The seroprevalence of antibodies to Japanese encephalitis virus in five New South Wales towns at high risk of infection, 2022

To the Editor: The findings from Baldwin and colleagues,¹ regarding the seroprevalence of Japanese encephalitis virus (JEV)-specific antibodies in community members (in settings not traditionally considered as risky), underscore the critical need to characterise transmission pathways and identify probable hosts of infection within New South Wales.

While critical to understand the scope of infection, what we are currently missing is a deep dive into the factors contributing to the risk of JEV. This is not a criticism of their work but rather a call to action as traditional epidemiological studies do not necessarily capture these points (due to the approaches taken) and there is a need to build stronger partnerships within One Health to ensure that the broader social–ecological risk factors at the individual, family, community, and national levels are captured.²

Given the increasing cases of arboviruses and the shift in epidemiology, it is critical that we start ensuring our epidemiology studies are coupled with opportunities to capture data on exposure history, behaviour and practices that facilitate prevention or transmission. To support public health measures, it is also critical to understand the risk perceptions of community members, what protective measures they are using to avoid mosquito bites and if they are willing to receive vaccines against JEV.

Regarding risk history, we do not have a good sense of how much time the infected individuals spent outside the home, what kinds of activities they did, and where. Vaccination is the best method to prevent JEV, but did we prepare this community for JEV vaccines? Lessons learnt during the coronavirus disease 2019 pandemic showed that the likelihood of getting the disease and risk perceptions towards the vaccine affected vaccine acceptance.³

Social science intelligence that uses open-ended unstructured interviews, participant observation and group discussion is in the best position to answer these questions.⁴ Outbreaks of JEV have been reported in Australia since 1995;⁵ however, it is likely that we will see increased JEV incidence. Now is the time to break down siloes and ensure that we are producing outbreak investigations and epidemiological studies that capture these critical social and behavioural factors to inform future approaches.

No relevant disclosures.