Japanese Encephalitis (JE), the disease known to be common in plain areas of the country, which kills hundreds of people every year, is increasing. Moreover, it has also been diagnosed among people living in Kathmandu Valley. Tula Kumari, 65 of Basundhara, Kathmandu is receiving treatment for JE for the last 35 days at TU Teaching Hospital (TUTH). JE is a disease that spreads to humans from infected mosquitoes. It is one of a group of mosquito-borne virus diseases that can affect the central nervous system and cause severe complications and even death. According to Dr Jagadish Agrawal, chief of Neurology Department at the hospital, even people who have never been outside Kathmandu are being diagnosed with JE. "This means JE virus is here in Kathmandu too," said Dr Agrawal. There is no specific treatment for JE. "Vaccination is the best option besides getting protected from mosquito bite," he added. One Ratna Maya Tamang of Lagankhel is also getting treated for encephalitis at the hospital. "But we have not yet received clinical report confirming JE," said Dr Agrawal. "But increasing number of JE cases are being seen within Kathmandu Valley." TUTH has treated about 25 cases of clinically diagnosed JE in the early season of the disease this year, which includes several cases from within the valley. "This is a big number," he said adding, "The government should initiate vaccination. Even if it does not have fund, it should look for donors because the number is increasing." The hospital treated about 50 cases last year. Sukraraj Tropical and Infectious Disease Hospital, Teku has treated 15 lab tested JE cases. June to September is the JE season. Dr Agrawal said that in people who develop a more severe disease, JE usually starts as a flu-like illness with fever, chills, tiredness, headache, nausea, and vomiting. Confusion and agitation can also occur in the early stage. The illness can progress to a serious infection of the brain and can be fatal in 30 percent of the cases. Among the survivors, five to 30 can suffer serous brain damage, including paralysis. Dr Laxmi Bikram Thapa, director of Epidemiology and Disease Control Division said, "Though there is no established reason for prevalence of JE in Kathmandu, global warming, environmental degradation in the valley and rapid flow of traffic from outside of the valley could be some of the reasons." "We are working on launching JE vaccine in Kathmandu." Nepal lost about Rs 13 million sanctioned by Japan through UNICEF for fiscal year 2006/07 to conduct mass vaccination program against JE. This happened because the company from where the government planned to buy vaccine did not have Good Manufacturing Practice (GMP) that must comply with the criteria set by UN. Similarly, in 2006, the government failed to conduct JE vaccination program on time. The vaccination that was supposed to be completed by March had not been completed even in August. Once a person is vaccinated s/he is protected from the disease.