je in india

7/30/2019 JE in India

1/23

Dr. Navneet Kumar Dham ijaAss istant Commiss ioner - Imm unizat ionMinistry of Health & FW, Gov t. of Ind ia

Mob iles : 8826772555, 9911220066

Offi ce : 23062993, 23062126, 23062728

E-mail : Immun izat ionAC@gmail .com

Japanese EncephalitisVaccination Program In India


2/23

Introduction of JE Vaccination

In 2005, a massive outbreak hit several

districts in many parts of the country and

many cases occurred in eastern U.P. and

adjoining districts of Bihar and Nepal

during this period more than 1600 children

were reported to have died of JE

BRD Medical College, Gorakhpurexperienced up to 20 admissions per day

with patients beyond its capacity where

patients were sharing beds, even in the ICU


3/23

Criteria to identify JE endemic districts

Case load of JE- Total number of cases

reported (AES/ suspected JE/ lab

confirmed JE).

Incidence of JE

Evidence of recent transmission of thedisease

Serological evidence from JE studies.

Epidemiological link to known areas of

transmission.

104 districts in 11 States were identified as JE endemic

Highest Priority Districts

High Risk Districts

Medium Risk Districts


4/23

JE Vaccination Program

Strategy

One time campaign covering

children aged 1-15 years followed by

integration of JE vaccine into UIP as

single dose for new cohort at 1-2

years of age

The Multi Year Plan

104 JE endemic districts to be

covered with JE mass vaccination

campaigns in 11 States in a span of 5years 2006 2010*

Review of data and strengthening of JE surveillance showed 4 new states as JE endemic thereby

including 15 JE endemic states and incerasing the no. of JE campaign districts to 109 in the Multi year

plan. Formation of 2 new districts which split up from Kolar and Thiruvannamalai districts Cheyyar

and Chikballapur increased the no. of JE endemic districts to 111. And recently another district has

split from Rae Bareilly and Sultanpur and a new district has been formed

Chattrapati Sahuji

Magaraj Nagar which has incerased the JE campaign districts to 112


5/23

Vaccine availability

Currently, there are three types of JE vaccines in large-scale use:

Mouse brain-derived, purified and inactivated vaccine

Cell culture-derived, inactivated JE vaccine based on the BeijingP-3 strain (only available in China and being replaced by liveattenuated vaccine).

Cell culture-derived, live attenuated vaccine based on the SA 14-14-2 strain of the JE virus.

Based on research studies, discussions by expert andvaccine availability issues for country needs, SA-14-14-2 JEvaccine manufactured by CDIBP, China was taken up for use


6/23

The Multiyear Plan

Based on the emergence of JE/ AES new cases and low coverage indicated in the Coverage

evaluat ion surv ey report in 2 divis ions of U.P 7 distr icts of Bast i and Gorakhpur divis ions

and 2 distr icts o f Assam, a decision to condu ct re-campaigns in 2010 thereby inc reasing the

no. of dist r ic ts from the in i t ia l ly planned 19 to 28.

