2.2–4.8%) (median age, 73 years [interquartile range, 63–78 years]; 13 female [48%]); none were IgM‐seropositive. JEV IgG‐seropositive participants were identified at all recruitment locations, including those without identified cases of Japanese encephalitis. The only risk factors associated with JEV IgG‐seropositivity were age (per year: prevalence odds ratio [POR], 1.07; 95% CI, 1.03–1.10) and exposure to feral pigs (POR, 21; 95% CI, 1.7–190). The seroprevalence of antibody to MVEV was 3.0% (95% CI, 1.9–4.5%; 23 of 760 participants), and of KUNV antibody 3.3% (95% CI, 2.1–4.8%; 25 of 761). Conclusions: People living in northern Victoria are vulnerable to future JEV infection, but few risk factors are consistently associated with infection. Additional prevention strategies, including expanding vaccine eligibility, may be required to protect people in this region from Japanese encephalitis. [ABSTRACT FROM AUTHOR]

Objectives: To determine the proportion of people in New South Wales towns at high risk of Japanese encephalitis virus (JEV) infections during the 2022 outbreak; to identify risk factors for JEV infection. Study design: Cross‐sectional serosurvey study of the seroprevalence of JEV‐specific antibodies in NSW. Setting, participants: Convenience sample of people (all ages) from five regional NSW towns deemed to be at high risk of JEV infections after first outbreak of Japanese encephalitis in southeastern Australia in early 2022 (Balranald, Corowa, Dubbo, Griffith, Temora), 21 June – 22 July 2022. Main outcome measures: Proportion of people seropositive for JEV total antibody, assayed by defined epitope‐blocking enzyme‐linked immunosorbent assay; prevalence odds ratios for exposure risk factors and protective behaviours. Results: Eighty of 917 eligible participants (559 girls or women, 61%; 42 Aboriginal and Torres Strait Islander people, 4.6%; median age, 52 years [IQR, 37–62 years]) were seropositive for JEV‐specific total antibody (8.7%); the median age of seropositive people was 61 years (IQR, 48–70 years). The seropositivity proportion was largest for people aged 65 years or more (30 of 192; weighted proportion, 13.7%) and larger for male than female participants (30 of 358, 10.6% v 50 of 559, 7.5%). Five of 42 samples from Aboriginal and Torres Strait Islander participants were seropositive (12%). We found mixed associations with a range of potential risk factors. Conclusion: We found evidence for a substantial number of JEV infections in five regional NSW towns during a single arbovirus season in 2022. Public health responses, including effective surveillance, vaccination against JEV, and mosquito management, are critical for controlling outbreaks. Promoting behaviours that reduce exposure to mosquitoes is a core component of prevention, particularly when the vaccine supply is limited. [ABSTRACT FROM AUTHOR]

The article discusses the seroprevalence of Japanese encephalitis virus (JEV) in five New South Wales towns, highlighting the need to understand transmission pathways and identify probable hosts of infection. It emphasizes the importance of capturing social-ecological risk factors at various levels and calls for stronger partnerships within One Health. The authors stress the need for epidemiological studies to include data on exposure history, behavior, and risk perceptions to support public health measures and vaccine acceptance in the community. The article suggests using social science intelligence to gather information on activities, risk history, and community perceptions to inform future approaches in preventing JEV outbreaks in Australia. [Extracted from the article]

Not just a disease of children In endemic regions where most people are first exposed to JEV at a young age, Japanese encephalitis is largely a disease of childhood. Keywords: Encephalitis, viral; Arbovirus infections; Vaccination; Central nervous system infections EN Encephalitis, viral Arbovirus infections Vaccination Central nervous system infections 344 347 4 05/03/23 20230501 NES 230501 A structured diagnostic approach is required when assessing for JEV in patients with encephalitis The Japanese encephalitis virus (JEV) has been a long-standing public health concern in Asia, where it is the most common cause of viral encephalitis in many countries. A prospective assessment of the accuracy of commercial IgM ELISAs in diagnosis of Japanese encephalitis virus infections in patients with suspected central nervous system infections in Laos. [Extracted from the article]

Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus that causes encephalitis in humans. In 2021, an outbreak of JEV genotype IV occurred in pigs in eastern Australia, leading to 44 cases of human disease. The emergence of this genotype raised questions about the origin and incidence of JEV in Australia. Two studies conducted in New South Wales and Victoria found evidence of past exposure to JEV in a small but significant proportion of people tested. The studies did not identify specific risk factors for exposure to the virus. Accurate serological studies are challenging due to cross-reactivity with other flaviviruses, but the findings of these studies suggest that the 2022 JEV outbreak was more extensive than initially thought. [Extracted from the article]

Summary: •Neglected tropical diseases (NTDs) represent a threat to the health, wellbeing and economic prosperity of billions of people worldwide, often causing serious disease or death.•Commonly considered diseases of low and middle‐income nations, the presence of NTDs in high income countries such as Australia is often overlooked.•Seven of the 20 recognised NTDs are endemic in Australia: scabies, soil‐transmitted helminths and strongyloidiasis, echinococcosis, Buruli ulcer, leprosy, trachoma, and snakebite envenoming.•Dengue, while not currently endemic, poses a risk of establishment in Australia. There are occasional outbreaks of dengue fever, with local transmission, due to introductions in travellers from endemic regions.•Similarly, the risk of introduction of other NTDs from neighbouring countries is a concern. Many NTDs are only seen in Australia in individuals travelling from endemic areas, but they need to be recognised in health settings as the potential consequences of infection can be severe.•In this review, we consider the status of NTDs in Australia, explore the risk of introducing and contracting these infections, and emphasise the negative impact they have on the health of Australians, especially Aboriginal and Torres Strait Islander peoples. [ABSTRACT FROM AUTHOR]

