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A recent publication in Eurosurveillance reports on a severe case of imported Japanese encephalitis (JE) in a Spanish traveller who developed symptoms after spending three weeks in a tourist area of Thailand.
A 20 year-old Spanish man travelled to Thailand on 25 January 2013, the expected duration of the trip was six weeks. Upon arriving in Thailand, he visited Bangkok for two days where he stayed in a hotel. On 28 January he travelled by bus to Surat Thani, where he took the ferry to Koh Samui island. He stayed in a bungalow on the beach (Chaweng and Lamai beaches) during his stay. In Koh Samui he also visited rural areas, visited waterfalls in the forest where he was bitten by mosquitoes.
On 21 February, the traveller was admitted to hospital in Koh Samui with a 48 hr history of fever, myalgia, malaise and headache. On 23 March, after being diagnosed in Thailand as a probable case of JE, he was transferred to hospital in Barcelona, Spain. He continues to convalesce.
It is estimated that the risk for travellers to these areas remains very low. To date, only 62 cases have been published in patients not living in endemic areas between 1973 and 2013, (30 imported cases in Europe).
(Via Eurosurveillance Vol 18, Issue 35 - accessed 02/09/13)
Advice for Travellers
This traveller did not seek pre-travel advice and was unimmunised against JE. JE vaccine is available for those considered to be at risk and bite avoidance measures are recommended for all travellers to Thailand.
