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Immunisation safety

By on December 3, 2012
There was a recent news item of a tragic case where a boy of around 10 years of age was given Japanese encephalitis immunisation.  Shortly after he collapsed and died.

This story is a sad reminder of the fact that no medical treatment or immunisations are completely safe.  In rare cases there may be a serious or even fatal reaction.    

It is always easy to be wise after the event, but it seems to me, from the information presented in the news report, that no one was to blame.  However, adverse reactions are more likely in those with allergic or neurological conditions so, as always, a risk assessment should be made before giving the immunisation.  

The one question that occurs to me is this: was the immunisation really necessary? According to official statistics in Japan in 2011 there were nine cases of Japanese encephalitis – an extremely low incidence in a county of 127 million people.  

How many cases would there have been if people were not routinely immunised?  I don’t know if it is possible to answer this question.   

Japanese encephalitis is a viral infection of the brain which is transmitted by the bites of mosquitoes.  The intermediate host is the pig, so the disease is found in rural areas of south east Asia in the vicinities of pig farms, and especially in the rainy season when more mosquitoes breed.  Therefore, the risk is extremely small in cities and in my view it is doubtful if it needs to be given routinely to the whole population.  If infected, only about one in 250 people will develop symptoms, but of these some 30% will be seriously affected or may die.    

This case reminds me of a similar event in 1990, when one of the twin 19 year old sons, Tristan, of the late actor Alan Bates, was found dead from what was described as a “freak asthma attack” in Tokyo.   What is not so well known is that the boy received an unnecessary cholera immunisation at a private clinic the previous day.  

Gabriel Symonds is the founder and director of the Tokyo British Clinic.  Comprehensive medical services, including travel advice and immunisations, are available.   Tel: 03-5458-6099   www.tokyobritishclinic.com

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com