उत्तर प्रदेश India - Uttar Pradesh, Acute Encephalitis Syndrome (AES)/JE cases rise- 567 dead

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Source: http://www.expressindia.com/latest-n...s-year/457807/

AES cases rise, but no enterovirus this year

Maulshree-Seth
Posted: May 12, 2009 at 0154 hrs IST

Lucknow A nearly 40 per cent increase in Acute Encephalitis Syndrome (AES) cases this year ? and none of them belonging to enterovirus category ? has brought back the question mark on the virus affecting children in eastern UP.

So far this year, 190 AES cases have been reported in eastern UP, mainly in Gorakhpur and Kushinagar, forcing the health authorities to begin a fresh investigation.

For the last two years, even as the number of Japanese Encephalitis cases dwindled, health experts were unable to identify the virus causing brain fever in thousands of children in the Gorakhpur region. Finally last year, experts from the National Institute of Virology, Pune, identified the virus as one belonging to the enterovirus group. Even though the symptoms are the same, unlike encephalitis, this virus is transmitted from person to person by the faecal-oral route and not through mosquitoes.

Thereafter, the authorities undertook measures to provide clean drinking water instead of targeting mosquitoes.
this year, of the 52 samples the NIV field laboratory in Gorakhpur had collected, not a single was of enterovirus, taking the wind out of the sails of the enterovirus theory. The doctors are back to square one, with the affected children only being provided symptomatic treatment. ?It is true that the number of AES cases has increased this year, but one can also attribute it to our better surveillance,? said Dr VS Nigam, the state Joint Director, Communicable Diseases. Asked if the virus was a new strain, Nigam said: ?It is true that NIV?s breakthrough last year holds no significance now. Thus, the identity of the virus causing AES this year remains a mystery, but experts have begun fresh investigations.?

?The mortality rate this year is around 20 per cent and in our hospital, nearly 35 deaths were reported in the first quarter of the year,? said Dr KP Kushwaha from the Paediatric Department of BRD Medical College, Gorakhpur. He said of the cases reported at the hospital, not a single JE case has been found till date.

The state government, meanwhile, is all set to begin the immunisation drive for Japanese Encephalitis in seven new districts from May 20. Nearly 93.57 lakh children would be immunised in the new districts ? Allahabad, Pratapgarh, Fatehpur, Ghazipur, Jaunpur, Kanpur and Shahjahanpur. The JE vaccine is given once in a lifetime to the children in the age group of 1 to 15 years. The vaccine has already been given to children in 27 districts.

Ayodhya protects itself from swine flu
FAIZABAD: The health department has geared up to protect the temple town of Ayodhya from swine flu, which can transmit through the foreignersvisiting the city. The department has issued notices to all hotels and rest houses to inform it immediately if any foreigner checks in. At the Indo- Nepal border, which covers five districts of eastern UP, teams of doctors have been deployed atimmigration points of Sonauli in Maharajganj , Barhni in Sidhartnagar and Rupaidiha in Bahraich, said Dr RN Mishra, chief medical officer of Gorakhpur. The government is monitoring tourist spots including Varanasi and Ayodhya, frequented by foreigners. ? ENS

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise

Source: http://www.ptinews.com/news/229011_J...s-in-Gorakhpur

* Japanese Encephalitis claims four lives in Gorakhpur


STAFF WRITER 10:15 HRS IST

Gorakhpur (UP), Aug 14 (PTI) Four children have died due to Japanese Encephalitis here, taking the toll in the viral infection in the district since January to 152, health officials said today.

Seventeen more children suffering from the disease were admitted to the BRD Medical College Hospital here yesterday, Additional Director (Health) L P Rawat said.

The four deaths were reported in the last two days.

The deadly Japanese Encephalitis fever is caused by a virus found in pigs and wild and transferred to humans by mosquito bite. It affects the brain and causes high fever and respiratory distress.

