The scourge of encephalitis has once again struck parts of Uttar Pradesh and killed or crippled a large number of children. This dance of death has become an annual feature. The public health community views it as a crisis that can be controlled, if the political will to engage in reforms exists. For one thing, the pattern of the epidemic, with Gorakhpur as its nucleus, has been studied well, after a major outbreak more than three decades ago. It is clearly linked to the monsoon rain, which inundates the large number of rice fields in this area, leading to a rapid rise in the density of Culex mosquitoes. The period between July and November then becomes transmission season for encephalitis through mosquito bites. The epidemic is amplified by the presence of large numbers of pigs, which act as hosts. What all this underscores is the need for a State-wide massive prevention campaign that should consist of three parts: distributing insecticide-treated bed nets, free or subsidised, to protect against mosquito bites; creating awareness on the need to keep pigs away from habitations; and persuading people to avoid outdoor movement when the mosquito is most active. Gorakhpur, where more than one child is assigned to the same hospital bed during an epidemic, also needs rapid expansion of its infrastructure.
Prevention is likely to be the more effective approach to curb the spread of encephalitis in India. The Indian Council of Medical Research is yet to confirm the different virus strains causing the annual epidemics. Last year, the ICMR said Japanese Encephalitis represents only about 15 per cent of the fatal cases, and it would take more research to isolate the other viruses. Union Health Minister Ghulam Nabi Azad has reiterated this view. If this is correct, vaccination against Japanese Encephalitis can only be of limited value, even if it is scaled up to cover the entire population. Public health policy should therefore focus on removing the factors that aid transmission. This can only be achieved through massive investments in hygienic housing, sanitation, supply of bed nets, vector control, and behaviour modification. Relocating pigs is a sensitive issue in the encephalitis-hit districts, and calls for measures that inspire confidence in the community. Andhra Pradesh has carried out such a programme successfully and may offer important lessons. Moreover, incentives for hygienic practices are bound to persuade those rearing the animals to do the right thing. What is worrying is that the infection is spreading — to more places in Uttar Pradesh and Bihar. The epidemic needs action on a war footing.
Keywords: encephalitis, epidemic
Comments:
This editorial promotes public awareness regarding an epidemic.Excellent step indeed!
If india is really growing ,it need to be felt by every indian in every corner of country .Govt stand is not clear yet for this endemic disease,which is spreading every year causing huge death of childrens.
GANDHIJI once said that the childrens are going to became master of nation - are we really following gandhian principle if yes why every year such a number of children are found to death.
Diseases of these sorts need to be studied from as many perspectives as possible. When animal biodiversity declines, the parasites will obviously be forced to relocate to newer species, adapt and then attempt to survive. In this case, many species are becoming extinct. And humans are the ones that are thriving. Obviously, in such circumstances the human species would be the natural solace for parasites, in their desperate bid to survive. For preventing such diseases, therefore, it is imperative that biodiversity of animal life is enhanced. It may not be elimination of pigs that should be the most convenient solution, but bringing in more domestic or wild animals that may solve such problems for humans in future.
Fine piece of information and suggestion of a possible solution in this article. Please let me know how i can help. I will be happy to be of any service. And i dearly wish the Union/State health ministry as well as every single person with the power and resources, roll into action, aggresively pursue this adversity and save precious lives. May God be with us all in this effort.
Your efforts to raise awareness is excellent and highly appreciated. Treatment of a preventable disease is always expensive and national wastage.Pevention is the simplest way to disallow the spread of a disease.Both government and public must cooperate each other to educate society for this awareness.Educating the mass how to prevent an ailment and to protect oneself is the 90% elemination of a prevetable disease.
Thank you for the common sense measures suggested here. Eliminating poverty, improving livelihoods, good living conditions, nutrition, clean water, sanitation will go a long way in tackling many diseases that strike the poor. Besides encephalopathy is also a common vaccine adverse event which explains many urban idiopathic cases. As per recent studies, Belladona, a homeopathic drug is found to be effective in many cases of encephalitis. It can also act as a prophylactic.
