India Encephalitis 2013; 1,312 fatalities

[Ronan Kelly]

Re: India Encephalitis 2013; 524 fatalities

Re: India Encephalitis 2013; 524 fatalities

It's difficult to make out the numbers in this google translated article, but it seems that some (19 or 41?)positive cases of JE are finally showing up in Uttar Pradesh. Some of the positive cases are from Kushinagar and Maharajganj which apparently only achieved 12% vaccination coverage. - Ro

JE officers by mounting unease
Updated on: Mon, 26 Aug 2013 11:37 PM (IST)

***
Hemant Pathak, Gorakhpur

Vaccination among other claims against the Faging and JE (Japanese Encephalitis) are increasing cases of the officials blew. History
*By this time the disease in the year nineteen
*The number 41 was confirmed at this time
*Is reached. Its increased in patients with JE Purvanchal
*Bring terrorists to prevent the immunization
*Have. The commissioner health authorities
*Have been directed to the analysis of all the cases. The
*JE vaccination has been told that he was out or not.

Top executives from departmental minister time and again claimed that Mchcrjnit the brunt of Japanese Encephalitis has been significantly reduced, there is only dealt with waterborne illness. Increased cases of Japanese Encephalitis in the last few weeks with the defense of these claims, arrangements have also been brought into question. This approach has raised the concern of the officers of the disease. Because it has also made efforts to clinch. In such a situation, it is essential that a detailed analysis of such patients should be made. It should be ascertained whether or not they have JE vaccination. CMO district level team formed the affected areas as well as in patients Faging verification, spraying, cleaning, disinfection of drinking water sources, should be taken of the blood forming plaque.

----------------

Questions on Immunization

The incidence of JE vaccination is also put into question. The campaign was started in November 2011 and January hundred percent - according to the vaccination. List of vaccination of children deprived of vaccination was made this year. Faging, spraying is out of all the claims made.

------------------

Negligence has been caught

Most affected by the disease Kushinagar and Maharajganj districts of Gorakhpur Division Two serious negligence Vaccination has already revealed. Commissioner JP Gupta himself CMO of these districts have sought clarification in this regard. In case of Kushinagar June, the annual target was achieved only 12.58 per cent and 12.04 in Maharajganj. The result is the opposite. Among those who have been tested positive for Japanese Encephalitis in Kushinagar and Maharajganj five of the six patients.
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10675361.html

 

[Ronan Kelly]

Re: India Encephalitis 2013; 524 fatalities

Re: India Encephalitis 2013; 524 fatalities

UP encephalitis toll rises to 202
By PTI - GORAKHPUR Published: 28th August 2013 10:35 AM Last Updated: 28th August 2013 10:36 AM
Four more children succumbed to encephalitis at the BRD Medical College Hospital here, taking the death toll in the disease in eastern Uttar Pradesh to 202 this year.

The deceased belonged to Gorakhpur, Mahrajganj, Kushinagar and Bihar, health officials said on Wednesday.
...
http://newindianexpress.com/nation/UP-encephalitis-toll-rises-to-202/2013/08/28/article1756213.ece

 

[Ronan Kelly]

Re: India Encephalitis 2013; 534 fatalities

Re: India Encephalitis 2013; 534 fatalities

Jharkhand:
Seizure disease stalks state, spurs tests

OUR CORRESPONDENT
Ranchi, Aug. 27: A certain virus is giving the health department sleepless nights.

Japanese encephalitis, caused by the Flavivirus and carried by the Culex mosquito, has vast swathes of the state in its grip.

While a 12-year-old girl apparently died of the disease in Palna village of Seraikela-Kharsawan?s Chandil block a few days ago, more than 18 cases have been reported from other districts.
...
http://www.telegraphindia.com/1130828/jsp/jharkhand/story_17281258.jsp#.Uh3PKtKuQ8A

 

[Ronan Kelly]

Re: India Encephalitis 2013; 527 fatalities

Re: India Encephalitis 2013; 527 fatalities

Uttar Pradesh, google translated;

Encephalitis claimed two more
Updated on: Thu, 29 Aug 2013 07:48 PM (IST)

News Correspondent, Gorakhpur

Deaths from encephalitis in Purvanchal continues. BRD Medical College in the last twenty-four hours, while two of the eleven new patients were admitted and died.

