According to the Advisory Committee on Immunization Practices (ACIP) (Centers for Disease Control and Prevention. Inactivated Japanese Encephalitis Virus Vaccine Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR. Jan 8, 1993;42:11): U.S. Expatriates: Japanese encephalitis vaccine is recommended for persons who plan to reside in areas where Japanese encephalitis is endemic or epidemic (residence during a transmission season).

By rice field breeding mosquitoes (primarily the Culex tritaeniorhynchus group) that become infected with Japanese encephalitis virus (a flavivirus antigenically related to St. Louis encephalitis virus).

Mild infections occur without apparent symptoms other than fever with headache. More severe infection is marked by quick onset, headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions (especially in infants) and spastic (but rarely flaccid) paralysis.

Residents of rural areas in endemic locations, active duty military deployed to endemic areas, and expatriates who visit rural areas. Japanese encephalitis does not usually occur in urban areas (see table).

Japanese encephalitis outbreaks are usually circumscribed and do not cover large areas. They usually do not last more than a couple of months, dying out after the majority of the pig amplifying hosts have become infected. Birds are the natural hosts for Japanese encephalitis. Epidemics occur when the virus is brought into the peridomestic environment by mosquito bridge vectors where there are pigs, which serve as amplification hosts, infecting more mosquitoes which then may infect humans.

See the CDC Japanese Encephalitis Home Page (http://www.cdc.gov/ncidod/dvbid/jencephalitis) and CDC Health Information for Travelers to Southeast Asia (http://www.cdc.gov/travel/seasia.htm).

Your healthcare provider is the best source of information on the benefits and risks of vaccines. Before your child receives a dose of any vaccine, discuss with your healthcare provider any health problems that your child may have and any medications that your child is currently taking or has been prescribed. Also, discuss any concerns you might have about vaccination.

Japanese encephalitis is the leading cause of viral encephalitis in Asia with 30-50,000 cases reported annually. Fewer than 1 case/year is reported in U.S. civilians and military personnel traveling to and living in Asia. Rare outbreaks in U.S. territories in Western Pacific have occurred.

The Advisory Committee on Immunization Practices (ACIP) has recommended anthrax vaccination for the following groups: Persons who work with imported animal hides or furs in areas where standards are insufficient to prevent exposure to anthrax spores. Persons who handle potentially infected animal products in high-incidence areas; while incidence is low in the United States, veterinarians who travel to work in other countries where incidence is higher should consider being vaccinated.

No. Vaccination is currently not recommended, and the vaccine is not available to healthcare providers or the public. In the unlikely chance a case of smallpox is detected, the Centers for Disease Control and Prevention has an emergency supply of vaccine to treat 15 million people. Unlike many vaccines, which take weeks or months to be effective, the vaccine for smallpox is effective if given 2-3 days after exposure and can prevent a fatal outcome even when given 4-5 days after exposure.

Freshmen college students, particularly those living in dormitories or residence halls, who elect to decrease their risk for meningococcal meningitis Undergraduate students 25 years of age or younger who request vaccination in order to decrease their risk for disease and are not pregnant Students with medical conditions that compromise immunity (e.g., HIV, absent spleen, antibody deficiency)

Encephalitis is an inflammation of the brain. When the brain becomes inflamed-swollen and irritated-normal blood flow to the brain is altered, leading to symptoms such as confusion, fever, and severe headache. Encephalitis is rare.

Classes at our school are divided into seven separate levels: complete beginner, beginner, pre-intermediate, intermediate, upper intermediate, advanced, and expert. A little more information on these levels is available here. On the first day of classes, we will give you a level test, to allow us to choose the best class for you, and to adapt the materials to fit your needs. This test has speaking, listening, reading and writing components.