Open Access Open Badges Correspondence

Evidence and rationale for the World Health Organization recommended standards for Japanese encephalitis surveillance

Susan Hills17*, Alya Dabbagh2, Julie Jacobson18, Anthony Marfin39, David Featherstone2, Joachim Hombach2, Pem Namgyal4, Manju Rani5, Tom Solomon6 and the Japanese Encephalitis Core Working Group

Author Affiliations

1 PATH, Seattle, WA, USA

2 World Health Organization (WHO), Geneva, Switzerland

3 Centers for Disease Control and Prevention, Fort Collins, CO, USA

4 WHO Regional Office for South-East Asia, New Delhi, India

5 WHO Regional Office for Western Pacific, Manila, Philippines

6 University of Liverpool, Liverpool, UK

7 Current address: Centers for Disease Control and Prevention, Fort Collins, CO, USA

8 Current address: Bill and Melinda Gates Foundation, Seattle, WA, USA

9 Current address: Washington State Department of Health, WA, USA

For all author emails, please log on.

BMC Infectious Diseases 2009, 9:214  doi:10.1186/1471-2334-9-214

Published: 29 December 2009



Japanese encephalitis (JE) is the most important form of viral encephalitis in Asia. Surveillance for the disease in many countries has been limited. To improve collection of accurate surveillance data in order to increase understanding of the full impact of JE and monitor control programs, World Health Organization (WHO) Recommended Standards for JE Surveillance have been developed. To aid acceptance of the Standards, we describe the process of development, provide the supporting evidence, and explain the rationale for the recommendations made in the document.


A JE Core Working Group was formed in 2002 and worked on development of JE surveillance standards. A series of questions on specific topics was initially developed. A literature review was undertaken and the findings were discussed and documented. The group then prepared a draft document, with emphasis placed on the feasibility of implementation in Asian countries. A field test version of the Standards was published by WHO in January 2006. Feedback was then sought from countries that piloted the Standards and from public health professionals in forums and individual meetings to modify the Standards accordingly.


After revisions, a final version of the JE surveillance standards was published in August 2008. The supporting information is presented here together with explanations of the rationale and levels of evidence for specific recommendations.


Provision of the supporting evidence and rationale should help to facilitate successful implementation of the JE surveillance standards in JE-endemic countries which will in turn enable better understanding of disease burden and the impact of control programs.