Nepalis traveling home to the Terai and inner Madhesh regions for the Dashain, Tihar, and Chhath festivals are at increased risk of Japanese Encephalitis (JE) infection, the Family Welfare Division’s Vaccine Section has warned. As of October 3, 2026, Nepal has recorded 131 confirmed cases and 28 deaths from the mosquito-borne disease nationwide.
Dr. Abhiyan Gautam, chief of the Vaccine Section, stated that while many children and women residing in JE-affected districts have been vaccinated, men working away from home or abroad often miss out on the vaccine, leaving them vulnerable to infection upon their return. He emphasized that the risk of transmission will persist for at least a month after the Chhath festival.
Vaccination and Prevention Efforts
Dr. Gautam urged those who have not been vaccinated to contact their nearest health facility for a free JE vaccine immediately upon arriving home. Vaccination campaigns have been conducted in all local levels of Jhapa and in Lamkichuha, Ghodaghodi, and Dhangadhi municipalities in Kailali. He highlighted the effectiveness of vaccination, noting that no JE infections have been reported in Nawalpur this year, where a vaccination campaign was conducted last year.
Nepal initiated its JE immunization program in 2006, and the vaccine was integrated into the nationwide routine immunization schedule for children in 2015. The most effective way to prevent JE is through vaccination. For those in areas without ongoing campaigns, avoiding mosquito bites by sleeping under nets, wearing protective clothing, and keeping ducks and pigs away from homes are crucial preventive measures.
Current Situation and Historical Context
Of the 1,372 acute encephalitis syndrome cases recorded this year, 131 were confirmed as JE, and approximately 87% of those infected were unvaccinated. The case fatality rate for JE in Nepal is around 23 percent.
In August 2026, nine deaths and 37 infections were reported in less than a month, followed by 121 infections and 26 deaths across all seven provinces in September 2026. Last year, in 2025, 35 people died and 179 were infected, with the disease spreading to over 117 local units in 45 districts.
Madhesh Province remains a high-risk area, reporting 17 infections and 3 deaths in 2025, and two deaths in August 2026 alone. Dr. Gautam advised special caution in all districts of Madhesh Province, as well as Chitwan, Morang, Sunsari, Banke, Bardiya, Kanchanpur, Rupandehi, Dang, Udayapur, Surkhet, Tanahu, and Nawalpur.
Historically, Nepal has faced significant JE challenges. A devastating outbreak in 2005 claimed the lives of nearly 2,000 people, primarily children in the Terai districts. Between 1998 and 2003, there were 8,874 reported cases and 1,264 fatalities, with a 14.2% fatality rate. In 2024, 23 deaths and 80 cases were reported, including one in Kathmandu Valley. In 2023, 105 cases and 7 deaths were recorded, and in 2022, there were 79 cases.
Future Outlook and Challenges
Health officials warn that JE cases could rise as the peak season approaches. The Ministry of Health and Population plans to seek a budget for a mass JE vaccination drive in 2026. The government has allocated Rs 460 million for a vaccination program in 11 high-burden districts, expected to commence after April next year due to vaccine procurement timelines.
However, the exact number of asymptomatic or mildly symptomatic JE cases remains unknown due to underreporting. The effectiveness of the JE vaccine in adults and the need for booster doses for those vaccinated years ago are areas requiring further investigation. Development partners have not yet shown interest in financing the planned mass immunization drive for 2026, and the availability of vaccines for adults and outbreak containment is a concern.
