Nepal reports at least nine Japanese encephalitis (JE) deaths and 37 infections in under a month, with officials warning of rising risks as the disease peaks, citing vaccination gaps and budget constraints.
In a stark reminder of persistent public health challenges, Nepal has recorded at least nine deaths and 37 infections from Japanese encephalitis (JE) in less than a month, with health officials warning that the toll could rise as the mosquito-borne disease reaches its peak season. The latest fatalities include a person in Nawalparasi East, where a vaccination campaign had been launched months earlier but coverage remained at just 77 percent, according to Dr Abhiyan Gautam, chief of Immunisation Section at the Family Welfare Division under the Department of Health Services.
Vaccination Gaps and Public Health Warnings
Our surveillance and investigation show that the person who died of JE infection was unvaccinated,
Gautam said, emphasizing the risks faced by those without immunization. The 77 percent vaccination rate in Nawalparasi East, where the infection rate was high, left a significant portion of the population vulnerable. JE, a viral brain infection transmitted by mosquitoes, kills about one-third of those who develop severe illness, according to the World Health Organisation, with up to half of survivors facing lifelong disabilities.
The recent deaths, six in Koshi province and two in Madhesh, highlight the disease’s spread across multiple regions. Last year, 41 people died and 141 were infected, with a 23 percent case fatality rate. In 2024, 23 people, including one in Kathmandu Valley, died of JE, while at least 80 were infected. This year, around 20 percent of reported cases have resulted in deaths, officials said.
Government Response and Budget Constraints
Despite the urgency, Nepal’s government has allocated Rs460 million to vaccinate people in 11 districts with high JE burdens, including Chitwan, Kailali, and Rupandehi. However, the vaccination program will not start before April next year due to delays in vaccine procurement. We only managed to launch vaccination in Nawalparasi East and some wards of Chitwan districts, where the infection rate was too high,
Gautam explained, noting that budget limitations prevented broader coverage.
Dr Shyam Raj Upreti, former director general at the Department of Health Services, stressed the need for immediate action. As JE infection causes high mortality and disability, authorities concerned must arrange the vaccine for the unvaccinated population,
he said. Upreti, an immunisation expert, added that vaccination remains the only effective way to prevent further deaths and disabilities from JE, alongside awareness campaigns and hygiene initiatives.
Historical Outbreaks and Current Challenges
JE has long been a major public health issue in Nepal. The virus killed nearly 2,000 people in 2005, mostly children in the Tarai districts. Nepal began administering the JE vaccine in 2006, eight years before the WHO issued prequalification certification, due to high infection rates. The program was later expanded with global health partners. Last year’s data showed that 76 percent of JE deaths were among those over 40, while 70 percent of infected individuals were older than 15, indicating the disease’s broad impact beyond childhood.
Experts warn that unvaccinated individuals remain at high risk of severe illness and death. We know that vaccination is a safe and proven method to prevent deaths, permanent disabilities, and infection from JE,
Gautam said. However, the government’s inability to fund widespread immunization leaves many vulnerable, particularly in rural areas where JE transmission is most prevalent.
What Comes Next? The Unanswered Questions
As Nepal grapples with the current surge, the delayed vaccination rollout and limited resources raise critical questions about long-term preparedness. With JE’s transmission linked to agricultural practices and monsoon rains, the lack of immediate preventive measures leaves communities exposed.
The CDC’s guidance on JE underscores the disease’s global reach, noting that it is the most common vaccine-preventable cause of encephalitis in Asia. While travel-associated cases remain rare for most visitors, prolonged stays in rural areas with active transmission pose significant risks. For Nepal, the challenge lies in bridging the gap between historical efforts and current needs, ensuring that vaccination campaigns reach those most at risk before the next peak season.
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