일본뇌염 예방접종, Japanease encephalitis, vaccine

최근에 17세 미만에서 이모젭을 접종한 경우가 있어 booster 접종에 대해 찾아 보았습니다.

 

이모젭은 12개월~ 17세인 경우에는 첫 접종 1-2년 후에 booster 접종이 필요하고,

18세 이상에서는 booster는 필요하지 않습니다.

 

Japanese encephalitis (JE) is an arboviral encephalitis endemic throughout most of Asia and parts of the western Pacific. The highest risk of JE exposure occurs in rural agricultural areas, often associated with rice production and flooding irrigation.

 

미국에서 맞을 수 있는 일본 뇌염 백신은 1종류가 있으며 inactivated Vero cell culture-derived vaccine (JE-VC; IXIARO)입니다. Inactivated mouse brain–derived vaccine (JE-MB; JE-VAX)는 더 이상 불가능합니다.

 

미국 이외의 지역에서 이용 가능한 백신으로 live attenuated YF-JE chimeric viral vaccine (IMOJEV)가 있으며 호주와 일부 아시아 국가에서 이용 가능합니다. 우리나라에서도 가능합니다. 12개월 이상에서 single 0.5 mL subcutaneous dose를 시행합니다. 12개월에서 17세 사이인 경우에는 long-term protection을 위해 booster dose를 1-2년 후에 접종합니다. 18세 이상에서는 첫 백신 접종 후 적어도 5년 동안은 booster 접종을 할 필요는 없습니다. Live attenuated vaccine이므로 면역이 저하된 환자에서 사용해서는 안되면 임신부에서는 안전성이 입증되지 않았습니다.

 

Recommendations for use of Japanese encephalitis vaccine in travelers

Recommendations:

JE vaccine is recommended for travelers who plan to spend a month or longer in endemic areas during the JEV transmission season. This includes long-term travelers, recurrent travelers, or expatriates who will be based in urban areas but are likely to visit endemic rural or agricultural areas during a high-risk period of JEV transmission.

JE vaccine should be considered for the following:

Short-term travelers (<1 month) to endemic areas during the JEV transmission season if they plan to travel outside of an urban area and have an increased risk of JEV exposure. Examples of higher risk activities or itineraries include: (1) Spending substantial time outdoors in rural or agricultural areas, especially during the evening or night; (2) Participating in extensive outdoor activities (eg, camping, hiking, trekking, biking, fishing, hunting, or farming); and (3) Staying in accommodations without air conditioning, screens, or bed nets.

Travelers to an area with an ongoing JE outbreak

Travelers to endemic areas who are uncertain of specific destinations, activities, or duration of travel

JE vaccine is not recommended for short-term travelers whose visit will be restricted to urban areas or times outside of a well-defined JEV transmission season.

Information on expected JEV transmission by country can be obtained from the CDC at http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/japanese-encephalitis. These data should be interpreted cautiously since JEV transmission activity varies within countries and from year to year.

JE vaccine is also recommended for laboratory personnel with potential for exposure to infectious JEV. Vaccinated, at-risk laboratory personnel should receive appropriate booster doses of JE vaccine or be evaluated regularly for JEV-specific neutralizing antibodies to assure adequate titers.

JE: Japanese encephalitis; JEV: Japanese encephalitis virus; CDC: Centers for Disease Control and Prevention.

 

https://wwwnc.cdc.gov/travel/diseases

 

우리나라도 일본뇌염 위험지역입니다.

https://wwwnc.cdc.gov/travel/yellowbook/2018/infectious-diseases-related-to-travel/japanese-encephalitis