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Peer-reviewedCC BY-NC 4.0BMJ Open

Seroprevalence of Japanese encephalitis virus and other flavivirus-specific antibodies among Australian blood donors following a novel epidemic spread of Japanese encephalitis virus: a cross-sectional study

  • Archana Koirala1,2,3,4,5
  • Noni Ella Winkler1
  • Shayal A Prasad1
  • Rena Hirani6,7
  • Jannah Baker5
  • Linda Hueston8,9
  • Matthew O’Sullivan2,5,8
  • Sandrine Stepien1
  • Veronica Hoad6
  • Jen Kok2,5,8
  • Iain B Gosbell6,10
  • Guddu Kaur1,11
5 more authors
  • Joanne Jackson1
  • Thomas L Snelling2,3,5
  • Dominic E Dwyer5,8
  • David O Irving6,12
  • Kristine Macartney1,2,5
12 affiliations
  1. 1National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia
  2. 2Sydney Infectious Diseases Institute, The University of Sydney, Camperdown, New South Wales, Australia
  3. 3Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
  4. 4Department of Infectious Diseases, Nepean Hospital, Kingswood, New South Wales, Australia
  5. 5Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  6. 6Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
  7. 7Faculty of Science and Engineering, Macquarie University, Macquarie Park, New South Wales, Australia
  8. 8Westmead Hospital Institute of Clinical Pathology and Medical Research, Westmead, New South Wales, Australia
  9. 9Griffith University Menzies Health Institute Queensland, Brisbane, Queensland, Australia
  10. 10Western Sydney University School of Medicine, South Penrith, New South Wales, Australia
  11. 11National Centre for Epidemiology and Population Health, Australian National University, Acton, Australian Capital Territory, Australia
  12. 12Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia
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Abstract

Objectives: In 2022, Japanese encephalitis virus (JEV) was detected in humans and animals across mainland Australia. We examined the prevalence of JEV and endemic flaviviruses, Murray Valley encephalitis virus (MVEV) and Kunjin virus (KUNV) antibodies in blood donors in different risk geographic areas across southern Australia.

Design: Prospective cross-sectional serosurvey for JEV, MVEV and KUNV-specific antibodies.

Setting: Southern Australia.

Participants: All Australian blood donors who attended nine high-risk (geographical proximity to recent human, animal and/or vector detections of JEV) and three low-risk (no competent JEV vector and no animal or human detections were nearby) donor centres between 8–26 August or 12–17 September 2022 were analysed.

Primary and secondary outcome measures: Seroprevalence estimates of JEV, MVEV and KUNV-specific antibodies were compared between blood donors from collection sites in areas considered high-risk and low-risk for JEV infection. Seroprevalence estimates were adjusted for age and sex after excluding donors born in JEV-endemic countries and those with documented JEV vaccination.

Results: JEV-specific antibody seroprevalence was 1.6% (95% CI 1.3% to 2.0%) from 5257 samples. Odds of JEV seropositivity were greater in high-risk versus low-risk areas (OR 1.8, 95% CI 1.5 to 2.2; absolute risk difference: 0.8 percentage points) and in males versus females (OR 2.1, 95% CI 1.2 to 3.6). In high-risk areas, people ≥70 years had higher seroprevalences than those aged 18–29 (OR 3.1, 95% CI 1.8 to 5.5). MVEV and KUNV-specific antibody seroprevalence were 2.2% (95% CI 1.9% to 2.7%) and 3.7% (95% CI 3.2% to 4.3%), respectively, with higher prevalence in high-risk areas (MVEV OR 2.6, 95% CI 1.6 to 4.3; KUNV OR 2.4, 95% CI 1.9 to 3.0) and older ages.

Conclusions: Blood donors in areas where JEV emerged in the 2021–2022 Australian summer had a 0.8 percentage point higher seroprevalence compared with non-JEV transmission areas, with older male donors most likely to be seropositive. Patterns were similar for endemic flaviviruses. This data informed recommendations for JEV vaccine distribution to high-risk areas and the need for non-pharmaceutical mosquito prevention strategies across Australia, given the highly susceptible population.

