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Background <p>Acute Encephalitis Syndrome (AES) is a critical public health issue, contributing significantly to morbidity and mortality in India, particularly among children. Despite ongoing vaccination efforts, Japanese Encephalitis (JE) remains a major cause of AES. This study analyzes the epidemiology of AES and JE in India from 2014 to 2023, using data from the Virus Research and Diagnostic Laboratory Network (VRDLN).</p> Methods <p>A cross-sectional analysis was conducted on AES cases reported by 159 VRDLN laboratories between 2014 and 2023. Standardized diagnostic tests such as polymerase chain reaction were used to identify causative pathogens, including JE virus. All the labs in the network followed BSL-2 standards. Descriptive analyses were performed on AES cases by year, etiology, and demographic factors. JE cases were further analyzed for geographic distribution, age, sex, and clinical characteristics.</p> Results <p>Over the study period, 124,890 AES cases were reported, with 16.3% testing positive for at least one pathogen, including 10% confirmed as JE. The highest JE positivity was observed in the northeastern states. An increasing trend in the number of cases tested and JE detections was noted, alongside a shift in the age distribution towards younger populations. The median (IQR) annual test positivity for JEV among tested was 16.2% (14.5%, 18.4%).</p> Conclusions <p>The VRDLN has substantially enhanced India’s capacity to diagnose and monitor AES and JE. Despite progress, JE transmission persists, particularly in endemic regions, posing significant public health challenges. Strengthened surveillance, improved diagnostic coverage, and integrated pathogen testing are essential for effective interventions. Targeted strategies and sustained public health efforts are critical to reducing the burden of AES and JE in India.</p>

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Acute encephalitis syndrome and Japanese encephalitis in India: insights from a nationally representative laboratory surveillance network, 2014–2023

