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I am starting a new thread with this ProMed post. Several other related articles have already been posted in the Acute Encephalitis Syndrome (AES) thread, which is not correct. Perhaps some of those posts should be moved here. AES was caused by an enterovirus during 2008 and was NOT Japanese encephalitis. Also, note that neither virus has anything to do with the country of Japan.
JAPANESE ENCEPHALITIS - INDIA (02): (UTTAR PRADESH, NAGALAND, ASSAM)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] Uttar Pradesh
[2] Nagaland
[3] Nagaland, Upper Assam
******
[1] Uttar Pradesh
Date: Mon 17 Aug 2009
Source: Indian Express [edited]
<http://www.indianexpress.com/news/what-about-encephalitis-up-doctor-writes-in-blood-to-rahul/502895/>
More than 200 cases and 40 deaths have taken place in eastern UP
[Uttar Pradesh state] in the past one month due to encephalitis, the
disease which has a mortality rate between 30 to 40 percent. In the
same period, only 20 cases of mild flu have been reported. According
to Dr K P Kushwaha of the BRD Medical College, 8-10 patients are
being admitted daily at BDR Medical College. However, while all
government attention is focused on swine flu [influenza (H1N1) 2009],
few seem to be bothered about encephalitis. For swine flu, all
hospitals have been put on alert, whereas there is no such alert for
encephalitis. Tests for detection of swine flu, each of which is 3
times costlier, are being done daily, while encephalitis-detection
tests are being conducted at a maximum of thrice a week.
"The reason is simple: swine flu is an imported disease where the
victims are either people who have returned from abroad or belong to
the middle class. Encephalitis is affecting children of poor people
in eastern UP. We have to find ways to draw attention towards
encephalitis deaths and cases," said Dr R N Singh, who heads
Encephalitis Eradication Movement, a private initiative.
[Byline: Maulshree-Seth]
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[These encephalitis cases are likely due to Japanese encephalitis
virus (JEV) infections. The state of Uttar Pradesh (UP) is endemic
for JEV. A report of 9 May 2009 (see ProMED archive number
20090513.1789) indicated that there were 38 fatalities and 170
hospitalized encephalitis cases suspected JEV infections in UP. This
current report above indicates that the hospital receiving the
patients is doing laboratory tests, but does not indicate if the
tests are confirming JEV as the etiological agent involved. ProMED
would appreciate receiving additional information. It would also be
of interest to know if the national JEV vaccination program has been
operating in this area this year.
A map showing the location of Indian states including Uttar Pradesh
in northeastern India can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/india_pol01.jpg>
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed/en?v=22.9,79.6,5>
- Mod.TY]
******
[2] Nagaland
Date: Mon 17 Aug 2009
Source: New Kerala.com [edited]
<http://www.newkerala.com/nkfullnews-1-93740.html>
Japanese encephalitis, a communicable [mosquito transmissible, not
transmissible from person-to-person - Mod.TY] disease, has entered
Nagaland and so far 4 cases have been detected throughout the state.
State Nodal Officer Dr Kevichusa Medikhru here today said samples of
5 patients were sent for testing, out of which 4 were confirmed to be
suffering from Japanese encephalitis. The patients were from Dimapur
and Tuli area of Mokokchung district. The cases were referred to the
National Vector Borne Control Programme (NVBCP) officials to initiate
necessary follow up action.
Japanese encephalitis [virus] is endemic to the state along the
foothill areas. However, no report of such cases have so far been
received from other districts of the state.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
******
[3] Nagaland, Upper Assam
Date: Sat 8 Aug 2009
Source: Eastern Mirror [edited]
<http://www.easternmirrornagaland.com/index.php?option=com_content&view=article&id=13640 :japanese-encephalitis-emerging-threat-to-states-health-&catid=61:top-news>
While the spreading H1NI virus (swine Flu) has been creating jitters
within the state medical department and the local populace, another
viral disease -- Japanese encephalitis [JE], also transmitted through
mosquitoes via pigs [and wild birds. - Mod.TY] -- is posing a more
immediate threat with 5 confirmed cases of mortality within 2 months.