Those who were admitted to five Kushinagar, Deoria and Gorakhpur three, Sntkbirnagr and township - a patient. Nehru 148 patients are being treated in hospital. Since January this year in medical school have come to treat 717 patients of whom 199 have died.
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10682513.html

 

[Ronan Kelly]

Re: India Encephalitis 2013; 527 fatalities

Re: India Encephalitis 2013; 527 fatalities

Eastern UP reels under encephalitis, toll 200
SURBHI KHYATI : Lucknow, Sat Aug 31 2013, 05:22 hrs
In spite of the steps taken by the state to control its spread, over 900 cases of encephalitis have been reported from eastern districts of UP so far with almost 200 having already succumbed to the disease.

The cases of Japanese Encephalitis, a more virulent strain of the disease, and which was zero until a fortnight ago, have also risen to 42 with 10 deaths in the past 15 days.

As per the state government's report, the cases of Acute Encephalitis Syndrome (AES) until Thursday stands at 936 (as against 1,156 until August 29 last year), with the toll already reaching 193 ? just one less than the deaths recorded last year.
...
http://www.indianexpress.com/news/eastern-up-reels-under-encephalitis-toll-200/1162699/

 

[Ronan Kelly]

Re: India Encephalitis 2013; 527 fatalities

Re: India Encephalitis 2013; 527 fatalities

List of Japanese Encephalitis (JE)/Acute Encephalitis Syndrome (AES) Affected Gram Panchayats (village districts) by state

http://tsc.gov.in/TSC/Report/PanchayatReport/RptGetJEMarkGPs_net.aspx?id=GP

 

[Ronan Kelly]

Re: India Encephalitis 2013; 527 fatalities

Re: India Encephalitis 2013; 527 fatalities

google translated & edited

Hemant Pathak , Gorakhpur

Encephalitis in Purvanchal remained sharply during this time to become more sinister . Despite government claims of improved treatment and prevention of disease is innocent consecutive falls dead . Compared to last year, affected by the epidemic deaths have increased in almost every district . The experts and officials have lost their slumber . They are engaged in efforts to find the cause .

The catastrophic situation of encephalitis deaths are constantly seeing the truth came to light were studied by BRD Medical College, Gorakhpur . From January to July last year, twenty-five patients admitted to the medical college and deaths when compared to the same period in 2013 patients were recruited and so many shocking details of the number of deaths occurred Although last year was the number of patients admitted and the percentage of deaths was low . Fewer deaths in patients admitted this year has been increasing . For instance, in medical school in 2012 from January to July twenty-five, 535 patients were recruited , of whom 94 were killed , while 237 patients were admitted to July this year, twenty-five of which 59 could not be saved . The entire board died last year while this year it was 17.57 per cent, 24.89 per cent is reached.

The truth emerged when the officers began to search for the reasons given . It has been detected that negligence in treating major reason behind the increase in deaths or is there some other reason . Japanese Encephalitis vaccination is being verified . The disease patients as soon as possible , given the alarming trend to better treatment is initiated . That the ambulance is also available in adequate numbers at all health centers . The patient's condition is severe enough ambulances referred to the Medical College .