Japanese Encephalitis claims many lives in Uttar Pradesh each yea

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise

Here is the link to the two Peer Revies

http://www.flutrackers.com/forum/showthread.php?t=121021&highlight=Ibuprofen

Snowy

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise

Source: http://news.bbc.co.uk/2/hi/south_asia/8206074.stm


Encephalitis toll approaches 130
By Ram Dutt Triphati
BBC News, Lucknow

A file photo of a encephalitis patient in Gorakhpur, Uttar Pradesh
Children are particularly vulnerable to the disease

Nearly 130 people are known to have died from Japanese encephalitis this year in eastern parts of the Indian state of Uttar Pradesh, officials say.

A senior health official told BBC that 640 people were admitted in hospitals for encephalitis, known locally as brain fever. Out of these, 129 died.

Doctors say that the high death ratio is "quite high" and "alarming".

Japanese encephalitis is caused by a virus. It is passed to humans by the bite of infected mosquitoes.

It cannot be transmitted by other humans and is usually a mild illness - in many cases there are no symptoms.

But in a small number of cases - normally about 1 in 200 infected people - the illness is much more serious.

A senior doctor in Gorakhpur Medical college - near the border with Nepal - said that the majority of victims in the latest outbreak were children.

They say there is not enough nursing and support staff to attend to them as new patients arrive every day.

Flood waters from Nepal combined with long standing water logging in Uttar Pradesh is has been blamed for extensive breeding of mosquitoes.

More serious infections may start with fever, tiredness, headache, vomiting, and sometimes confusion and agitation leading to encephalitis (inflammation of the brain).

It can cause permanent brain damage in some cases.

Eastern Uttar Pradesh is a poor and backward area without adequate health facilities and encephalitis has killed a large number of people there over the last 30 years.

One of the worst outbreaks happened in 2005 when hundreds of people were killed.

Deforestation and increasing sugar cane farming have added to the problem.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise

Source: http://www.flutrackers.com/forum/new...ote=1&p=232634

Monday, 24 August 2009 06:41 UK
Encephalitis kills 200 in India
By Ram Dutt Tripathi
BBC Hindi, Lucknow

At least 200 children have died in an outbreak of Japanese encephalitis in northern India, health officials say.

So far, 900 affected children have been admitted to hospitals in Uttar Pradesh state. Some patients have come from neighbouring Bihar state and Nepal.

There is no specific cure for the mosquito-borne disease which has killed thousands in India since 1978.

Health experts complain that red tape has prevented development of an effective vaccination programme.

The disease occurs regularly during India's monsoon.

Doctors say children between the age of six months to 15 years are worst affected and most of the victims are poor people from rural areas.

Breeding ground

"The attack of the encephalitis virus is extremely ferocious this year," says Dr Rashmi Kumar, an expert on Japanese encephalitis at Lucknow Medical College hospital.

"Children are developing a serious condition within a day or two of getting infected," she says.

Health officials in the state capital, Lucknow, say cases of acute encephalitis are being reported mostly from 14 districts of eastern Uttar Pradesh in the foothills of the Himalayas.

The low-lying areas are prone to annual floods, and severe water-logging and a lack of sanitation provide a breeding ground for mosquitoes.

Doctors say Gorakhpur town is the epicentre of the disease.

Last year, the government said it would spend 60 million rupees ($1.24m) to upgrade facilities at Gorakhpur Medical College hospital.

But, doctors say, the hospital does not have adequate numbers of medical staff to deal with the large numbers of patients.

Doctors say the children who survive will have to face lifelong problems as the disease has a crippling effect.

'Preventable'

While there is no specific cure for the disease after it has been contracted, three vaccines are in use worldwide that have reportedly been successful in preventing the disease.

But India has so far failed to develop an effective vaccination programme.

After the disease killed 1,500 children in 2005, a public outcry forced the government to import vaccines from China and a mass vaccination project was started.

However, doctors say the vaccine coverage has not been satisfactory this year, with many parents of affected children saying no vaccination was done in their areas.

Japanese encephalitis, which causes high fever, vomiting and can leave patients comatose, usually hits Uttar Pradesh state in July-August.