The impact of this viral disease here in the state cannot be fully
gauged at the moment because no survey has been conducted yet.
The common symptoms of JE [virus infections] are headache, stupor,
fever, disorientation, coma and paralysis -- loss of co-ordination.
There is no specific treatment or cure for JE. However, supportive
treatment and good nursing care can significantly reduce case
fatality rate. It is, therefore, important that encephalitis cases
should be referred to a hospital as early as possible, doctors insisted.
The Japanese encephalitis virus has a complex life cycle involving
domestic pigs and a specific type of mosquito, _Culex
tritaeniorhynchus_ [and other closely related _Culex_ species -
Mod.TY], that lives in rice-growing and pig-farming regions. The
animal hosts mainly include pigs and amongst birds are the water
birds, poultry birds and ducks. Pigs are the major vertebrate hosts
and are considered as amplifying hosts. Infection in man appears to
be correlated with living in close proximity with animal reservoirs,
especially pigs. The virus in an infected person invades the central
nervous system, including the brain and spinal cord, causing brain
damage, including paralysis and also death.
Zion Hospital has reported clinically confirmed death of 5 patients
from around 17 suspected cases. Most of the cases reported till now
are from various areas in Dimapur including Purana Bazar, Thlixu
village, Diphupar, Notun Basti, Supply Colony and Ao Kashiram. One
isolated case from Tenning under Peren district and around 2 from
Tuli have been reported so far.
In slight contrast, Dr Neiketou Angami, Joint Director NVBDCP
informed that 11 cases have been reported. Among the 11 reported
cases, 4 out of 5 samples sent to National Centre for Infectious
Disease (NCID) for blood test have been confirmed positive. And 2 of
the patients who tested positive, have reportedly succumbed. The
joint director informed that 3 more blood samples, 2 from Referral
hospital and another from Dimapur Hospital have been sent to NCID for
blood test. With no proper testing facilities in the state, about one
week is wasted in sending the samples to Delhi for testing and
confirming the results.
Efforts are being made to identify the outbreak areas of the disease
so that fogging and impregnation of bed-nets would be carried out
along with sensitization, Dr Imcha, DMO, Malaria department informed.
Meanwhile, outbreak of JE from Tuli in Mokokchung district has been
reported, with one confirmed death and 2 other positive cases. 2
places namely Teyong Mopu at Tzudikong and Longpong ward, Tuli have
also been identified for protection measures. Residents of Tuli and
Tzudikong town also expressed suspicion that 3 patients, whose deaths
were suspected to have been caused by malaria, might actually have
been infected with JE.
The state malaria department has alerted all district malaria
officers with regard to JE and has been in the process of going about
with control measures like fogging, distributing insecticide treated
bed-nets, introducing Larvivorous fish in water bodies and
sensitizing the citizens on the disease.
It may be mentioned that in 2007, 11 cases of JE were reported with
one death. During 1985-86, the 1st reported outbreak of JE in
Nagaland, 50 cases were confirmed with 60 percent mortality (30
deaths), according to reports.
Japanese Encephalitis (JE) poses a serious threat in Nagaland,
particularly with unmonitored rearing of pigs in residential areas.
And with the late onset of monsoon this year, it would only mean more
density of mosquitoes and so chances of more cases of JE disease.
Even in developed towns like Dimapur, pigsties can be found in
backyards of many homes, in close proximity to living quarters of
people. Dr Imcha, while stressing that pigs should normally be reared
5 kilometers away from human inhabitation, said enforcement of such
laws has been found practically impossible in Nagaland. Added to
that, the town and municipal councils are yet to wake up from their
slumber, to monitor rearing of pigs in residential areas.
Most doctors, when asked about the magnitude of threat posed by JE,
expressed concern over possibility of many undetected cases,
particularly with pig-rearing being a common practice among Nagas.
The only option to battle the spread of the fatal infection, Dr.