---------------------

In deaths per cent by July 25

District // 2012 // 2013

Ngorkpur // 25.50 // 34.55
Devaria // 17.59 // 22.86
Kushinagar // 12.92 // 23.94 am
Maharajganj // 14.49 // 17.07

---------------------

Pictures of August

Year Recruitment deaths

2012 // 427 // 65

2013 // 413 // 115

--------------

Says expert

BRD Medical College Principal and Head of the Department of Pediatrics, Dr. KP Kushwaha says that this is the most frightening disease . Patient access to treatment, medical colleges are also many of them are living in extremely critical condition . There are more deaths than this . To be more worrisome deaths are being investigated and the reasons for it .
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10691234.html

 

[Ronan Kelly]

Re: India Encephalitis 2013; 527 fatalities

Re: India Encephalitis 2013; 527 fatalities

google translated

Learn six Encephalitis Lee
Updated on: Tue, 03 Sep 2013 12:25 AM (IST)
News reporter, Gorakhpur

The situation remains serious havoc encephalitis in Purvanchal. In bygone days, 31 new patients were admitted in medical school, killing six. Nehru Hospital, 173 patients admitted to wards being treated.

Six of the seven deaths Ankita BSc them, sixteen-year-old Karan hum and two-year, two-year Afisa township, and nine-year-old honey and one year of Kushinagar include AYUSH. Seven of those recruited most of Gorakhpur, Deoria six, Sntkbirnagr and Bihar, three - three, Siddharth and township two - two and one patient in Balrampur. BRD since January this year
* Including 774 patients have been enrolled in medical school
There have been 211 deaths.
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10694393.html

 

[Ronan Kelly]

Re: India Encephalitis 2013; 536 fatalities

Re: India Encephalitis 2013; 536 fatalities

Encephalitis claims two more lives in Gorakhpur
TNN | Sep 4, 2013, 01.27 AM IST


GORAKHPUR: Two children suffering from encephalitis died on Monday night. Four-and-half-year old Phagu of Ahirouli in Kushinagar and four-year-old Indrawati of Sahjanwa in Gorakhpur succumbed at the medical college.
...
Till date, 789 cases of encephalitis have been reported this year, including 172 patients are undergoing treatment at the hospital. Till date, 213 encephalitis patients have died at BRD Medical College, while 345 have been successfully treated.
http://timesofindia.indiatimes.com/...e-lives-in-Gorakhpur/articleshow/22270477.cms

 

[Ronan Kelly]

Re: India Encephalitis 2013; 538 fatalities

Re: India Encephalitis 2013; 538 fatalities

A couple of cautions about this report - the encephalitis fatality total for Uttar Pradesh is 213 at this time. Of the almost 800 patients this year to date, around 5% are confirmed JE. - Ro

Japanese Encephalitis claims four lives
TNN | Sep 4, 2013, 04.49 AM IST


BAHRAICH: Four persons died due to Japanese Encephalitis (JE) in the district while 27 more patients of the disease have been admitted to the district hospital. 181 deaths due to JE have been reported since January.

Panchu (25), a resident of Khairighat, Ayub (8) of Nanpara, Etbar (45) of Balrampur and Sadhu (70) of Payagpur, who were admitted to the hospital in unconscious state with high fever, died on Monday during the treatment. The condition of five patients including Arsh, Anas, Gudiya, Zikra Khatoon and Mithun has been stated to be serious.
...
http://timesofindia.indiatimes.com/...is-claims-four-lives/articleshow/22274674.cms

 

[Ronan Kelly]

Re: India Encephalitis 2013; 538 fatalities

Re: India Encephalitis 2013; 538 fatalities

Encephalitis bogs down eastern UP
By Subhash Mishra | ENS - LUCKNOW Published: 05th September 2013 07:39 AM Last Updated: 05th September 2013 07:39 AM
...
Chief Minister Akhilesh Yadav had visited Gorakhpur in November last and promised a 500-bed child ward in the medical college to treat the encephalitis patients. But after nearly a year, no step has been taken. The medical college now remains congested with the encephalitis patients to the extent even the hospital floor is being occupied by them.

