Reuben R, Gajanana A
           Centre for Research in Medical Entomology (ICMR), Madurai, India.
           Indian J Pediatr 1997 Mar-Apr;64(2):243-51

        Japanese encephalitis (JE), caused by a mosquito-borne virus was first
        recognised in India in 1955 and since then many major out-breaks from
        different parts of the country have been reported, predominantly in
        rural areas. Children are mainly affected, with morbidity rate estimated
        at 0.30 to 1.5 per 100,000 population. Case fatality rate has ranged
        from 10% to 60%, and up to 50% of those who recover may be left with
        neurological deficits. Reported incidence has generally been higher in
        males than in females, but subclinical infections have occurred equally
        in both sexes. A large number of subclinical infections occur each year
        during the transmission season. Diagnosis at the primary health centre
        (PHC) level is based on clinical symptoms only. Therefore, there is a
        need to develop simple tests for use at the peripheral level both for
        diagnosis and for epidemiological surveys. JE is a vaccine preventable
        disease, but there are many logistic problems for effective
        implementation of vaccination.