Deadly brain fever takes toll in UP
26 Oct 2007, 0215 hrs IST,Rema Nagarajan,TNN
GORAKHPUR: A new and deadly brain fever is stalking eastern Uttar Pradesh. Since January this year, it has affected more than 1,450 people of which 320 have died. The outbreak refuses to recede since peaking in the monsoon season, with 250 deaths having taken place since August.
Unlike Japanese encephalitis (JE) which has ravaged the region in recent years, this form of encephalitis is caused by an entero virus transmitted through water and food contaminated with faeces rather than through mosquitoes.
And while JE just attacks the brain, this virus - being referred to as acute encephalitis syndrome (AES) - can affect any system.
"AES can hit the heart, kidney, liver, lungs, the GI tract or the brain. The system that is affected differs from case to case," Dr A K Rathi, head of the department of paediatrics at Gorakhpur's Baba Raghav Das Medical College, told TOI.
Children have been the worst victims accounting for 237 of the deaths so far. "The new entero virus is like a sister virus of polio with the same route of transmission. Water supply and sanitation will be the key in controlling this disease," he added.
And that's where the problem lies. While JE, which claimed 1,000 lives in 2005, could be contained by controlling mosquitoes, AES demands good personal and community hygiene - something that's difficult in these parts. The virus lives in the digestive tract and spreads when faecal matter of an infected person gets mixed with water and food. There's no vaccine against AES.
"It's similar to a virus found in Bangladesh in 1976. Though the death rate is slightly less than that of JE, it causes longer hospitalisation and can lead to multi-organ failure. It is a huge drain on resources," explained Dr K P Kushwaha, senior paediatrician in BDR Medical College, Gorakhpur.
The worst affected are areas surrounding Gorakhpur, including the districts of Maharajganj, Kushinagar, Sant Kabir Nagar, Siddarth Nagar and Azamgarh. Patients are also pouring in from adjoining districts of Bihar ? West Champaran, Siwan and Gopalganj.
Dr Rathi said children's low immunity made them very susceptible to the disease. "Most patients are between 6 months to 10 years of age, though some older children too have been infected."
And, there are no signs of the cases dropping off after peaking in August and September. "Though its getting cooler, October has already seen 87 deaths. Unless things improve soon, it could turn out to be worse than September when 111 died of AES," explained Dr Rathi. The October toll has since risen to 102, with 15 more deaths - all children - being reported in the past four days alone, Dr Kushwaha added. He said that there is no specific treatment for AES: "If a child's kidneys are affected we treat it like a case of renal failure; if it's the liver, it is treated like a hepatic failure case and so on."
The disease seems to be on the rise. "We saw just a few cases in 2004, then a few hundreds in 2005, about 1,000 in 2006 and this year we have seen more than 1,400 cases. And these are just the cases coming to the medical college," Dr Kushwaha said.
26 Oct 2007, 0215 hrs IST,Rema Nagarajan,TNN
GORAKHPUR: A new and deadly brain fever is stalking eastern Uttar Pradesh. Since January this year, it has affected more than 1,450 people of which 320 have died. The outbreak refuses to recede since peaking in the monsoon season, with 250 deaths having taken place since August.
Unlike Japanese encephalitis (JE) which has ravaged the region in recent years, this form of encephalitis is caused by an entero virus transmitted through water and food contaminated with faeces rather than through mosquitoes.
And while JE just attacks the brain, this virus - being referred to as acute encephalitis syndrome (AES) - can affect any system.
"AES can hit the heart, kidney, liver, lungs, the GI tract or the brain. The system that is affected differs from case to case," Dr A K Rathi, head of the department of paediatrics at Gorakhpur's Baba Raghav Das Medical College, told TOI.
Children have been the worst victims accounting for 237 of the deaths so far. "The new entero virus is like a sister virus of polio with the same route of transmission. Water supply and sanitation will be the key in controlling this disease," he added.
And that's where the problem lies. While JE, which claimed 1,000 lives in 2005, could be contained by controlling mosquitoes, AES demands good personal and community hygiene - something that's difficult in these parts. The virus lives in the digestive tract and spreads when faecal matter of an infected person gets mixed with water and food. There's no vaccine against AES.
"It's similar to a virus found in Bangladesh in 1976. Though the death rate is slightly less than that of JE, it causes longer hospitalisation and can lead to multi-organ failure. It is a huge drain on resources," explained Dr K P Kushwaha, senior paediatrician in BDR Medical College, Gorakhpur.
The worst affected are areas surrounding Gorakhpur, including the districts of Maharajganj, Kushinagar, Sant Kabir Nagar, Siddarth Nagar and Azamgarh. Patients are also pouring in from adjoining districts of Bihar ? West Champaran, Siwan and Gopalganj.
Dr Rathi said children's low immunity made them very susceptible to the disease. "Most patients are between 6 months to 10 years of age, though some older children too have been infected."
And, there are no signs of the cases dropping off after peaking in August and September. "Though its getting cooler, October has already seen 87 deaths. Unless things improve soon, it could turn out to be worse than September when 111 died of AES," explained Dr Rathi. The October toll has since risen to 102, with 15 more deaths - all children - being reported in the past four days alone, Dr Kushwaha added. He said that there is no specific treatment for AES: "If a child's kidneys are affected we treat it like a case of renal failure; if it's the liver, it is treated like a hepatic failure case and so on."
The disease seems to be on the rise. "We saw just a few cases in 2004, then a few hundreds in 2005, about 1,000 in 2006 and this year we have seen more than 1,400 cases. And these are just the cases coming to the medical college," Dr Kushwaha said.