The disease has recurred annually in eastern regions of the state since 1978.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise

Source: http://www.expressindia.com/latest-n...-tizzy/508280/


JE vaccination in UP: Fuzzy figures spark a tizzy

Maulshree-Seth
Posted: Aug 28, 2009 at 0434 hrs IST

Lucknow The Uttar Pradesh government?s claim of 85 to 95 per cent immunisation for Japanese Encephalitis (JE) has come under a scanner with a majority of JE positive cases reported at Baba Raghav Das Medical College in Gorakhpur being found without a history of vaccination.

Of the 40 reported JE positive cases so far this year, just two have been found with a history of JE vaccination. In a tizzy, health officials now plan to visit each of these JE positive houses and trace their vaccination history again.

So far this year, there have been over 650 Acute Encephalitis Syndrome cases and 174 children have succumbed to AES in eastern UP.

Sources said a majority of AES cases admitted at the BRD have also been found without a vaccination history.

While state government claims that since AES cases are not JE, implying that the JE vaccination has worked, experts say JE vaccination protects just the vaccinated child and so every unimmunised case should be taken carefully.

?This is a serious cause of concern because JE vaccination protects just the child, who has been vaccinated. It does not create herd immunity like oral polio vaccine,? said Dr Pritu Dhalaria, director, immunisation projects of PATH in India. PATH is an international non-profit organization providing technical support to various countries, including India, for JE programmes.

?It is clear we have missed a lot of children and now the biggest challenge is to strengthen routine immunization and see how majority of the children can be covered.?

None of the officials at BRD Medical College were available for comment.

The state government is now planning to visit the houses of JE positive patients and talk to them in detail about vaccination of their children. ?The first JE vaccination campaign in Gorakhpur took place in 2006. Thus it becomes difficult for parents to remember the vaccination of their children. We have asked the chief medical officers of the affected districts in eastern UP to get these figures verified. The real picture will only emerge after that,? said

Dr VS Nigam, joint director, communicable disease wing of the state health department.

Meanwhile, just-released JE coverage evaluation survey report, which was conducted in collaboration with immunization wing of Government of India and partners like UNICEF and WHO in different parts of the country including Gorakhapur and Behraich in UP, has also found lacunae in JE vaccination campaign.

The study found that just 52 per cent children in Gorakhpur received JE vaccine during campaign in the district despite the fact that around 77 per cent mothers were found to have knowledge about the campaign. While the figures have not been accepted by the state government, the officials associated with the survey say it was only in UP that the huge gap was found in the figures quoted by the state and those found in the study.

?We conducted a similar study on similar parameters in Assam, Karnataka, Maharashtra, West Bengal and in other states. The figures in our study were close to that of state government?s,? said one of the officials.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 210 dead

Source; http://www.ptinews.com/news/256570_5...l-rises-to-210

* 5 children die of Encephalitis, toll rises to 210

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STAFF WRITER 23:44 HRS IST

Gorakhpur (UP), Aug 30 (PTI) With five more children succumbing to encephalitis, the total toll in the division due to the disease has mounted to 210, officials sources said.

Five more children have died due to encephalitis at BRD Medical College here, while 145 patients are being treated during the last 24 hours, Additional Director Health L P Rawat said, adding 22 fresh cases were admitted in different hospitals.

He said a total of 960 patients suffering from Japanese Encephalitis and Acute Encephalitis Syndrome (AES) were admitted this year to the medical college and other hospitals of the region, out of which 210 died.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 210 dead

Source: http://www.dnaindia.com/india/report...s-here_1286791

Move over H1N1, a bigger killer is here
Deepak Gidwani / DNA
Tuesday, September 1, 2009 3:40 IST


Lucknow: Over 200 people have died of acute encephalitis syndrome (AES), which is similar to Japanese Encephalitis (JE), in eastern Uttar Pradesh (UP) in the past few months.

The disease claimed the lives of five children at BRD Medical College, Gorakhpur, in the past 24 hours, while 145 patients are being treated, additional director (health) LP Rawat said. He said 960 patients suffering from JE and AES were admitted to the medical college and other hospitals in the region this year. Of these, 210 died.