Similarly, Union Minister for Health Ghulam Nabi Azad had visited Gorakhpur in 2011 and assured a special package to control the disease. But hardly anything has been done.
http://newindianexpress.com/nation/Encephalitis-bogs-down-eastern-UP/2013/09/05/article1768717.ece

First indigenous Japanese Encephalitis vaccine awaits formal launch
Umesh Isalkar & Durgesh Nandan Jha, TNN | Sep 5, 2013, 05.06 AM IST

PUNE/NEW DELHI: The first totally indigenous vaccine against Japanese Encephalitis (JE) ? created using an Indian strain of the virus ? has received the nod of Drug Controller General of India (DCGI). The vaccine is going to be formally launched for public use soon.

"DCGI has given its approval for manufacturing and marketing of the vaccine in India. It is going to be formally launched in India. We are awaiting the Union health ministry's response in this regard," senior scientist Devendra Mourya, director of National Institute of Virology (NIV), Pune, told TOI. NIV had provided vaccine Bharat Biotech International Limited (BBIL) with a strain of the JE virus isolated from Karnataka's Kolar ? hotbed for JE infections ? for the vaccine.
...
http://timesofindia.indiatimes.com/...awaits-formal-launch/articleshow/22306481.cms

 

[Ronan Kelly]

Re: India Encephalitis 2013; 538 fatalities

Re: India Encephalitis 2013; 538 fatalities

Press Trust of India | Gorakhpur September 7, 2013 Last Updated at 01:40 IST
Two more die of encephalitis in UP, toll climbs to 237

...

As many as 19 fresh encephalitis patients were admitted to BRD-MCH today and two children died of the disease, the officials said.

About 184 patients of the disease are being treated at different government hospitals of the region, they said.
http://www.business-standard.com/ar...-in-up-toll-climbs-to-237-113090700051_1.html

 

[dr.baidya.nath.jha]

Re: India Encephalitis 2013; 60 fatalities

Re: India Encephalitis 2013; 60 fatalities

It is not the litchi plant, the reason is unripe litchi and roundworm already present in the gut, which causes vomiting then anti-emetics, phenothiazine derivatives are given in presence of dehydration n malnutrition which causes encephalitis like syndrome known as extrapyramidal syndrome, a drug hazard.

Also, Litchi is exported worldwide from the place, if the reason was viral strain in the plant the epidemic would have spread throughout.

http://theladyhousesurgeon.blogspot.in/2013/08/the-epidemic-of-encepahalitis-at.html

Dr Jha B N
Surgeon
Saharsa, Bihar

 

[Ronan Kelly]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Welcome Dr. Jha and thank you for joining FluTrackers. I linked to your blog post on August 4th shortly after you posted it. While you speak primarily of Muzaffarpur, Bihar, I notice that the major centers for encephalitis in Uttar Pradesh - Gorakhpur, Maharajganj, Kushinagar - are also the major litchi producing areas in the state http://www.biotechpark.org.in/db/Fruit/HTML/Litchi/Litchi_Status_In-UP.htm. In UP though, the onset of encephalitis season seems to come one to two months after Bihar - Do you know when litchi ripening occurs in each state? Do they begin to form and ripen earlier in Bihar leading to an earlier encephalitis season?
Do you know of any studies of and/or changes in medical practice due to your theory?
Recently much of the media and several academic papers postulate an enteroviral cause for encephalitis resulting from contaminated water. Do you know of any evidence (anecdotal or otherwise) to support or disprove this?

Thanks in advance!

 

[Ronan Kelly]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

google translated;

Encephalitis claimed the lives of two people!
Updated on: Sat, 07 Sep 2013 08:52 PM (IST)

News reporter, Gorakhpur: Insefelatis in medical school here in the last 24 hours has killed two and innocent. Both the state and the age of 2 years. Sunita's name and the other is a mascara. The Gorakhpur, 3 to 4 Kushinagar, Deoria Sntkbir 2 and 1-1 new patients were admitted to the city and Nepal. With these 11 new patients increased to 149 the total number of patients admitted to the ward. Recruitment from January so far, 228 of 816 patients have died.

