Japanese Encephalitis Ecosystem in India: The Infection Landscape and the Socio-economic and Cultural Perspective for Disease Prevention and Control

Japanese encephalitis (JE) is a serious public health problem in several parts of India, because of its threatening morbidity and mortality outcome, particularly among children. In India, there are 3 known mosquito vector species widely present in all the endemic areas. The ecology of JE is a multidimensional issue involving several macro- to- micro level factors influencing the spatio- temporal dynamics of transmission. There is a need to understand the ecological linkage and the interface of the reservoir (bird)- amplifier (pig)- the vector (mosquito) as a crucial aspect of the biologic route in the maintenance of the JEV in nature. The type of association of domestic and peridomestic biotopes as drivers of JEV also needs to be understood at the local scale. Risk factor identification based on micro analysis of diverse factors ranging from local ecology to socio- economic well being of people living in endemic areas, is of utmost importance for JE prevention and control. The scarcity of specific information and importance of socioeconomic and cultural aspects in relation to JE epidemiology has been emphasized and reviewed in the article. All these aspects of JE ecosystem have been grossly reviewed highlighting specific areas of interest for disease prevention/ control programme in order to provoke ecological thinking among various specialists like epidemiologists, medical entomologists, molecular epidemiologists and public health decision makers.