Its the total failure of governance in UP.Instead of investing so much money on erecting statutes if Mayawati government had spent that much amount of money on awareness programmes and sanitation measures we could have saved hundreds of lives in these areas. Merely sticking posters on the wall and expecting people to do the rest of work is only going to perpetuate the problem. Areas like Gorkahpur and suburbs need a different approach due to their demographic structure. If we analyze the victims of encephalitis in this zone of UP we will find majority of the children belong to rural areas where the level of awareness amongst the people is very low. Therefore the government should penetrate a bit further in these areas. Sprinkling insecticides in stagnated areas, proper drainage system, identifying the areas where constant encephalitis problems have been reported and approaching these areas and giving personal counciling to a group of people can change the condition.
For proper eradication of disease local public awareness is required and health facilities required to increase .
As we envisaged vision 2020 we are left only of eight years. Still we are in curing mode rather than in preventive mode
The number of Indians dying through mosquitoe bite is phenomenal but unfortunately Vector control measures has failed to have a significant impact.It's very clear that without PIG as an intermediary host JE virus can't infect human beings. It is the right time for the Indian government and all the state government to form a strict workable guidelines for Pig farming. Loss of few hundred children life may sound less for a countyr with 1.2 billion population for politicians. But the immense sorrow and grief experienced by the individual family can't be measured in any quantity. Vector control is another key area our country needs to act.But in Warm countries like India we are going to fail miserably only by pesticides as the mosquitoes easily develop resistance. We need to innvent new methods of vector control by research. Until then Government has the responsobility to provide mosquitoe nets and repellant cream atleast for children and ban the pig farms anywhere near human habitation.
The government must have taken steps to prevent the mosquito transmission of JE. Wide distribution of insecticide laden mosquito nets, release of larvae eating fish and active fumigation of the houses and buildings was to be done by the government. But the Health minister was busy in supressing Telangana agitation with the connivance of some powerful Corporates in Andhra. The government must atleast now act to control mosquito population and prevent the cycle of transmiision of JE.
I am surprised that nobody has stressed on the importance of hygiene. And before blaming the government for that(although they are equally at fault), let us ask a question to ourselves: how far do we, the educated citizens of the country, go to keep our surroundings clean? I am shocked when seemingly educated people wearing fancy clothes and driving fancy cars throw garbage on the streets, from their vehicles, urinate and spit in public spaces, and junk trash in water bodies. And one fine day when the cumulative effect of such shameful actions by a class of society that is supposed to set an example, strikes hapless people we decry governments and nations. It is only a matter of time before more epidemic diseases strike due to unhygienic conditions that prevail in the country.
Japanese Encephalitis, deadly mosquito borne disease has been a cause of concern for the health ministry. Earlier, the JE fatal attack was generally reported from Gorakhpur, Uttar Pradesh claiming the lives of thousands of children every year. This year JE spread its wing in Bihar and now reached Delhi posing much threat to the children.
Even though, in Bihar many children died of JE, the so called susasan (good governance) government has done nothing to combat with the deadly disease and condition is equally bad in national capital New Delhi.
It is right time the center and states governments realized their responsibilities and work in tandem to eradicate the fatal disease from its root and save the innocent lives, before the JE breaks out across the country.
The writer has rightly focused on the preventive measures to curb the menace of Encephalitis in India. The approach in this regard should be multi-pronged with the involvement of stakeholders from macro as well as micro level and effective intersectoral coordination. The grass root NGOs could play a very crucial role in Encephalitis control as the dynamics of Encephalitis is governed by local factors like breeding places for mosquitoes, rearing of pigs, sleeping habits of the local community etc. This makes involvement of the community perhaps the most important factor in Encephalitis control. Presence of NGOs at the grassroots level means that NGO workers can work in tandem with the community and find local solutions for management of Encephalitis in the area.This effort of working regularly and closely with the community coupled with the technical support of the Encephalitis Control Program can make a significant dent in the Encephalitis burden.