Year

No. of

Districts

covered till

date Total Population

Target

population

- 1-15

years

Total JE

vaccination

campaign

coverage

JE

vaccination

campaign

coverage %

1 2006 11

29420139 10531554 9308688 88.39

2 2007 27

65934009 21758223 18431087 84.713 2008 22

57772199 20040262 16881941 84.24

4 2009 30

45032191 27170604 18097182 66.61

5 2010* 19

28292755.21 9336609 7626354 81.7

6

2010*re-

campaigns 9 23211927

7659936 7495380

97.85

Total for India till

date118 249663220 96497188 77840632 80.67


7/23

JE Vaccination Program Overview

JE campaign States & districts

1 Andhra Pradesh 10

2 Kerala 2

3 Uttar Pradesh 34

4 Goa 2

5 Assam 11

6 Bihar 6

7 Haryana 6

8 Karnataka 8

9 Tamil Nadu 10

10 Maharashtra 8

11 West Bengal 5

12 Manipur 5

13 Nagaland 2

14 Arunanchal Pradesh 1

15 Uttrakhand 1

Total 111

JE vaccinat ion Campaigns in al l the 112 distr ic ts have been com pleted in 15

states

112 JE vaccination

campaign districts

2006-2011

JE campaigns completed


8/23

111 Districts - 2006 - 2011

S.N Name of State District's Name

1 Andhra Pradesh Warrangal

2 Andhra Pradesh Kurnool

3 Andhra Pradesh Krishna

4 Andhra Pradesh Nellore

5 Andhra Pradesh Medak

6 Andhra Pradesh Adilabad

7 Andhra Pradesh Khamam

8 Andhra Pradesh Nalgonda

9 Andhra Pradesh Mahboobnagar

10 Andhra Pradesh Nizamabad

11 Kerala Thiruvananthapuram

12 Kerala Alappuzha

13 UP Allahabad

14 UP Ambedkar Nagar

15 UP Azamgarh

16 UP Ballia

17 UP Balrampur

18 UP Barabanki

19 UP Bareilly

20 UP Basti

21 UP Behraich

22 UP Deoria

23 UP Faizabad

24 UP Fatehpur

25 UP Ghazipur

26 UP Gonda

27 UP Gorakhpur

28 UP Hardoi

29 UP Jaunpur

30 UP Kanpur Nagar

31 UP Kheri

32 UP Kushi Nagar

33 UP Lucknow

34 UP Maharajganj

35 UP Mau

36 UP Muzaffar Nagar

37 UP Pratapgarh

38 UP Rae Barelly

39 UP Saharanpur

40 UP Shahjahanpur

41 UP Shrawasti

42 UP Sant Kabir Nagar


9/23

43 UP Sitapur

44 UP Siddharth Nagar

45 UP Sultanpur

46 UP Unnao

47 Goa North Goa

48 Goa South Goa

49 Assam Sonitpur

50 Assam Dibrugarh

51 Assam Jorhat

52 Assam Dhemaji

53 Assam Sivsagar

54 Assam Golaghat

55 Assam Tinsukia

56 Assam Lakhimpur

57 Assam Kamrup

58 Assam Udalgiri

59 Assam Nagaon

60 Bihar Champaran West

61 Bihar Muzaffarpur

62 Bihar Gaya63 Bihar Gopalganj

64 Bihar Nawada

65 Bihar Siwan

66 Haryana Kurukshetra

67 Haryana Ambala

68 Haryana Panipat

69 Haryana Karnal

70 Haryana Yamuna Nagar

71 Haryana Kaithal

72 Karnataka Bellary

73 Karnataka Kolar (+C ballapur )74 Karnataka Raichure

75 Karnataka Koppal

76 Karnataka Mandya

77 Karnataka Bijapure

78 Karnataka Dharwad

79 Maharashtra Amravati+Amravati MC

80 Maharashtra Bhandara

81 Maharashtra Nagpur Rural

82 Maharashtra Washim

83 Maharashtra Beed

84 Maharashtra Latur


10/23

85 Maharashtra Gadchirolli

86 Maharashtra Yavatmal87 West Bengal Birbhum

88 West Bengal Hoogly

89 West Bengal Burdwan

90 West Bengal Howrah

91 West Bengal West Medinapore92 Tamil Nadu Cuddalore

93 Tamil Nadu Villupuram

94 Tamil Nadu Virudhunagar

95 Tamil Nadu Trichy

96 Tamil Nadu Thiruvarur97 Tamil Nadu Madurai

98 Tamil Nadu Perambalur

99 Tamil Nadu Thanjavur

100Tamil Nadu Thiruvannamalai

101Manipur Imphal east

102Manipur Imphal West

103Manipur Thoubal

104Manipur Bishnupur

105Manipur Chandel

106Nagaland Dimapur

107Nagaland Mokongchung

108 Arunanchal Pradesh Lohit

109Uttrakhand Udham Singh Nagar


11/23

0

10

20

30

40

50

60

70

80

90

100 88% 84.7% 84.2%

66.6%69.6%

97.9%

Cove

rage%

Year of Campaign

JE vaccination campaigns - Year coverage

2006 - 2011

Over 76 mi l l ion chi ldren have been imm unized in the JE vaccinat ion camp aigns from