Every year, brain fever claims hundreds of lives mostly during rains. Most victims are children in the age group of one to 15. As per official figures, AES and JE claimed 1,135 lives in 2005, 437 in 2006, 547 in 2007 and 453 in 2008. This year, the toll has already touched 210. A health department official said: "Since the the deaths do nottake place in the metro, the media does not care to report them."

UP's director general (health and family welfare) RR Bharti said, "The problem is there is still no known cure for the disease." He said the National Institute of Virology, Pune, had set up a centre to study the causes of the disease. Experts from the National Institute of Communicable Diseases visited the affected areas and collected samples.

Health department officials said JE, which used to claim a large number of lives earlier, had been brought under control with vaccination and increased awareness in the affected districts. But AES continues to take lives every day.

The symptoms of AES are acute fever, confusion, disorientation, coma, or inability to talk and seizures which affect the nervous system. Other symptoms may include irritability, somnolence or abnormal behaviour.

Like swine flu, JE also has its origin in pigs. It is transmitted to humans through the culex mosquito which breeds in stagnant water, mainly during rains. There is no specific treatment for JE.

Poverty, filth and malnourishment make things worse. No wonder, eastern UP accounts for the largest number of JE/AES deaths. KP Kushwaha of BRD Medical College points out that there is only one doctor to look after encephalitis patients. This, for a disease which kills at least 25% of its patients.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 226 dead

Source: http://www.indopia.in/India-usa-uk-n...ational/1/20/1

Seven more children die of encephalitis, toll touches 226

Published: September 3,2009

Gorakhpur (UP), Sep 2 Seven children succumbed to deadly encephalitis today at BRD Medical College Hospital here, while 25 fresh cases of encephalitis were admitted, official sources said.

With this, the toll due to deadly disease has mounted to 226 in the division, additional director health Dr LP Rawat said adding that 126 patients are being treated at BRD Medical College and 38 in other hospitals.

He said that a total of 1,047 patients suffering from Japanese Encephalitis and Acute Encephalitis Syndrome were admitted this year to BRD Medical College and other hospitals of the region.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 232 dead

Source: http://www.ptinews.com/news/263901_S...ll-touches-232

* Six more children die of encephalitis, toll touches 232

STAFF WRITER 20:32 HRS IST

Gorakhpur (UP), Sep 2 (PTI) Six more children succumbed to deadly encephalitis today at BRD Medical College Hospital here, while 19 fresh cases of encephalitis were admitted, official sources said.

With this, the toll due to deadly disease has mounted to 232 in the division, additional director health Dr LP Rawat said adding that 164 patients are being treated at BRD Medical College.

He said that a total of 1,066 patients suffering from Japanese Encephalitis and Acute Encephalitis Syndrome were admitted this year to BRD Medical College and other hospitals of the region.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 241 dead

Source: http://www.ptinews.com/news/267259_E...ives--toll-241

* Encephalitis claims 6 more lives; toll 241

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STAFF WRITER 12:28 HRS IST

Gorakhpur (UP) Sep 6 (PTI) Encephalitis claimed six more lives at the BRD medical college hospital here, raising the total number of victims of the disease to 241 since January this year, health officials said today.

Six persons died during last 24 hours, while 25 fresh patients with encephalitis symptoms were admitted in the BRD hospital, the officials said.

Additional Director (health) L P Rawat said that 186 patients with symptoms of encephalitis have been admitted in BRD hospital, while 11 are undergoing treatment in other hospitals in Kushinagar, Gorakhpur, Deoria, Basti and Siddharthanagar.

A total of 1,115 patients admitted to various hospitals in the region this year of which 241 died. The six persons who fell prey to the disease in the last 24 hours belonged to Gorakhpur, Siddharthanagar, Kushinagar and Mahrajganj districts, they said.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 241 dead

Source: http://www.expressindia.com/latest-n...affled/513410/


New AES virus? doctors baffled

Express News Service
Posted: Sep 06, 2009 at 0219 hrs IST

Lucknow The CSMMU doctors seem to be in a fix with rising number of patients diagnosed with Acute Encephalitis Syndrome (AES) succumbing to the disease.