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  • 发表日期：

    2025年12月8日

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  • Rizwan Suliankatchi Abdulkader,
  • Sabarinathan Ramasamy,
  • Raman Swathy Vaman,
  • Gajanan N. Sapkal,
  • Jitendra Narayan,
  • Neetu Vijay,
  • Vanessa Ravel,
  • Sinthanai Selvan Palanisamy,
  • Gururaj Rao Deshpande,
  • Nivedita Gupta,
  • Manoj V. Murhekar,
  • Arpna Srivastava,
  • Kamal Singh,
  • Shiwangi Gupta,
  • Ravi Muthusamy,
  • Kalaivani Sekar,
  • Thambithurai Boopathy,
  • Swetha Durai,
  • Shankar Vidhate,
  • Rashmi Gunjikar,
  • Asha Salunke,
  • Rashi Srivastava,
  • Kirtee Khutwad,
  • Pradnya Shinde,
  • Muruganandan Nagarajan,
  • Shahina Mustaqim,
  • B. V. Sivamma,
  • Usha Kalawat,
  • Sarada Dulla,
  • Prasanna Kumar,
  • Siva Kalyani,
  • Sumit Rai,
  • Bathala Nagasrilatha,
  • Boyapalli Shanti Reddy,
  • Nagajyothi Beldonu,
  • Mika Umpo,
  • Biswa Jyoti Borkakoti,
  • Ajanta Sharma,
  • Angshurekha Das,
  • Debadatta Dhar Chanda,
  • Samrat Biswas,
  • Sanjay Bhattacharya,
  • Pallabi Sargiary,
  • DeepJyoti Kalita,
  • Jashbeer Singh Roy,
  • Lahari Saikia,
  • Binod Kumar Pati,
  • Ganesh Chandra Sahoo,
  • Vijay Kumar,
  • Kanhaiya Jha,
  • Poonam Kumari,
  • Ashif Ali Hashan,
  • Radha Kanta Ratho,
  • Varsha Gupta,
  • Anudita Bhargava,
  • Debashish Samal,
  • Nikita Sherwani,
  • Rekha Barapatre,
  • Erumalla Naveen,
  • Richa Anjleen Tigga,
  • Aashish Choudhary,
  • Sonal Saxena,
  • Mala Chabbra,
  • Manoj Jais,
  • Charu Jain,
  • Santosh Karade,
  • Madhu Khanna,
  • Anita Sandhya Estibeiro,
  • Neeta Khandelwal,
  • Summaiya Mullan,
  • Madhulika Mistry,
  • Hiral M. Gadhavi,
  • Govind Ninama,
  • Kairavi J. Desai,
  • Ashwini Agarwal,
  • Paramjeet Gill,
  • Surinder Kumar,
  • Prerna Aggarwal,
  • Priti Agarwal,
  • Santwana Verma,
  • Anuradha Sood,
  • Ramesh Chander Guleria,
  • Sridhar Rao,
  • Bashir Ahmed Fomda,
  • Sandeep Dogra,
  • Asifa Nazir,
  • Junaid Ahmad,
  • Abiroo Jan,
  • Suman Kumar,
  • Manoj Kumar,
  • Preeti Mohan,
  • G. B. Shantala,
  • Mallikarjun Koppad,
  • S. Krishna,
  • B. Amurtha Kumari,
  • S. Mahesh Kumar,
  • H. G. Sreedhara,
  • Sunil Kumar Biradar,
  • Kamran Zaman,
  • Reeta Mani,
  • Nazeema Tabaseera,
  • Anitha Puduvail Moorkoth,
  • Balakrishnan Anukumar,
  • Pushpa Kizhakkekarammel,
  • N. Saritha,
  • Kalpana George,
  • T. K. Raji,
  • Joana Mary Magdaline,
  • Kavita Raja,
  • Debasis Biswas,
  • Pushpendra Singh,
  • Amresh Nigudgi,
  • Vaibhav Mishra,
  • Sumit Kumar Rawat,
  • Manish Purohit,
  • Prafulla Songara,
  • Mahesh Reddy,
  • Vaishali Rahangdale,
  • Jyoti Iravane,
  • Vijay Kumar Chincholkar,
  • Neeta Jangale,
  • Gita Nataraj,
  • Meena Mishra,
  • Nayana Ingole,
  • Rupali S. Mantri,
  • Dilip Gedam,
  • Madhuri Magan Suryawanshi,
  • Heigrujam Rebachandra Singh,
  • Rajkumar Manojkumar Singh,
  • Annie Bakorlin Khyriem,
  • Swagnik Roy,
  • Ira Prahraj,
  • Baijayantimala Mishra,
  • Bhabani Patnaik,
  • Susmita Kumari Sahu,
  • Sanghamitra Padhi,
  • Dipankar Pattanik,
  • Rahul Dhodapkar,
  • Sampath Srinivasan,
  • Kanwardeep Dhingra,
  • Rupinder Bakshi,
  • Shipra Galhotra,
  • Kamla Kant,
  • Ritu Garg,
  • Ravisekhar Gadepalli,
  • Bharti Malhotra,
  • Anshu Sharma,
  • Anjli Gupta,
  • Rajesh Bansal,
  • Naveen Saxena,
  • Prabhu Prakash,
  • Ashish Bahal,
  • Kaveri Krishnasamy,
  • Barathi Santose,
  • Sundarajan Thangavel,
  • C. Sugumari,
  • Santhana Kumarasamy Poongodi,
  • Sucila Thangam,
  • Navaneetha Krishnan Ratnapriya,
  • K. Girija,
  • Luke Elizabeth Hanna,
  • C. Nithya,
  • J. K. Surekha,
  • Sudha Rani,
  • Rahul Narang,
  • N. Srinivas,
  • Tapan Majumdar,
  • Shruti Radera,
  • Gaurav Dwivedi,
  • Gopal Nath,
  • Shefali Gupta,
  • Varun Goel,
  • Nazish Fatima,
  • Rajesh Kumar Verma,
  • Amit Garg,
  • Atul Garg,
  • Yogendra Pratap Mathuria,
  • Umesh,
  • Shalabh Jauhari,
  • Mamta Chawla Sarkar,
  • Raja Ray,
  • Ranadeep Ghosh,
  • Nandita Pal,
  • Reena Ray Ghosh,
  • Sayantan Banerjee,
  • Arunabhao Sarkar,
  • Bipasa Chakraborty,
  • Asis Manna,
  • Tanusri Biswas

摘要

Background

Acute Encephalitis Syndrome (AES) is a critical public health issue, contributing significantly to morbidity and mortality in India, particularly among children. Despite ongoing vaccination efforts, Japanese Encephalitis (JE) remains a major cause of AES. This study analyzes the epidemiology of AES and JE in India from 2014 to 2023, using data from the Virus Research and Diagnostic Laboratory Network (VRDLN).

Methods

A cross-sectional analysis was conducted on AES cases reported by 159 VRDLN laboratories between 2014 and 2023. Standardized diagnostic tests such as polymerase chain reaction were used to identify causative pathogens, including JE virus. All the labs in the network followed BSL-2 standards. Descriptive analyses were performed on AES cases by year, etiology, and demographic factors. JE cases were further analyzed for geographic distribution, age, sex, and clinical characteristics.

Results

Over the study period, 124,890 AES cases were reported, with 16.3% testing positive for at least one pathogen, including 10% confirmed as JE. The highest JE positivity was observed in the northeastern states. An increasing trend in the number of cases tested and JE detections was noted, alongside a shift in the age distribution towards younger populations. The median (IQR) annual test positivity for JEV among tested was 16.2% (14.5%, 18.4%).

Conclusions

The VRDLN has substantially enhanced India’s capacity to diagnose and monitor AES and JE. Despite progress, JE transmission persists, particularly in endemic regions, posing significant public health challenges. Strengthened surveillance, improved diagnostic coverage, and integrated pathogen testing are essential for effective interventions. Targeted strategies and sustained public health efforts are critical to reducing the burden of AES and JE in India.