Nepal’s Ministry of Health has reported approximately 110 laboratory-confirmed Japanese encephalitis cases, including 21 deaths, since early August 2025 – a two-fold increase over normal levels. Cases are concentrated primarily in Lumbini Province but have been reported nationwide. While traveler risk remains minimal, this outbreak warrants increased awareness and preventive measures.
While absolute risk to international travelers remains low due to short exposure periods, the current outbreak elevates risk levels, particularly for certain travel profiles. Travelers at highest risk include those visiting rural agricultural areas, staying in basic accommodations without mosquito screening, or participating in outdoor activities during peak mosquito activity periods.
Early symptoms include fever, headache, and altered mental status, progressing rapidly to encephalitis with seizures, coma, and focal neurological deficits. The rapid progression and lack of specific antiviral treatments make prevention through vaccination and mosquito control the primary defense strategies.
Japanese Encephalitis Vaccination Considerations
The IXIARO® Japanese Encephalitis(JE) vaccine series can protect travelers from the disease caused by Japanese encephalitis virus, approved for use in individuals 2 months of age and older. The vaccine series requires advance planning, as protection develops 1-2 weeks after the final dose. Two doses are administered 7 or 28 days apart, providing protection, with booster doses extending immunity.
Comprehensive Mosquito Protection Strategy
Given that JE mosquitoes (primarily Culex species) are most active during nighttime hours, protection measures should focus on evening and overnight periods. Travelers visiting rural areas below 1,500 meters (5,000 feet) elevation should consider Japanese encephalitis vaccination. All visitors should practice strict mosquito protection, using EPA-approved repellents, protective clothing, and screened accommodations.
Medical Preparedness
Travelers should ensure comprehensive travel health insurance that covers medical evacuation, as severe JE cases may require intensive care not available in rural areas. Seek immediate medical attention for fever, headache, or altered mental status during or after travel to affected areas, informing healthcare providers about potential JE exposure. Preventive measures through vaccination and mosquito protection remain the most effective strategies for travelers to affected regions.
Schedule a consult with TravelBug Health to discuss whether the Japanese Encephalitis vaccine is right for you.
To learn more about the JE vaccine series, visit our Japanese Encephalitis vaccination page.
For more information about JE disease, visit the CDC’s Japanese Encephalitis website.
