Neuronal cell death in JE may occur directly, from viral cytopathology, and indirectly via immune mediated mechanisms.This may include over activation of microglia cells [52], which release pro-inflammatory cytokines such as interleukin 6 (IL-6), TNF-α, and RANTES (regulated upon activation, normal T cell expressed and secreted), causing massive migration and infiltration of leukocytes into the brain [53]. Here, IL6 is linked to Japanese encephalitis.