Japanese encephalitis in north Queensland, Australia, 1998

Objective: To describe the circumstances of two cases of Japanese encephalitis (JE) in north Queensland in 1998, including one acquired on the Australian mainland. Design: Serological surveillance of sentinel pigs for JE virus activity; serological surveys of humans and pigs and viral cultures of mosquito collections. Setting: Islands in the Torres Strait and communities in the Northern Peninsula Area (NPA) and near the mouth of the Mitchell River in Cape York, Queensland, in the 1998 wet season (December 1997-May 1998). Results: Sentinel pigs in the Torres Strait began to seroconvert to JE virus in February 1998, just before onset of JE in an unvaccinated 12-year-old boy on Badu island. By mid-April, most sentinel pigs had seroconverted. Numerous JE viruses were isolated from Culex annulirostris mosquitoes collected on Badu. In early March, a person working at the mouth of the Mitchell River developed JE. Serological surveys showed recent JE virus infection in 13 young pigs on a nearby farm, but not in 488 nearby residents. In NPA communities, sentinel pigs seroconverted slowly and JE viruses were isolated from three, but none of 604 residents showed evidence of recent infection. Nucleotide sequencing showed that 1998 JE virus isolates from the Torres Strait were virtually identical not only to the 1998 isolate from an NPA pig, but also to previous (1995) Badu isolates. Conclusions: JE virus activity was more widespread in north Queensland in the 1998 wet season than in the three previous wet seasons, but ecological circumstances leg, less intensive pig husbandry, fewer mosquitoes) appear to have limited transmission on the mainland. Nucleotide sequencing indicated a common source for the 1995 and 1998 JE viruses. Circumstantial evidence suggests that cyclonic winds carried infected mosquitoes from Papua New Guinea.