WHO launches global encephalitis policy

The World Health Organization (WHO) is releasing a new global policy for encephalitis this week in the face of what experts describe as ‘the increasing global threat’ of the disease.
 
The technical document includes prevention strategies, as well as exploring existing gaps in the diagnosis, treatment and care. It will also outline public health actions needed to reduce the impact of the disease, a rare but serious condition most often caused by a virus.
 
Encephalitis International Chief Executive Dr Ava Easton said the WHO policy is particularly pertinent for Australia given the annual cases recorded from infections caused by mosquito-borne viruses such as Japanese encephalitis virus (JEV) and Murray Valley encephalitis virus.

‘Encephalitis is an increasing global threat,’ Dr Easton said. ‘Without urgent attention and investment, we will see more needless death and disability from the condition.’

While JEV is noted as one of the main causes of viral encephalitis in Asia, accounting for around 100,000 cases and 25,000 deaths each year, it was not found in most Australian states until recently.
 
In March 2022, a JEV outbreak was declared a Communicable Disease Incident of National Significance in Australia after cases were found in humans in several Australian states, a status that was later dropped in June 2023.
 
Several deaths caused by JEV were also recorded in the eastern states of Australia in 2022, including in New South Wales and Victoria.
 
Recorded cases have been less frequent this year so far, although NSW Health recently announced the first case in the state this year, with the patient thought to have contracted the virus while camping in the Murrumbidgee region.
 
This followed a case reported in Victoria last month.
 
Vaccination is now available in affected areas for people deemed most at risk of the disease.
 
Dr Catherine Pendrey, the author of a 2023 clinical update on Japanese encephalitis in the Australian Journal of General Practice, said the new WHO policy is welcome.
 
‘It’s particularly relevant to Australia, given that in recent years we’ve seen a considerable expansion in the areas affected by Japanese encephalitis, which is a rare but potentially very dangerous disease,’ she told newsGP.
 
‘It’s very likely that Japanese encephalitis is now endemic in Australia, and this is something that’s completely new.’
 
Dr Pendrey said that prior to 2021, Japanese encephalitis had only been seen in very limited cases in Australia, in the very far northern reaches of Queensland and the Torres Strait.
 
‘However, as we’ve seen warmer and wetter conditions related to climate change, we’ve seen the area where Japanese encephalitis is transmitted expand considerably,’ she said.
 
‘Initially, it can present with quite non-specific flu-like symptoms, but in its more advanced stages, it presents with symptoms classic of meningitis or encephalitis.’
 
An Encephalitis International survey published last year found that among health professionals, including those in Australia, most thought they did not have enough knowledge to diagnose encephalitis.
 
Dr Pendrey, who is also Chair of RACGP Specific Interests Climate and Environmental Medicine, said the increasing cases of JEV highlight the importance of adapting to a changing environment.
 
‘The spread of Japanese encephalitis throughout Australia is an example of the health impacts of climate change we’re seeing more and more every day,’ she said.
 
‘A number of mosquito-borne diseases that we do not usually see in Australia may well spread to other areas due to changing environmental conditions and due to the effects of extreme weather events.
 
‘So all GPs should be tuning into public health advice and keeping abreast of how the changing climate is needing us to update our practice.’
 
For further information about Japanese encephalitis, including vaccination recommendations, see the Australian Immunisation Handbook.
 
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