# An Overview of Japanese Encephalitis in Australia: Trends, Impact and Interventions
## 5 Future Implications and Concluding Remarks
Despite the restrictive eligibility criteria, Australian residents are currently able to access these vaccinations not only at hospitals or their local councils, but also from community pharmacists who have been provided online training via the JE eLearning module, a government education initiative aimed at expanding the health workforce to assist in vaccine rollout programmes [34]. To ultimately eliminate JE in humans, research that focuses on protection and treatment is required. While significant efforts have been focused on developing the JE vaccine as the primary approach for protection, there are currently no treatments for JE [38] primarily due to poor understanding of the virus per se and its precise infection mechanism. Pathogenesis of viral infections of the CNS is poorly understood and there is a paucity of evidence as to how JE infects the CNS and causes subsequent neural damage. Understanding the detailed mechanisms by which JE invades and damages the CNS specifically will ultimately aid the development of effective treatment strategies. In light of the increasing public health threat of JE around the world, emerging evidence has increased our understanding of the modes of JEV infection and the delivery of the virus to various organs [28; 62] as well as new insights into the development of novel JE models for research [63]. Using human-derived stem cells, brain organoids are being developed and used as an experimental model to study viral infections, such as JEV and the Zika virus [63]. Such pre-clinical research could shed light on new therapeutic developments targeting JEV-induced CNS infections, hence preventing or ameliorating neurological and psychiatric sequelae and their long-term functional consequences. The global spread of JEV infection is still not under control. Alarmingly, while JE remains most prevalent in Asia, there is a clear trend towards global expansion, including throughout Australia [2; 12; 38], Europe [64; 65], America [66] and Africa [44], as evidenced by increasing case numbers. This raises a public health alert and has implications for future surveillance. JE affects not only individuals but also families and communities. Nanotechnology-based vector control systems are the focus of current research efforts to intervene in the different stages of the life cycles of mosquito vectors. The use of nanotechnology to generate repellents and formulations that target the larvae stage are deemed to be less toxic to other wildlife due to increased water solubility. Nevertheless, they are deemed to be more efficacious with wider coverage and sustained release of the pesticide or mosquito repellent [12; 52]. Nanotechnology has also enabled the development of biometallic nano-sensors that can rapidly detect mosquito-borne diseases [12]. The use of nanotechnology brings new hope to the prevention and treatment of JE, and this research area has progressed extensively in 2022 [12]. Following the recent advancement in the understanding of JEV replication and immune evasion mechanisms, chemotherapeutic targets are emerging, representing a new therapeutic strategy that could directly and effectively combat viral infection [67]. In conclusion, the recent JE outbreak in Australia demonstrates the need for a large collaborative research effort to improve our understanding of the epidemiology and pathogenesis regarding JEV infection, surveillance, diagnosis and treatment to ultimately eliminate JE globally. Furthermore, new and improved environmental, agricultural, animal husbandry and health practices and interventions must be considered holistically to form a unified disease control strategy that will effectively minimise viral transmission and curb the growth of present JE viral endemics into an epidemic and beyond [19]. Adopting a One Health approach that recognises the important role of viral reservoirs and environmental hazards in disease spread is essential for reducing JEV-related morbidity and mortality. Conceptualization, F.A.A.K., E.K. and J.X. ; Investigation, F.A.A.K., E.K. and J.X.