Though the patients reportedly show the symptoms of Japanese Encephalitis (JE), they tested negative for the virus. Now, doctors seem to be baffled with the identity of the new virus.

Interestingly, every year during this period, the Chhatrapati Shahuji Maharaj Medical University Trauma Centre admits two to three patients everyday suffering from AES. This year, these patients are succumbing to the disease due to multiple organ failure within two to three days.

?There are many groups of viruses that can cause encephalitis. It is very difficult to test for all the viruses in an individual patient. More than 50 patients have came in August and about one-third of them have died,? said Dr Rashmi Kumar, Head of Paediatrics Department, CSMMU.

?Though the cases are reported as encephalitis, more than 80 per cent tested negative for JE. Earlier, about 50 to sixty per cent tested positive for JE,? said Dr Amita Jain of Microbiology Department, CSMMU.

The Gorakhpur medicos, however, claim the new virus to be enterovirus ? a type of encephalitis virus.

?But we do not have the equipments to further our research in this field. Also, we are presently unaware about the virus and we do not know what to do next. The trend is now emerging and we can think of a proper study,? added Dr Jain.

According to the doctors, in case of JE patients, the brain tends to get affected but here the virus is affecting the other organs, leading to the death of the patient.

?Though we are receiving reports from Gorakhpur everyday about encephalitis, CSMMU has not reported any such case to the government,? said Dr V S Nigam, Joint Director of Vector-Borne Wing of the state Health department.

?A few days ago, members from National Institute of Virology, Pune and even CDC, Atlanta had gone to Gorakhpur to collect samples, but have not yet been able to trace the virus,? said Nigam. The state government is ready to support any research for this virus, he added.

The government is being briefed on each and every development, said Dr Kumar.

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 241 dead

Therapeutic effect of erythromycin on influenza virus-induced lung injury in mice.

Sato K, Suga M, Akaike T, Fujii S, Muranaka H, Doi T, Maeda H, Ando M.
First Department of Internal Medicine, Kumamoto University School of Medicine, Japan.

Erythromycin (EM) is an antibiotic with potent antiinflammatory effects that is used for treating chronic lower respiratory tract infections.

It has been shown that free radicals, such as the superoxide anion and nitric oxide (NO), are pathogenic molecules in viral disease.

Much attention has been given to a critical role of NO in the pathologic events of various inflammatory diseases.

In the present study, we evaluated the effects of EM on influenza-virus-induced pneumonia in mice infected with a lethal dose of influenza virus A/Kumamoto/Y5/67 (H2N2).

The administration of EM at a dose of 3.3 mg/kg/d (intraperitoneally, from Days 1 to 6 after infection), significantly improved the survival rate of mice infected with influenza virus, and the survival rate of the virus-infected mice at Day 20 after infection increased in a dose-dependent fashion with EM administered to the animals, from 14% among controls to 42% among animals given EM at 1.0 mg/kg/d and 57% among those given EM at 3.3 mg/kg/d. The induction of interferon-gamma (IFN-gamma) in the mouse lung was inhibited by EM treatment on Day 6 after infection.

Simultaneously, the number of inflammatory cells recovered in lung lavage fluid 6 d after virus infection was significantly reduced by the treatment with EM.

The EM treatment resulted in a dose-dependent decrease in the level of nitrite/nitrate (metabolites of NO) in the serum and the NO synthase (NOS)-inducting potential in the lungs of the virus-infected mice.

These results indicate that EM may have substantial therapeutic value for various acute inflammatory disorders such as influenza-virus-induced pneumonia, by inhibiting inflammatory-cell responses and suppressing NO overproduction in the lung.


http://www.ncbi.nlm.nih.gov/pubmed/9...ubmed_RVDocSum

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Re: India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 241 dead

Source: http://www.expressindia.com/latest-n...idered/513770/


Central team to take stock of JE deaths, second vaccination maybe considered

Maulshree-Seth
Posted: Sep 07, 2009 at 0223 hrs IST

Lucknow After a number of pleas by health activists to intervene in the rising Japanese Encephalitis deaths, a Central government team will be arriving on Monday for a two-day visit to Gorakhpur, the epicentre of the disease.

