Bulletin of the World Health Organization

Estimated global incidence of Japanese encephalitis: a systematic review

Grant L Campbell, Susan L Hills, Marc Fischer, Julie A Jacobson, Charles H Hoke, Joachim M Hombach, Anthony A Marfin, Tom Solomon, Theodore F Tsai, Vivien D Tsu & Amy S Ginsburg

Volume 89, Number 10, October 2011, 766-774E

Table 1. Japanese encephalitis (JE) incidence group, endemic areas, current vaccine programme description (as of 2009) and population data, by country

IG Description Country Endemic area(s) Vaccination programme Population, endemic area(s) only
Year Data type Total (millions) Age (years)
0–14 ≥ 15
A Historically high-incidence areas with long-standing, high-quality vaccination programmes China
Countrywide Mass vaccination of children was begun in 1968, followed by routine childhood vaccination 2010 Inter-census estimate 23.1 3.6 19.5
Japan Countrywide Vaccine first introduced in 1954; widespread childhood vaccination conducted from 1967 to 2004; recommendation for vaccination withdrawn in 2005 and coverage declined; recommendation reinstated in 2009, but coverage remains low 2010 Census 128.1 17.2 110.9
Republic of Korea Countrywide Routine childhood vaccination programme began in the 1970s 2005 Census 47.3 7.8 39.5
B Extremely low-incidence areas; rare human cases; minimal or no vaccination programmes Australia Torres Strait Islands and Far North Statistical Division, Queensland State Mass vaccination was conducted on outer Torres Straits Islands only in 1995, followed by routine vaccination programme 2009 Inter-census estimate 0.25 0.05 0.2
India Lowest-incidence stratum (north-west –Haryana, Punjab) Generally none, but mass-vaccination campaigns conducted in a portion of Haryana state in 2007–2009 2008 Inter-census estimate 53.1 16.2 36.8
Pakistan Sindh province None 1998 Census 30.4 10.8 19.7
Russian Federation Primorsky Krai None 2010 Census 2.0 0.3 1.7
Singapore Countrywide None 2010 Census 3.8 0.7 3.1
C1 Historically high-incidence areas with expanding vaccination programmes China Higher-incidence stratum (Anhui, Chongqing, Fujian, Gansu, Guangdong, Guangxi, Guizhou, Henan, Hubei, Hunan, Jiangsu, Jiangxi, Shaanxi, Shandong, Shanxi, Sichuan, Yunnan, and Zhejiang provinces) From 1981 to 2007, vaccine used extensively but non-uniformly in children; beginning in 2008, incorporated into Expanded Programme on Immunization in all endemic provinces 2010 Census 1025.7 200.0 825.7
C2 Historically medium-incidence areas with expanding vaccination programme China Lower-incidence stratum (Beijing, Hainan, Hebei, Heilongjiang, Jilin, Liaoning, Nei Mongol, Ningxia, Shanghai, and Tianjin provinces; Hong Kong Special Administrative Region and Macau Special Administrative Region) As above, except for Hong Kong SAR and Macau SAR, which have no vaccination programmes 2007 Inter-census estimate 276.6 53.9 222.7
D High-incidence areas with nascent or no vaccination programmes Cambodia Countrywide National programme started in three provinces in late 2009 2008 Census 13.4 4.3 9.1
Indonesia Higher-incidence stratum (Bali, Nusa Tenggara, all provinces on Borneo and Sulawesi, and the Moluccas) None 2010 Census 50.4 13.6 36.8
Lao People's Democratic Republic Countrywide None 2009 Inter-census estimate 6.1 2.1 4.0
Malaysia Sabah and Labuan (all of Malaysian Borneo except Sarawak) None 2000 Census 3.2 1.0 2.2
Myanmar Countrywide None 2000 Inter-census estimate 49.0 12.5 36.5
Philippines Countrywide None 2007 Census 88.6 31.4 57.2
Timor-Leste Countrywide None 2010 Census 1.1 0.5 0.6
E Medium-incidence areas with no vaccination programmes Indonesia Lower-incidence stratum (all provinces on Sumatra, Java and Papua, plus Kepulauan Bangka Belitung and Riau) None 2005 Inter-census estimate 187.2 50.5 136.6
Malaysia Peninsular Malaysia None 2000 Census 21.9 6.6 15.3
Papua New Guinea All provinces on the main island None 2000 Census 4.4 1.7 2.7
F Historically high-incidence areas with expanding vaccination programmes India Highest-incidence stratum (north-central and north-eastern – Assam, Bangla [West Bengal], Bihar, Manipur, Uttar Pradesh) National programme started in 2006; previously, very limited state-based use as outbreak response 2008 Inter-census estimate 428.6 131.2 297.5
Nepal Higher-incidence stratum (24 Terai and Inner Terai districts) Vaccine introduced in 2006 2001 Census 12.5 4.5 8.0
G Low-incidence areas with minimal or no vaccination programmes Bangladesh Countrywide None 2001 Census 124.4 38.9 85.4
Bhutan Southern foothillls (Chhukha, Dagana, Monggar, Pemagatshel, Samdrupjongkhar, Samtse, Sarpang, Trashigang, Tsirang, Zhemgang districts) None 2005 Census 0.4 0.1 0.3
Brunei Darussalam Countrywide None 2010 Census 0.4 0.1 0.3
Nepal Lower-incidence stratum (51 mountain and hill districts) Vaccine campaigns conducted in three hill districts in 2008–2009 2001 Census 10.7 3.9 6.8
H Historically medium-to-high-incidence areas with expanding vaccination programmes India Medium-incidence stratum (south – Andhra Pradesh, Goa, Kerala, Karnataka, Maharashtra, Pondicherry, Tamil Nadu) National programme started in 2006; previously, very limited state-based use as outbreak response 2008 Inter-census estimate 366.4 112.1 254.3
Malaysia Sarawak Vaccine introduced in 2001 nationwide, but subsequently scaled-back to Sarawak only 2000 Census 2.4 0.7 1.7
Sri Lanka Countrywide Vaccine introduced in 1988, with initial use in high-risk areas 2010 Inter-census estimate 20.7 5.1 15.5
Thailand Countrywide Routine childhood vaccination began in 1990, initially in higher-risk provinces 2006 Inter-census estimate 62.8 12.9 49.9
Viet Nam Countrywide Vaccine introduced in 1997, with initial use in high-risk areas 2009 Census 85.8 20.3 65.6
I Historically medium-to-high-incidence area with expanding vaccination programme Democratic People's Republic of Korea All provinces except Ryanggang and North Hamyong Minimal vaccine coverage from 1994 to 2008; in 2009, a mass campaign vaccinated nearly half a million children in five provinces and Pyongyang 2008 Census 20.3 4.6 15.7
Subtotal (JE-endemic areas only)a 3150.9 769.2 2381.7

IG, incidence group.

a The total population (endemic + non-endemic areas) aged 0–14 years is 1000.9 million, aged 15+ years is 2692.7 million, and combined is 3693.6 million (country-specific data not shown).