Potential difficulty in treating the patient and as a limited natural resource.
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10706963.html

 

[Ronan Kelly]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Encephalitis took out 230 so far
Updated on: Sat, 07 Sep 2013 11:50 PM (IST)


Encephalitis took out 230 so far

- Two more deaths in the last twenty-four hours, seven new patient recruitment

- Medical College going to treat 141

News reporter, Gorakhpur:

Deaths from encephalitis in Purvanchal continues. In the last twenty-four hours in medical school twice and disease took the lives of innocents. With this, the total number of deaths since last January has reached 230. During this period, 826 new patients were admitted. 141 patients admitted to different wards in the hospital undergoing treatment.

Those who were admitted to Gorakhpur and Deoria two - two and Maharajganj, Kushinagar and one of Sntkbirnagr - includes a patient.

The constant increase in medical school rush of patients were in serious condition. The number of beds in wards of Pediatrics to double the number of patients due to the increased difficulty.
...
http://www.jagran.com/uttar-pradesh/gorakhpur-city-10707269.html

 

[dr.baidya.nath.jha]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Welcome Dr. Jha and thank you for joining FluTrackers. I linked to your blog post on August 4th shortly after you posted it. While you speak primarily of Muzaffarpur, Bihar, I notice that the major centers for encephalitis in Uttar Pradesh - Gorakhpur, Maharajganj, Kushinagar - are also the major litchi producing areas in the state http://www.biotechpark.org.in/db/Fruit/HTML/Litchi/Litchi_Status_In-UP.htm. In UP though, the onset of encephalitis season seems to come one to two months after Bihar - Do you know when litchi ripening occurs in each state? Do they begin to form and ripen earlier in Bihar leading to an earlier encephalitis season?
Do you know of any studies of and/or changes in medical practice due to your theory?
Recently much of the media and several academic papers postulate an enteroviral cause for encephalitis resulting from contaminated water. Do you know of any evidence (anecdotal or otherwise) to support or disprove this?

Thanks in advance!

Mr Kelly,

Thanks a lot for reading and posting my blog post and taking keen interest in it.
There is an old story named ?How to be a doctor??? written by some great humourist. It says that if you go to any doctor and ask that ?what is your diagnosis?? but if the doctor does not find the diagnosis very clear he will say that this is a case of encephalitis .

It is not wise to blame enterovirus or any virus because
a. Only the affected baby doesn?t drink that very water. The whole family which drinks the same water should be affected.
b. The contaminated water is drunk not only in the certain month. They drink the same water throughout the year.

Doctors under commercial pressure and influence over promote some drugs and some have fancy for prescribing the latest and costliest drugs only to influence patient and the people.
And the quacks follow their prescription without knowing the toxicity of drugs.Many a doctors avoid old & well tried drugs.

In General, doctors are too ready to prescribe drugs and the patients are too ready to take them for conditions which are self-limiting and cause only trivial discomfort. Doctors fail to restrict themselves from prescribing at least ten drugs for which one was enough.When a drug becomes popular it crosses frontiers, may affect neighbouring countries.

It is not connected to a virus in litchi or litchi plant but connected to vomiting due to ingestion of semi ripe litchi n mango which are highly acidic in nature and causes vomiting in malnourished children and children who have already round worm in their gut.And they are dehydrated due to
a. Vomiting
b. Moving naked in the scorching sun.

When brought to a medical shop or a quack who give them phenothiazine derivatives and they start giving the feature of extrapyramidal syndrome which is highly confused with encephalitis. In my opinion it is phenothiazine drug disaster like thalidomide disaster in west germany and great britian in 1960-61.

To confirm the theory post mortem of the deceased babies should be done for round worm. Doctors should strictly make it a code of conduct to take proper drug use history & history of round worm. Govt should crack down on quacks and drug stores very sternly & strictly otherwise the epidemic cant be contained.