The team, led by Joint Secretary Shakuntala Gamblin, will be taking a close look at the epidemic, which has already claimed more than 200 lives since January.

The visit comes on the heels of a surprise visit conducted last week by the experts from National Vector Borne Disease Control Programme. Earlier, Dr R K Srivastava, Director General (Medical and Health), had also held a review meeting on encephalitis in Lucknow.

Last week, Union Minister of Health and Family Welfare Ghulam Nabi Azad had convened a special meeting to assess the ground reality about encephalitis in the region.

The experts accompanying Gamblin will look into the possibility of a second special vaccination drive in eastern Uttar Pradesh.

Uttar Pradesh Congress chief Rita Bahuguna Joshi said: ?While the state government has not done enough, I am really happy that the Central government is taking the initiative to tackle the problem.?

According to the existing guidelines, JE vaccination is given to children aged 1 to 15 years and that too once in a lifetime. In eastern UP, a special drive was conducted in 2006 to cover the entire population in this age group. Thereafter, the new borns were to be vaccinated.

Due to poor routine immunisation coverage, many children were left out in the last few years. Experts have long been demanding a second round of JE vaccination drive for eastern UP.

The team is also scheduled to hold a meeting with senior state government officials.

A few weeks ago, health activists from eastern UP had sent letters ? written in blood ? to Prime Minister Manmohan Singh and Rahul Gandhi, requesting that as much government attention be paid to encephalitis as in the case of H1N1.

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Re: उत्तर प्रदेश India - Uttar Pradesh, Acute Encephalitis Syndrome (AES) cases rise- 241 dead

Source: http://www.expressindia.com/latest-n...mpaign/514840/


Once bitten, UP plans new JE vaccine campaign
Maulshree Seth
Posted: Sep 09, 2009 at 0603 hrs IST


Lucknow Following the state?s inability to immunise newborn children in last three years, seven high-risk districts will go in for second phase of the Japanese Encephalitis mass vaccination soon.

The JE vaccination is administered once in a lifetime and a mass campaign in eastern UP had already taken place in 2006.

The decision for fresh campaign has been recently taken after the two-day review by the high-level delegation sent to Gorakhpur by the Union Minister for Health and Family Welfare, Ghulam Nabi Azad.

Besides visiting BRD Medical College, Gorakhpur, and meeting the patients, the team also met the chief medical officers of all the affected districts of eastern UP. Sources said the delegation lead by Shakuntala D Gamblin, Joint

Secretary, Ministry of Health, found lacunae in the routine immunsiation coverage because of which large number of children were not immunised in the last three years. The move has been welcomed by health experts, who were demanding the second round of mass vaccination in eastern Uttar Pradesh for long to protect the children between 1-4 years.

The vaccination will also mean an additional burden of around Rs 20 crore on the government. ?It could have been avoided if there was proper routine immunisation in Uttar Pradesh. However, now it has become a necessity,? said a senior official.

Officials said the fresh mass immunisation is likely to take place in January-February 2010 and will require around 1 crore doses of JE vaccine to be imported from China, and the government will have to place an additional order for import of vaccines.

While the cost per dose comes to around Rs 12, the operational charges are nearly Rs 10 per dose.

To make the vaccination programme a success, the Central officials have given the instructions to ensure digitalisation of the list of children between 1-15 years of age in seven high-risk districts of Uttar Pradesh in Gorakhpur and Basti division. The data would be recorded village-wise in these areas.

?The Centre has taken a wise step and we hope to get good support from the state. The fresh immunisation will help solve the JE problem to a great extent as this time we will be more cautious in monitoring coverage of children,? said Dr Pritu Dhalaria, Director for Immunisation projects in India for PATH, an NGO that provides technical support to JE programme.