title: Recurrence of Japanese encephalitis epidemic in Wuhan, China, 2009-2010.
abstract: BACKGROUND
  Japanese encephalitis (JE) was once epidemic in most areas of China, including Wuhan, a city located in the central part of China. The incidence of JE dramatically decreased due to nationwide immunization with the live attenuated JE virus (JEV) vaccine, and no JE cases were reported during 2005-2008 in Wuhan. In 2009 and 2010, 31 JE cases reoccurred in this area. In this study, we investigated the causes of JE recurrence.
  
  
  RESULTS
  All JE cases were laboratory-confirmed by detecting the JEV-specific IgM antibody with an IgM-capture enzyme-linked immunosorbent assay (ELISA). All patients were children between 2 months and 9 years of age with a median age of 2 years. Of the 31 cases, 9 had received one or two doses of the JEV vaccine, 11 had not been immunized previously with the JEV vaccine, and 11 had an unclear immunization history. Through reverse transcription polymerase chain reaction (RT-PCR), sequencing, and phylogenetic analysis, two new strains of JEV were isolated from Culex tritaeniorhynchus and identified as genotype 1 JEV, rather than genotype 3, which circulated in this area previously.
  
  
  CONCLUSIONS
  Vaccine failure or missed vaccination may have caused JE recurrence. Local centers for disease control and prevention need to improve immunization coverage, and the efficacy of the JE vaccine needs to be reevaluated in a population at risk for disease.
authors: Wuhan Centers for Disease Control and Prevention, Wuhan, China. powerhu21@yahoo.com
authors: Quan
authors: Q
authors: Hu
authors: Banghua
authors: B
authors: Chen
authors: Zerong
authors: Z
authors: Zhu
authors: Junhua
authors: J
authors: Tian
authors: Yu
authors: Y
authors: Zhou
authors: Xiaoyong
authors: X
authors: Zhang
authors: Xin
authors: X
authors: Zheng
mesh_terms: D000818:Animals; D000914:Antibodies, Viral / Q000276:immunology; D002460:Cell Line; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D009033:Culicidae / Q000821:virology; D004664:Encephalitis Virus, Japanese / Q000145:classification / Q000235:genetics / Q000276:immunology*; D004672:Encephalitis, Japanese / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D005260:Female; D005838:Genotype; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D015994:Incidence; D007223:Infant; D022321:Japanese Encephalitis Vaccines / Q000008:administration & dosage / Q000276:immunology; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D012008:Recurrence; D014611:Vaccination / Q000379:methods
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D022321:Japanese Encephalitis Vaccines