Imcha says, would be to adopt preventive measures as directed by the
malaria department. And though, National Vector Borne Disease Control
Programme, Nagaland under malaria department has been making efforts
to take preventive measures, awareness of the viral disease is found
to be still lacking among the citizens, with many confusing it for
malaria or typhoid.
Officially, 34 people have died of encephalitis in Upper Assam in
July [2009], according to newspaper reports, while the unofficial
number has been pegged beyond 50. More than 100 people are now
battling the disease in hospitals across Upper Assam.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[These JE reports indicate the need for a well organized and
integrated prevention, control and treatment approach to JE in areas
where the virus is endemic. Sentinel pig and _Culex_ mosquito
monitoring would provide an indication of the time and places where
transmission is becoming active. This requires rapid laboratory
support. Ongoing public education reduce mosquito breeding and avoid
mosquito bites would reduce human cases. Public education is also
important for timely visits to health centers and hospitals to
improve early provision of treatment of JE virus infected patients
and reduce case fatality rates. India has an active JE virus
vaccination program, and it would be of interest to know its extent
in Nagaland and Upper Assam. All of these measures require
considerable financial support, and would compete with other
important public health programs.
General information on Japanese encephalitis can be accessed at
<http://www.who.int/water_sanitation_health/diseases/encephalitis/en/> and
<http://www.cdc.gov/ncidod/dvbid/jencephalitis/qa.htm> - Mod.TY]
[The interactive HealthMap/ProMED map for India is available at:
<http://healthmap.org/r/008o> - CopyEd.EJP]
[see also:
Japanese encephalitis - India (UP): susp, RFI 20090513.1789
2008
---
Japanese encephalitis - India (08): (UP) 20081115.3609
Japanese encephalitis - India (07): (UP) 20081110.3542
Japanese encephalitis - India (06): (WB, UP) 20081017.3295
Japanese encephalitis - India (05): (UP) RFI 20081014.3260
Japanese encephalitis - India (04): (UP, AS) 20080923.3011
Japanese encephalitis - India (03): (UP), RFI 20080923.2998
Japanese encephalitis - India (02): (UP) 20080918.2924
Japanese encephalitis - India: (UP) 20080731.2345]
....................ty/ejp/mpp
JAPANESE ENCEPHALITIS - INDIA (02): (UTTAR PRADESH, NAGALAND, ASSAM)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] Uttar Pradesh
[2] Nagaland
[3] Nagaland, Upper Assam
******
[1] Uttar Pradesh
Date: Mon 17 Aug 2009
Source: Indian Express [edited]
<http://www.indianexpress.com/news/what-about-encephalitis-up-doctor-writes-in-blood-to-rahul/502895/>
More than 200 cases and 40 deaths have taken place in eastern UP
[Uttar Pradesh state] in the past one month due to encephalitis, the
disease which has a mortality rate between 30 to 40 percent. In the
same period, only 20 cases of mild flu have been reported. According
to Dr K P Kushwaha of the BRD Medical College, 8-10 patients are
being admitted daily at BDR Medical College. However, while all
government attention is focused on swine flu [influenza (H1N1) 2009],
few seem to be bothered about encephalitis. For swine flu, all
hospitals have been put on alert, whereas there is no such alert for
encephalitis. Tests for detection of swine flu, each of which is 3
times costlier, are being done daily, while encephalitis-detection
tests are being conducted at a maximum of thrice a week.
"The reason is simple: swine flu is an imported disease where the
victims are either people who have returned from abroad or belong to
the middle class. Encephalitis is affecting children of poor people
in eastern UP. We have to find ways to draw attention towards
encephalitis deaths and cases," said Dr R N Singh, who heads
Encephalitis Eradication Movement, a private initiative.
[Byline: Maulshree-Seth]
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[These encephalitis cases are likely due to Japanese encephalitis
virus (JEV) infections. The state of Uttar Pradesh (UP) is endemic
for JEV. A report of 9 May 2009 (see ProMED archive number
20090513.1789) indicated that there were 38 fatalities and 170
hospitalized encephalitis cases suspected JEV infections in UP. This
current report above indicates that the hospital receiving the
patients is doing laboratory tests, but does not indicate if the
tests are confirming JEV as the etiological agent involved. ProMED
would appreciate receiving additional information. It would also be
of interest to know if the national JEV vaccination program has been
operating in this area this year.
