{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:44:18Z","timestamp":1790815458868,"version":"4.1.0"},"reference-count":79,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Japanese encephalitis (JE) is becoming an increasingly important issue among adults. The reasons for this are multifactorial. During the past decades, new areas of Japanese encephalitis virus (JEV) transmission have occurred in several locations, most notably in a markedly expanded area of Australia during 2021\u20132022. When JEV enters new areas, cases in adults frequently occur. This is unlike the typical pattern in endemic areas where the burden of disease is in children because most adults are protected through natural immunity following earlier exposure to the virus. Even in endemic areas, JEV has become relatively more important in adults because improved JE control through childhood immunization programs has resulted in a substantial decrease in pediatric JE cases and thus more prominence of adult JE cases. Finally, increases in tourism to JE risk areas have resulted in more exposure of adult travelers, who are usually non-immune, to infection in JE risk areas. In this review we describe the increasing importance of JE in adults in some areas and then consider the comparative clinical presentation and severity of illness among children and adults.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0036","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T09:37:59Z","timestamp":1681119479000},"page":"860-864","source":"Crossref","is-referenced-by-count":45,"title":["Japanese Encephalitis among Adults: A Review"],"prefix":"10.4269","volume":"108","author":[{"given":"Susan L.","family":"Hills","sequence":"first","affiliation":[{"name":"Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Netravathi","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Solomon","sequence":"additional","affiliation":[{"name":"The Pandemic Institute and The National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"579","article-title":"Japanese encephalitis surveillance and immunization - Asia and Western Pacific regions, 2016","volume":"66","author":"Heffelfinger","year":"2017"},{"key":"b2","series-title":"Viruses","first-page":"2480","article-title":"Japanese encephalitis virus: the emergence of genotype IV in Australia and its potential endemicity","volume":"14","author":"Mackenzie","year":"2022"},{"key":"b3","series-title":"Am J Trop Med Hyg","first-page":"651","article-title":"Ecologic studies of Japanese encephalitis virus in Japan. 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