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Published Date: 2012-06-06 15:32:26
Subject: PRO/AH/EDR> Japanese encephalitis & other - India (02): (UP)
Archive Number: 20120606.1158514

JAPANESE ENCEPHALITIS AND OTHER - INDIA (02): (UTTAR PRADESH)
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Date: Wed 6 Jun 2012
Source: The Indian Express [edited]
http://www.indianexpress.com/news/encephalitis-peak-season-in-up-a-month-away-80-already-dead/958301/

Even before the peak season of encephalitis, acute encephalitis syndrome [AES] has already claimed 80 lives in Uttar Pradesh.

In spite of infrastructural support, including new ventilators and wards for encephalitis patients in BRD Medical College, Gorakhpur, as well as awareness campaigns in the area, the number of cases and deaths are constantly increasing in the eastern part of the state.

The peak season of encephalitis is considered to be between July-September, when maximum number of cases are reported. As per the state government figures, till 2 Jun [2012], a total of 334 cases of AES have been reported across the state and 80 patients have died. But none of these have been confirmed as Japanese encephalitis [virus infection] cases.

Till June 2011, 346 cases of AES, including 3 of Japanese encephalitis [JE], were reported. The number of deaths was 60. By the end of 2011, however, around 3500 AES cases were reported, with over 550 deaths.

Last year [2011], Union health minister Ghulam Nabi Azad visited Gorakhpur and promised infrastructural support to BRD Medical College; 4 ventilators were sanctioned by the centre under the NRHM [National Rural Health Mission]. Former chief minister Mayawati had announced a 100-bed special ward for encephalitis patients at the college. Campaigns were undertaken to create awareness about hygiene, safe drinking water, and prevention of encephalitis.

"Cases are slightly more than last year [2011]. Deaths have also increased," said Dr Ramji Lal, director general, Medical and Health. He said since AES is a waterborne disease, the only prevention is providing safe drinking water. "We have moved a proposal to arrange for clean drinking water in AES-affected areas. We have trained officials in these areas to create awareness about safe drinking water and rushing AES patients to nearest CHC-PHC [community health centres-primary health centres] at the earliest," said Lal, adding that if the measures being taken now are successful, AES cases may be controlled during the peak season.

The number of cases of JE, on the other hand, are under control, for which experts credit a special vaccination drive in 2010.

"The response of the vaccine is up to 80 per cent and if the routine immunisation for JE is continued, it can be well controlled this year [2012]," said Dr MM Gore, in charge of the Gorakhpur unit of National Institute of Virology. [If the live attenuated virus vaccine were used, immunity might persist for several years. If the inactive vaccine were used, revaccination campaigns would be necessary to provide good herd immunity. - Mod.TY]

[byline: Surbhi Khayati]

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[It will be of interest to see if the JE virus vaccination campaign is, indeed, continued as the transmission season gets under way. If the live attenuated virus vaccine were used, immunity might persist for several years. If the inactive vaccine were used, revaccination campaigns would be necessary to provide good herd immunity. As indicated in previous reports last year (2011), JE virus infections are responsible for a minority of AES cases. There is still no virological diagnosis provided for the other etiological agents responsible for AES. Because cases are associated with contaminated water, presumably enteroviruses are involved. Providing clean drinking water, as proposed, should be very helpful for prevention of additional cases. Prevention through provision of potable water and public education are undoubtedly considerably more cost-effective than providing hospital care for severely ill, infected patients.

A HealthMap/ProMED-mail interactive map showing the location of Uttar Pradesh state can be accessed at http://healthmap.org/r/1-k3. - Mod.TY]

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