About 15 years back I was posted as in-charge medical officer of referral hospital Sakra in Muzaffarpur. In those days encephalitis was also prevalent every year at Muzaffarpur sadar hospital, I ordered purchase of heavy volume of drugs for de-worming patients and requested all my doctors to de-worm all the children patient who visited my hospital due to any reason whatsoever and fortunately there was almost none who suffered from the said encephalitis from my area.

Kindly read about the toxicity of pheno-thiazine group and extrapyramidal syndrome. Some newer derivatives are very much prone to cause the extrapyramidal syndrome. Even a single tablet is dangerous in presence of slight dehydration. Many a times it may be confused with parkinson's disease as well due to tremors n rigidity of limbs but the most diagnostic feature is open mouth, protruding tongue , occulogyric crisis, torticolis, retrocolis & spasm of limb muscles.

Regards
Dr Jha B.N.
Surgeon,Saharsa, Bihar

 

[Ronan Kelly]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Thanks again, Doctor. While epidemiological data is incomplete and inconclusive, I have noticed that encephalitis outbreaks involving mixed age groups tend to be more likely to test positive for JE, while these AES outbreaks tend to concentrate more on younger children. I have been wondering what seasonal behaviors that children do that could lead to their illness. I agree that the enterovirus hypothesis is unsatisfying as it does not explain the seasonality, the localized nature or the age specificity of the outbreaks. I'm going to send portions of this thread to ProMED as it may generate some important conversations.

There was a large de-worming drive in Bihar in 2011, but presumably, reinfection is possible if the initial routes of infestation remain -
Mass de-worming drive for Bihar children from Monday

The first ever State-wide school-based mass de-worming programme is being launched in Bihar this Monday.

Supported by Deworm the World, a US-based non-profit organisation, the programme aims at treating 21 million school-age children in the State. It will be rolled out in over 67,000 schools in all 38 districts of Bihar in three phases from February-April 2011. In the process, nearly 140,000 teachers and 20,000 auxiliary nurse midwives (ANMs) and other health staff will be trained to implement and monitor the programme, DtW South Asia regional director Prerna Makkar told journalists here.

Worms can cause anaemia, malnourishment and impairment of mental and physical development, and children in the age group of 6 to 14 years are most impacted by these infections. The affected children are too sick to concentrate in school and often cannot attend school at all. The benefits of school-based de-worming are immediate. Regular treatment can reduce school absenteeism by 25 per cent and that too at a cost of less than Rs.25 per child per year.
...
http://www.thehindu.com/todays-pape...bihar-children-from-monday/article1161047.ece

Indian State Of Bihar Makes History With World?s Largest School-Based Deworming Program
Oct 3, 2011 |
Patna, India:
Over 17 million children in the Indian state of Bihar were provided with deworming treatment as part of one of the largest school-based deworming efforts ever conducted in the world. The announcement was made by Mr. Rajesh Bhushan, the State Project Director of the Bihar Education Project Council (BEPC) and Secretary of Public Relations Department, Mr. Sanjay Kumar, Secretary of Department of Health & Family Welfare and Executive Director of the State Health Society Bihar (SHSB), and Ms. Prerna Makkar, Regional Director ? South Asia, Deworm the World (DtW) as they reported the results of Bihar?s first-ever statewide school-based deworming program implemented from February through April 2011. Mr. Kumar said "it is remarkable that such a technically simple intervention, as regular and systematic deworming, can have such a profound effect on the nutritional, health and education status of millions of children."
...
http://www.thehindu.com/todays-pape...bihar-children-from-monday/article1161047.ece

 

[Ronan Kelly]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Assam
Three persons struggling for life due to encephalitis in Jorhat
Posted on 08-09-2013 | 18:32:48 IST | DY365 Bureau


Jorhat: Once again three persons were found to be infected by encephalitis in Jorhat. It was about two month; they were struggling with this deadly disease. Biman Das from Saruhuj of here was struggling for life from more than two months in Jorhat Civil Hospital. Further, one more person from Jorhat city along with Aonima Kanu and Nrigun Gayan has been admitted in the hospital.

