JE comes under umbrella term AES (Acute encephalitis Syndrome). Gorakhpur is a low-lying to flat area, which leads to problems of water logging and flooding during high-rainfall months of June to August. "This stagnant water becomes breeding sites for mosquitoes, increasing the risk of JE. Sewage also continues to be mismanaged and open defecation is common in the area. Mixing of sewage with standing water also contaminates the groundwater and shallow drinking water sources leading to the spread of AES in the area.

Poverty, poor hygiene, and poor nutrition increase the vulnerability to encephalitis pathogens. And when people get sick, they can only afford public health facilities, most of which can neither diagnose nor treat the disease as quickly as it is needed.

Most importantly, climate has not been a research topic for JE till date, but would be interesting if we could find the association.

Japanese Encephalitis (JE) is characterized by the inflammation of the brain and high fever. There is no medical treatment for the disease, and as with other viruses, patients are treated for the symptoms they develop. Fatality rates for severe infections hover between 20% and 30%, according to the World Health Organization (WHO). (Source: http://indiaclimatedialogue.net)

Changing temperature and rainfall patterns may affect the development and infection capacity of mosquitoes and virus that causes JE. However, the relative humidity is an important parameter which creates the suitable environment for the survival of mosquitoes and the JE transmission.

Also, the aftermath of floods provides suitable time for the mosquitoes breeding which makes situation worst.

Japanese encephalitis(JE) in Gorakhpur has been occurring since last many years .The main cause of this disease is mosquitoes biting which are main vector to spread the JE viruse especially in children. The topography of eastern Uttar Pradesh may also be a major factor causing the spread of this disease, JE is closely associated with the pattern of precipitation, and flooding in Gorakhpur. Symptoms usually take 5-15 days to develop and include fever, headache, vomiting, confusion, and difficulty moving. Symptoms that develop later include swelling around the brain and coma. JE is a serious disease that may cause death.

Japanese encephalitis (JE) is the most common form of sporadic and epidemic encephalitis, a vector-borne viral disease, is a disease of major public health importance due to its high epidemic potential, high case fatality rate (CFR) and Neuropsychiatric Sequelae among survivors is endemic to large parts of Asia and the Pacific. However, transmission of JE is likely to increase in South-East Asian countries because of population growth, intensified rice farming, pig rearing, and the lack of vaccination programs and surveillance. Illiteracy, low socio-economic status and living in unhygienic conditions near rice fields contributed to the high incidence of J.E. Residents in endemic areas should take personal protection to reduce the number of mosquito bites. The peak incidence of J.E. is seen from October to December which is the post monsoon period.

Gorakhpur is considered as the initial spot of Japanese encephalitis since 1978 in Uttar Pradesh. Actually, Gorakhpur is a bowl-shaped city with high groundwater tables. The gradient of the city is low to flat which leads to problem of water logging and flooding. This creates abundant tenancy for JE vectors to thrive in urban areas. This district is located in mid-gangetic planes between the river Rapti and Rohin basins. One of the most important causative factors for JE is cultivation and management of paddy under the agricultural land. JE vectors thrive easily in irrigated paddy fields. Primary carriers of the JE virus are pig and pond heron. The neighboring districts of Gorakhpur like Siddharthnagar, Kushinagar, and Maharajganj make JE more vulnerable. The prevalence rate of JE is higher in these districts compared to the rest of the state. The temperatures in Gorakhpur range from 8.9⁰C and 38.0⁰C which favors JE. The district receives rainfall between June and August with an average of 52.2 days in a year. The most appropriate condition for increase in mosquito density is favored at 28⁰C temperature with 50-55% relative humidity.

The breeding of mosquitoes are flattered at Gorakhpur due to hot and humid weather. Presently the emerging research suggests that JE virus may not necessarily be constrained to rural environments in contrast to urban areas.