Japanese encephalitis following liver transplantation: A rare case report

Potential for emergence of Japanese encephalitis in the European Union

BACKGROUND AND OBJECTIVE

No autochthonous human cases of Japanese encephalitis (JE) have been reported to date in the European Union (EU). In this study, we assess the likelihood of Japanese encephalitis virus (JEV) introduction and transmission within the EU and propose outbreak response measures.

RISK ASSESSMENT

Given the global geographical distribution of JEV, the probability of virus introduction into the EU is currently very low, with viremic bird migration being the most plausible pathway of introduction. However, this likelihood would significantly increase if the virus were to become established in the Middle East, Caucasus, Central Asia or Africa. Considering the environmental conditions that are expected to be conducive for virus circulation, there is a high likelihood of virus transmission within the EU after its introduction in environmentally suitable areas. The spread of the virus within the EU would likely occur through the movement of wild birds, pigs and mosquitoes.

MITIGATION

To mitigate or potentially contain the emergence of JE in the EU, early detection of both human and animal cases will be crucial.

South Asian Transplant Infectious Disease Guidelines for Solid Organ Transplant Candidates, Recipients, and Donors

These guidelines discuss the epidemiology, screening, diagnosis, posttransplant prophylaxis, monitoring, and management of endemic infections in solid organ transplant (SOT) candidates, recipients, and donors in South Asia. The guidelines also provide recommendations for SOT recipients traveling to this region. These guidelines are based on literature review and expert opinion by transplant physicians, surgeons, and infectious diseases specialists, mostly from South Asian countries (India, Pakistan, Bangladesh, Nepal, and Sri Lanka) as well as transplant experts from other countries. These guidelines cover relevant endemic bacterial infections (tuberculosis, leptospirosis, melioidosis, typhoid, scrub typhus), viral infections (hepatitis A, B, C, D, and E; rabies; and the arboviruses including dengue, chikungunya, Zika, Japanese encephalitis), endemic fungal infections (mucormycosis, histoplasmosis, talaromycosis, sporotrichosis), and endemic parasitic infections (malaria, leishmaniasis, toxoplasmosis, cryptosporidiosis, strongyloidiasis, and filariasis) as well as travelers' diarrhea and vaccination for SOT candidates and recipients including travelers visiting this region. These guidelines are intended to be an overview of each topic; more detailed reviews are being published as a special supplement in the Indian Journal of Transplantation .

Japanese Encephalitis Virus-Infected Cells

RNA virus infections have been a leading cause of pandemics. Aided by global warming and increased connectivity, their threat is likely to increase over time. The flaviviruses are one such RNA virus family, and its prototypes such as the Japanese encephalitis virus (JEV), Dengue virus, Zika virus, West Nile virus, etc., pose a significant health burden on several endemic countries. All viruses start off their life cycle with an infected cell, wherein a series of events are set in motion as the virus and host battle for autonomy. With their remarkable capacity to hijack cellular systems and, subvert/escape defence pathways, viruses are able to establish infection and disseminate in the body, causing disease. Using this strategy, JEV replicates and spreads through several cell types such as epithelial cells, fibroblasts, monocytes and macrophages, and ultimately breaches the blood-brain barrier to infect neurons and microglia. The neurotropic nature of JEV, its high burden on the paediatric population, and its lack of any specific antivirals/treatment strategies emphasise the need for biomedical research-driven solutions. Here, we highlight the latest research developments on Japanese encephalitis virus-infected cells and discuss how these can aid in the development of future therapies.

A Bibliometric Analysis of Global Research on Japanese Encephalitis From 1934 to 2020

Japanese encephalitis (JE) is a mosquito-borne disease caused by the Japanese encephalitis virus (JEV). The disease is mainly an epidemic in Asia and has been studied for nearly 90 years. To evaluate the research trends of JE, 3,023 English publications between 1934 and 2020 were retrieved and analyzed from the Web of Science database using indicators for publication, country or territory, citation, journal, author and affiliation, keyword co-occurrence cluster, and strongest citation bursts detection. The results of the bibliometric analysis and the visualization tools show that the number of annual publications on JE has been increasing. JE has been continuously studied in the USA and also many Asian countries, such as Japan, China, India, and South Korea; however, only a few publications have high citations. The main research groups of JE in the last 5 years were in China, Japan, and the UK. The keyword co-occurrence analysis and the strongest citation bursts detection revealed that most studies focused on the pathogenic mechanism of JEV, control of outbreaks, and immunization with JE vaccine. The research maps on JE obtained by our analysis are expected to help researchers effectively explore the disease.