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Cite

BibTeXRIS
BibTeX
@article{koirala2026seroprevalence,
  title = {{Seroprevalence of Japanese encephalitis virus and other flavivirus-specific antibodies among Australian blood donors following a novel epidemic spread of Japanese encephalitis virus: a cross-sectional study}},
  author = {Archana Koirala and Noni Ella Winkler and Shayal A Prasad and Rena Hirani and Jannah Baker and Linda Hueston and Matthew O’Sullivan and Sandrine Stepien and Veronica Hoad and Jen Kok and Iain B Gosbell and Guddu Kaur and Joanne Jackson and Thomas L Snelling and Dominic E Dwyer and David O Irving and Kristine Macartney},
  journal = {BMJ Open},
  year = {2026},
  month = sep,
  doi = {10.1136/bmjopen-2026-117510},
  url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117510},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Seroprevalence of Japanese encephalitis virus and other flavivirus-specific antibodies among Australian blood donors following a novel epidemic spread of Japanese encephalitis virus: a cross-sectional study
AU  - Archana Koirala
AU  - Noni Ella Winkler
AU  - Shayal A Prasad
AU  - Rena Hirani
AU  - Jannah Baker
AU  - Linda Hueston
AU  - Matthew O’Sullivan
AU  - Sandrine Stepien
AU  - Veronica Hoad
AU  - Jen Kok
AU  - Iain B Gosbell
AU  - Guddu Kaur
AU  - Joanne Jackson
AU  - Thomas L Snelling
AU  - Dominic E Dwyer
AU  - David O Irving
AU  - Kristine Macartney
PY  - 2026
DA  - 2026/09/30
JO  - BMJ Open
DO  - 10.1136/bmjopen-2026-117510
UR  - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117510
AB  - Objectives: In 2022, Japanese encephalitis virus (JEV) was detected in humans and animals across mainland Australia. We examined the prevalence of JEV and endemic flaviviruses, Murray Valley encephalitis virus (MVEV) and Kunjin virus (KUNV) antibodies in blood donors in different risk geographic areas across southern Australia.  Design: Prospective cross-sectional serosurvey for JEV, MVEV and KUNV-specific antibodies.  Setting: Southern Australia.  Participants: All Australian blood donors who attended nine high-risk (geographical proximity to recent human, animal and/or vector detections of JEV) and three low-risk (no competent JEV vector and no animal or human detections were nearby) donor centres between 8–26 August or 12–17 September 2022 were analysed.  Primary and secondary outcome measures: Seroprevalence estimates of JEV, MVEV and KUNV-specific antibodies were compared between blood donors from collection sites in areas considered high-risk and low-risk for JEV infection. Seroprevalence estimates were adjusted for age and sex after excluding donors born in JEV-endemic countries and those with documented JEV vaccination.  Results: JEV-specific antibody seroprevalence was 1.6% (95% CI 1.3% to 2.0%) from 5257 samples. Odds of JEV seropositivity were greater in high-risk versus low-risk areas (OR 1.8, 95% CI 1.5 to 2.2; absolute risk difference: 0.8 percentage points) and in males versus females (OR 2.1, 95% CI 1.2 to 3.6). In high-risk areas, people ≥70 years had higher seroprevalences than those aged 18–29 (OR 3.1, 95% CI 1.8 to 5.5). MVEV and KUNV-specific antibody seroprevalence were 2.2% (95% CI 1.9% to 2.7%) and 3.7% (95% CI 3.2% to 4.3%), respectively, with higher prevalence in high-risk areas (MVEV OR 2.6, 95% CI 1.6 to 4.3; KUNV OR 2.4, 95% CI 1.9 to 3.0) and older ages.  Conclusions: Blood donors in areas where JEV emerged in the 2021–2022 Australian summer had a 0.8 percentage point higher seroprevalence compared with non-JEV transmission areas, with older male donors most likely to be seropositive. Patterns were similar for endemic flaviviruses. This data informed recommendations for JEV vaccine distribution to high-risk areas and the need for non-pharmaceutical mosquito prevention strategies across Australia, given the highly susceptible population.
SN  - 2044-6055
SN  - 2044-6055
ER  -