A map showing the location of Indian states including Uttar Pradesh
in northeastern India can be accessed at
<http://www.lib.utexas.edu/maps/middle_east_and_asia/india_pol01.jpg>
A HealthMap/ProMED-mail interactive map of India can be accessed at
<http://healthmap.org/promed/en?v=22.9,79.6,5>
- Mod.TY]
******
[2] Nagaland
Date: Mon 17 Aug 2009
Source: New Kerala.com [edited]
<http://www.newkerala.com/nkfullnews-1-93740.html>
Japanese encephalitis, a communicable [mosquito transmissible, not
transmissible from person-to-person - Mod.TY] disease, has entered
Nagaland and so far 4 cases have been detected throughout the state.
State Nodal Officer Dr Kevichusa Medikhru here today said samples of
5 patients were sent for testing, out of which 4 were confirmed to be
suffering from Japanese encephalitis. The patients were from Dimapur
and Tuli area of Mokokchung district. The cases were referred to the
National Vector Borne Control Programme (NVBCP) officials to initiate
necessary follow up action.
Japanese encephalitis [virus] is endemic to the state along the
foothill areas. However, no report of such cases have so far been
received from other districts of the state.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
******
[3] Nagaland, Upper Assam
Date: Sat 8 Aug 2009
Source: Eastern Mirror [edited]
<http://www.easternmirrornagaland.com/index.php?option=com_content&view=article&id=13640 :japanese-encephalitis-emerging-threat-to-states-health-&catid=61:top-news>
While the spreading H1NI virus (swine Flu) has been creating jitters
within the state medical department and the local populace, another
viral disease -- Japanese encephalitis [JE], also transmitted through
mosquitoes via pigs [and wild birds. - Mod.TY] -- is posing a more
immediate threat with 5 confirmed cases of mortality within 2 months.
The impact of this viral disease here in the state cannot be fully
gauged at the moment because no survey has been conducted yet.
The common symptoms of JE [virus infections] are headache, stupor,
fever, disorientation, coma and paralysis -- loss of co-ordination.
There is no specific treatment or cure for JE. However, supportive
treatment and good nursing care can significantly reduce case
fatality rate. It is, therefore, important that encephalitis cases
should be referred to a hospital as early as possible, doctors insisted.
The Japanese encephalitis virus has a complex life cycle involving
domestic pigs and a specific type of mosquito, _Culex
tritaeniorhynchus_ [and other closely related _Culex_ species -
Mod.TY], that lives in rice-growing and pig-farming regions. The
animal hosts mainly include pigs and amongst birds are the water
birds, poultry birds and ducks. Pigs are the major vertebrate hosts
and are considered as amplifying hosts. Infection in man appears to
be correlated with living in close proximity with animal reservoirs,
especially pigs. The virus in an infected person invades the central
nervous system, including the brain and spinal cord, causing brain
damage, including paralysis and also death.
Zion Hospital has reported clinically confirmed death of 5 patients
from around 17 suspected cases. Most of the cases reported till now
are from various areas in Dimapur including Purana Bazar, Thlixu
village, Diphupar, Notun Basti, Supply Colony and Ao Kashiram. One
isolated case from Tenning under Peren district and around 2 from
Tuli have been reported so far.
In slight contrast, Dr Neiketou Angami, Joint Director NVBDCP
informed that 11 cases have been reported. Among the 11 reported
cases, 4 out of 5 samples sent to National Centre for Infectious
Disease (NCID) for blood test have been confirmed positive. And 2 of
the patients who tested positive, have reportedly succumbed. The
joint director informed that 3 more blood samples, 2 from Referral
hospital and another from Dimapur Hospital have been sent to NCID for
blood test. With no proper testing facilities in the state, about one
week is wasted in sending the samples to Delhi for testing and
confirming the results.