2006 2011 Arou nd 3.7 mi l l ion chi ldren h ave been immu nized w ith JE vaccine t i l l

date under RI


12/23

010

20

30

40

50

60

70

80

90

100

West Bengal Assam Karnataka U.P.

56.12%

82.7% 82.6%

99.9%

JE Vaccination campaign coverage 2006

Coverage%

JE Campaign States


13/23

0

10

20

30

40

5060

70

80

90

100 93%88%

75%

97%90%

87%80%

57%

79%


JE Campaign States

Coverage%


14/23

0

10

20

30

40

50

60

70

80

90

100

75%

91%95%

70%

42%

73%

64%

99%

57%

JE Campaign States


Coverage

%


15/23

0

10

20

30

40

50

60

70

80

90

74% 74%

82%

34%

87%78%

40% 35%

70%

85%

25%

JE Campaign States

Covera

ge%



16/23

0

10

20

30

40

50

60

70

80

90

100

77%

96%

87% 85%

93%

72%

89%

82%

Cov

erage%

JE Campaign States



17/23

0

10

20

30

40

50

60

70

80

90

100

Dibrugarh

Sivsagar

Deoria

Gorakhpur

Kushinagar

Maharajganj

S.K.Nagar

SiddharthNagar

Basti

Assam Assam UP UP UP UP UP UP UP

93%

84%

100.2% 99.6% 99% 97% 96%100% 99%

Coverage%

JE Campaign States

JE Vaccination Re-Campaign*

Coverage 2010


18/23

JE vaccination Campaigns and

integration in RI in WB

S.No. Name of Sta te District's NameYear of

Campaign

Coverage Coverage %

JE vaccine

was to be

introduced in

Actually

introduced in

1 West Bengal Burdwan 2006 1229404 56% Jan-07 Feb-09

2 West Bengal Birbhum 2007 792872 74.50% Dec-07 Feb-09

3 West Bengal West Medinapore 2008 1091672 57% Apr-09 Apr-094 West Bengal Hoogly 2009 379295 22.30% Jan-10 Jan-10

5 West Bengal Howrah 2009 440379 28.80% Jan-10 Jan-10


19/23

AEFIs - During JE Vaccination Campaigns

2006 - 2011

Year DistrictsCovered Coverage(Million) AEFIReported Minor Major DeathsInvestigated2006 11 9.3 504 439 65 22

2007 27 18.5 1209 1059 150 8

2008 22 16.9 1039 996 43 6

2009 30 18 755 625 130 5

2010 19 7.4 16 16 0 0

2010* Re-campaigns 9 7.4 180 177 3 1

Total 103 77.5 3703 3312 391 42


20/23

The 5 year JE vaccination plan has been completed in 2011

Previous JE campaign states like Assam, Arunanchal Pradesh,

Manipur, U.P., Bihar, Haryana, Karnataka, Kerala, Tamil Nadu,

Maharashtra, Goa, West Bengal are still reporting JE cases

Issue of Age shift in many states

A large cohort of children still remain un- immunized in

previous campaign districts under JE vaccination in RI

Challenges


21/23

Recommendations

Review of JE incidence

Review JE vaccination program at the State and National

level to recommend the way forward

Strengthen JE vaccination under RI

Coverage reporting

Vaccine demand and supply issues

Monitoring RI sessions

Strengthen coordination and data flow

Immediate action required Introduction of JE

vaccine in RI in the pending districts


22/23

Courage is what

It takes to stand and speak

Courage is also what

It takes to sit down and listen


23/23

je in india

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