Dear Arnaud and Al.
Firstly, congratulations for this preliminary and necessary review of literature concerning a major public health concern in SEA region. I would like to provide few comments in 6 bullet points:
1. Myanmar is definitely part of the Mekong Sub-region, including at the political level (Mekong River Sub-region at ASEAN, MBDS for disease surveillance). Due to the size (surface and population) of this country, and due to its expected very fast development in all sectors, including agricuture and transport, its impact on the change of epidemiological patterns of communicable diseases is to be taken into consideration, including for JEV and other encephalitis,
2. Quality of primary health care: this is how to improve surveillance, case management and disease control. I believe it is the right level of analysis and action (district/commune),
3. Animal health wise: it is not just JEV vaccination, but also pig raising methods and integration with rice culture,
4. Grey literature from the numerous regional meeting tackling JEV (for instance the last WPRO meeting on vaccination, held in Manila in 2013) should be included in this kind of assessment,
5. Change in demographics and in economic trends as well as in agriculture and urban settings’ relations will lead to a change in the epidemiological setting of JEV, with a probable shift to occasional urban outbreaks,
6. The only way of improvement is a more global approach estimating how to put together as a unique strategy of control: human and animal, vaccine and case management, agriculture sector and public health. Global health are not just words, but definitely the right vision that encompasses all aspects of health as a component of sustainable development for all.

Again, thank you very much for this great job at IPC!.

JJ Bernatas