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Public Health Laboratory Surveillance and Diagnosis of Japanese Encephalitis: Time to Revisit. OBJECTIVE: We assessed detection of recent Japanese encephalitis virus infection using recommended strategy. METHODS: Cross-sectional community-based study conducted in 12 villages in Kushinagar, Uttar-Pradesh, India in 2012-13. Recent infection with Japanese encephalitis virus in 239 healthy children aged 1-15 year was detected using a combination of serology and molecular methods. RESULTS: 24 (10%) children showed recent infection; 2 by serology and 22 by molecular method. Symptomatic cases were estimated as 626 in Kushinagar against reported 139 in all age groups across the state. CONCLUSIONS: Lower positivity using recommended serology suggests major gap in existing surveillance and diagnostic protocols and estimation of burden of Japanese encephalitis.