The initial serology samples were negative for endemic NT flaviviruses (Japanese encephalitis, MVE and Kunjin viruses) (Box). Following the 2022 national outbreak of Japanese encephalitis across the southern and eastern states of Australia,[[1]] the NT conducted a retrospective audit of NT patients with encephalitis presenting between October 2020 and March 2022. Keywords: Encephalitis; viral; Arbovirus infections; Infectious diseases; Communicable diseases; Serology; Public health; Vaccination EN Encephalitis viral Arbovirus infections Infectious diseases Communicable diseases Serology Public health Vaccination 253 254 2 09/20/23 20230915 NES 230915 Clinical record We present the case of a patient with Japanese encephalitis who was identified by a retrospective audit. [Extracted from the article]

This represents the first detections of MVEV in south-east Australia in the 2022-2023 mosquito season, the first surveillance detections in Victoria since 2011, and the first confirmed human case in Victoria since 1974. Keywords: Arbovirus infections; Virology; Zoonoses; Encephalitis, viral; Public health; Surveillance EN Arbovirus infections Virology Zoonoses Encephalitis, viral Public health Surveillance 40 41 2 06/30/23 20230701 NES 230701 Competing interests No relevant disclosures. [Extracted from the article]

Meningitis and encephalitis are medical emergencies. Patients need prompt evaluation and immediate empiric therapy to reduce the likelihood of fatal outcomes and chronic neurological sequelae. Conjugate bacterial vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. As the results of changes in patterns of bacterial drug sensitivity, ceftriaxone is now part of the recommended empiric treatment for bacterial meningitis and should be administered as early as possible. Neuroimaging delays the treatment of meningitis and is not needed in most cases. Adjunctive corticosteroid therapy is of benefit for many patients with meningitis and should be initiated in most adults before antibiotic therapy. Molecular testing can assist the specific diagnosis of encephalitis and should be based on the exposure history and geographic risk factors relevant to the patient, but non-infectious causes of encephalitis are also common. Empiric therapy for encephalitis should be directed at the most frequently identified infectious pathogen, herpes simplex virus type 1 (ie, intravenous aciclovir). Vaccines can protect against the major pathogens of childhood infections (measles, mumps, rubella, polio, varicella viruses), influenza viruses, and exotic pathogens that cause meningitis and encephalitis (rabies, Japanese encephalitis, dengue, yellow fever, tick-borne encephalitis viruses, Mycobacterium tuberculosis). [ABSTRACT FROM AUTHOR]

Given the presence of I Ae. aegypti i in Central Queensland and the increasing numbers of travellers and visitors returning from countries in which dengue is endemic, it is important that Rockhampton be recognised as a dengue-receptive area. Keywords: Dengue; Public health; Epidemiology; Arbovirus infections EN Dengue Public health Epidemiology Arbovirus infections 182 182 1 08/17/21 20210816 NES 210816 On 23 May 2019, the Central Queensland Public Health Unit received a confirmed laboratory notification of a dengue virus serotype-2 (DENV-2) infection in a Rockhampton resident. Re-defining the dengue-receptive area of Queensland after the 2019 dengue outbreak in Rockhampton. [Extracted from the article]

Cerebrospinal fluid (CSF) white cell count was 287 × 10 SP 6 sp /L with 90% mononuclear cells, CSF protein elevated at 1.49 g/L (normal range [NR], 0.15-0.45 g/L), and CSF glucose 4.5 mmol/L (NR, 2.7-4.2 mmol/L). It is our recommendation that when MVEV infection is suspected, unfractionated whole blood and urine be referred for MVEV molecular testing in addition to CSF and serum. In the case of Murray Valley encephalitis virus (MVEV) infection, the virus can be detected by polymerase chain reaction (PCR) in whole blood for 11 weeks and in urine for 5 weeks. [Extracted from the article]

This is one of two reported cases of imported West Nile virus infection into Australia causing neuroinvasive disease. West Nile virus management is predominantly supportive, although intravenous immunoglobulin with high anti-West Nile virus antibody titres may provide benefit.[8]Box 2 summarises current avenues of pharmacotherapy. MRI imaging demonstrating typical features of bilateral thalamic and basal ganglia changes supports a diagnosis of West Nile virus encephalitis and can assist with diagnosis, management and prognostication. Encephalitis, viral, Travel medicine, Neuroimaging, Pathology, molecular, Diagnostic tests and procedures, Arbovirus infections, Central nervous system viral diseases, Climate change. [Extracted from the article]

The incubation time of epidemic polyarthritis was estimated in 20 patients with evidence of Ross River virus infection after spending less than three weeks in areas of risk. The smallest estimate consistent with all cases was a range of seven to nine days.