http://dy365.in/news/details.php?aID=26673&subC=0

 

[dr.baidya.nath.jha]

Re: India Encephalitis 2013; 562 fatalities

Re: India Encephalitis 2013; 562 fatalities

Thanks again, Doctor. While epidemiological data is incomplete and inconclusive, I have noticed that encephalitis outbreaks involving mixed age groups tend to be more likely to test positive for JE, while these AES outbreaks tend to concentrate more on younger children. I have been wondering what seasonal behaviors that children do that could lead to their illness. I agree that the enterovirus hypothesis is unsatisfying as it does not explain the seasonality, the localized nature or the age specificity of the outbreaks. I'm going to send portions of this thread to ProMED as it may generate some important conversations.

There was a large de-worming drive in Bihar in 2011, but presumably, reinfection is possible if the initial routes of infestation remain -
Mass de-worming drive for Bihar children from Monday

The first ever State-wide school-based mass de-worming programme is being launched in Bihar this Monday.

Supported by Deworm the World, a US-based non-profit organisation, the programme aims at treating 21 million school-age children in the State. It will be rolled out in over 67,000 schools in all 38 districts of Bihar in three phases from February-April 2011. In the process, nearly 140,000 teachers and 20,000 auxiliary nurse midwives (ANMs) and other health staff will be trained to implement and monitor the programme, DtW South Asia regional director Prerna Makkar told journalists here.

Worms can cause anaemia, malnourishment and impairment of mental and physical development, and children in the age group of 6 to 14 years are most impacted by these infections. The affected children are too sick to concentrate in school and often cannot attend school at all. The benefits of school-based de-worming are immediate. Regular treatment can reduce school absenteeism by 25 per cent and that too at a cost of less than Rs.25 per child per year.
...
http://www.thehindu.com/todays-pape...bihar-children-from-monday/article1161047.ece

Indian State Of Bihar Makes History With World?s Largest School-Based Deworming Program
Oct 3, 2011 |
Patna, India:
Over 17 million children in the Indian state of Bihar were provided with deworming treatment as part of one of the largest school-based deworming efforts ever conducted in the world. The announcement was made by Mr. Rajesh Bhushan, the State Project Director of the Bihar Education Project Council (BEPC) and Secretary of Public Relations Department, Mr. Sanjay Kumar, Secretary of Department of Health & Family Welfare and Executive Director of the State Health Society Bihar (SHSB), and Ms. Prerna Makkar, Regional Director ? South Asia, Deworm the World (DtW) as they reported the results of Bihar?s first-ever statewide school-based deworming program implemented from February through April 2011. Mr. Kumar said "it is remarkable that such a technically simple intervention, as regular and systematic deworming, can have such a profound effect on the nutritional, health and education status of millions of children."
...
http://www.thehindu.com/todays-pape...bihar-children-from-monday/article1161047.ece

Respected Mr. Kelly,

If it is insisted that the cause of encephalitis is enterovirus or any other virus ,the blood and CSF (cerebro spinal fluid) should be sent to different and distant places of three patients for culture of viruses and confirm without much delay.

A board of neurophysicians who work in mental hospitals in different states should examine the cases for extrapyramidal syndrome.

History of at taking drugs for vomiting prescribed by local quacks ,medical shops or any practitioner should be taken at least of ten patients very seriously or any anti-psychotics drugs due to any reason.History of taking even a single tablet is important especially when it comes to children.

Which recent anti-emetics is commonly used in that area? Those drugs should be sent for testing and recommended for withdrawl from the market.

Eradication of these epidemics is next to impossible if the quacks and medical shops are not sternly dealt with by the Govt like thalidomide disaster in west Germany and Great Britian.

These small steps should provide a quick check of all the floating diagnosis.

Regards
Dr JHA B.N.
Surgeon
Saharsa,Bihar
India