Efforts are being made to identify the outbreak areas of the disease
so that fogging and impregnation of bed-nets would be carried out
along with sensitization, Dr Imcha, DMO, Malaria department informed.
Meanwhile, outbreak of JE from Tuli in Mokokchung district has been
reported, with one confirmed death and 2 other positive cases. 2
places namely Teyong Mopu at Tzudikong and Longpong ward, Tuli have
also been identified for protection measures. Residents of Tuli and
Tzudikong town also expressed suspicion that 3 patients, whose deaths
were suspected to have been caused by malaria, might actually have
been infected with JE.
The state malaria department has alerted all district malaria
officers with regard to JE and has been in the process of going about
with control measures like fogging, distributing insecticide treated
bed-nets, introducing Larvivorous fish in water bodies and
sensitizing the citizens on the disease.
It may be mentioned that in 2007, 11 cases of JE were reported with
one death. During 1985-86, the 1st reported outbreak of JE in
Nagaland, 50 cases were confirmed with 60 percent mortality (30
deaths), according to reports.
Japanese Encephalitis (JE) poses a serious threat in Nagaland,
particularly with unmonitored rearing of pigs in residential areas.
And with the late onset of monsoon this year, it would only mean more
density of mosquitoes and so chances of more cases of JE disease.
Even in developed towns like Dimapur, pigsties can be found in
backyards of many homes, in close proximity to living quarters of
people. Dr Imcha, while stressing that pigs should normally be reared
5 kilometers away from human inhabitation, said enforcement of such
laws has been found practically impossible in Nagaland. Added to
that, the town and municipal councils are yet to wake up from their
slumber, to monitor rearing of pigs in residential areas.
Most doctors, when asked about the magnitude of threat posed by JE,
expressed concern over possibility of many undetected cases,
particularly with pig-rearing being a common practice among Nagas.
The only option to battle the spread of the fatal infection, Dr.
Imcha says, would be to adopt preventive measures as directed by the
malaria department. And though, National Vector Borne Disease Control
Programme, Nagaland under malaria department has been making efforts
to take preventive measures, awareness of the viral disease is found
to be still lacking among the citizens, with many confusing it for
malaria or typhoid.
Officially, 34 people have died of encephalitis in Upper Assam in
July [2009], according to newspaper reports, while the unofficial
number has been pegged beyond 50. More than 100 people are now
battling the disease in hospitals across Upper Assam.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[These JE reports indicate the need for a well organized and
integrated prevention, control and treatment approach to JE in areas
where the virus is endemic. Sentinel pig and _Culex_ mosquito
monitoring would provide an indication of the time and places where
transmission is becoming active. This requires rapid laboratory
support. Ongoing public education reduce mosquito breeding and avoid
mosquito bites would reduce human cases. Public education is also
important for timely visits to health centers and hospitals to
improve early provision of treatment of JE virus infected patients
and reduce case fatality rates. India has an active JE virus
vaccination program, and it would be of interest to know its extent
in Nagaland and Upper Assam. All of these measures require
considerable financial support, and would compete with other
important public health programs.
General information on Japanese encephalitis can be accessed at
<http://www.who.int/water_sanitation_health/diseases/encephalitis/en/> and
<http://www.cdc.gov/ncidod/dvbid/jencephalitis/qa.htm> - Mod.TY]
[The interactive HealthMap/ProMED map for India is available at:
<http://healthmap.org/r/008o> - CopyEd.EJP]
[see also:
Japanese encephalitis - India (UP): susp, RFI 20090513.1789
2008
---
Japanese encephalitis - India (08): (UP) 20081115.3609
Japanese encephalitis - India (07): (UP) 20081110.3542
Japanese encephalitis - India (06): (WB, UP) 20081017.3295
Japanese encephalitis - India (05): (UP) RFI 20081014.3260
Japanese encephalitis - India (04): (UP, AS) 20080923.3011
Japanese encephalitis - India (03): (UP), RFI 20080923.2998
Japanese encephalitis - India (02): (UP) 20080918.2924
Japanese encephalitis - India: (UP) 20080731.2345]
....................ty/ejp/mpp
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