India Encephalitis 2019; 1,152 fatalities

[Ronan Kelly]

Uttar Pradesh
23 children suffering from fever, six AES
Publish Date: Tue, 24 Sep 2019 12:12 AM (IST)

Maharajganj: Due to sudden change in the Terai season, where 23 children suffering from fever have been admitted to the district hospital, six are in the grip of AES. While one patient of possible glitter was referred to Rajan Medical College at the bottom, the condition of the doll is being reported to improve.

Even though the graph of deaths from encephalitis has decreased in the district as compared to previous years, but the number of patients is not decreasing. Every day patients are being admitted to the district hospital. The health department is also alert to see patients. Patients are being treated under special supervision of doctors and staff nurses in the encephalitis ward. At present 23 patients with fever, jerk etc. are admitted, while Sonam, Tamanna, Rita, Rani, Sehrana Khatoon and Seema are admitted in AES ward, Struggling for life The pangs of the parents supporting the hospitalized children and the folds of the bed of the innocent are telling their yearning for pain. In this, Sonam was referred by the CHC doctor on Sunday as a symptom of chill fever. While Rajan, a patient of possible skin, was referred to the Medical College from the District Hospital. If the doctors agreed here, there were symptoms of AES in it. However, the condition of the doll is improving. Chief Medical Superintendent Dr. RB Ram said that Sonam and Gudiya have been admitted in the AES ward. Sonam's condition is improving. Sonam is undergoing treatment.
https://www.jagran.com/uttar-pradesh/maharajganj-23-children-suffer-from-fever-19607133.html

 

[Ronan Kelly]

National
From the latest NHM report to August (report date September 21); (+change since September 14 report)

18,657 tests for JE (+489) of which 2,612 (+70) were positive. Andhra Pradesh 0 positive form 1 test (unchanged), Arunachal Pradesh (165 (+1)/245 (+5)), Assam (1,924 (+27) /9,184(+233)), Chandigarh (0/55 (unchanged)), Chhattisgarh (0 ( -1)/0(-1)), Delhi (0/1 (unchanged)), Goa (0/3 (unch)), Karnataka (0/65(unch)), Kerala (0/23(unch)), Madhya Pradesh (14/0 sic (unchanged)), Maharashtra (17 (unch) / 36 (unch)), Manipur (72 (unch)/164 (unch)), Meghalaya (138 (+22) /377 (+101)), Nagaland (15 (unch) /75 (unch)), Odisha (19 (unchanged) /62 (unchanged)), Tamil Nadu (3 (unch) /81 (+28)), Tripura (115 (unch) /1,016 (+unch)), Uttar Pradesh (43 (unch) /6,140 (unch)), West Bengal (87 (+21) /1,129 (+123))

355 (+11) AES deaths distributed as follows; Andaman and Nicobar Islands (1 (unchanged)), Andhra Pradesh (4 (unch)), Arunachal Pradesh (2 (unchanged)), Assam (117 (+8)), Bihar (4 (+3)), Chandigarh (37 (unchanged)), D&NH (1 (unchanged)), Gujarat (9 (unch)), Haryana (2 (unch)), Karnataka (11 (unchanged)), Kerala (3 (unch), Madhya Pradesh (6 (unch)), Maharashtra (47 (unch)), Meghalaya (6 (unchanged)), Odisha (7 (unch)), Rajasthan (35 (unch)), Tamil Nadu (12 (unch)), Telangana (5 (unchanged)), Uttar Pradesh (4 (unch)), West Bengal (42 (unch))

284 (+11) JE deaths distributed as follows; Arunachal Pradesh (1 (unch)), Assam (61 (+1)), Chhattisgarh (8 (unchanged)), Daman & Diu (1(unchanged)), Gujarat (5 (unch), Karnataka (3 (unch)), Kerala (7 (unchanged)), Madhya Pradesh (2(unchanged)), Maharashtra (6 (unch)), Meghalaya (1 (unchanged)), Nagaland (2 (unch)), Odisha (111 (unchanged)), Rajasthan (45 (+10)), Uttar Pradesh (30 (unch)), West Bengal (1 (unchanged)).


https://nrhm-mis.nic.in/hmisreports/...d_reports.aspx
https://nrhm-mis.nic.in/HMISReports/...djBt3WMvTifuft


Comment: Bihar has reported 212 total AES deaths (157 in Muzaffarpur & 55 in other districts), Assam has increased the number of JE deaths to 154 (Sep 12) and AES to 139 (July 20) for a total of at least 293. A total of 318 deaths were reported from the state by the IDSP in the week of July 15-21. The overall number of AES/JE deaths in the state is probably close to 350. Uttar Pradesh media has reported 38 fatalities. There have also been reports of 5 deaths from Manipur , 2 deaths in Jharkhand and 1 in Uttarakhand. These numbers should not be considered as complete - Ro

Week 31 IDSP report: https://idsp.nic.in/WriteReadData/l8...1569322122.pdf
GJ/PAN/2019/31/0959 Gujarat Panchmahal
Chandipura Viral Encephalitis
01 00 31-07-19 31-07-19 Under
Surveillance
Case reported from Village Kaliyavav, PHC
Samp, Block Godhra. District RRT investigated
outbreak. Serum sample collected and sent to
NIV Pune, result reported as positive by CHPV
PCR Test. Samples of contact also sent to NIV,
Pune and reported as Not Positive. House to
house survey done. Case treated symptomatically.
Health education given.

AR/WSN/2019/31/0969
Arunachal Pradesh West Siang
Japanese
Encephalitis
05 00 19-07-19 Under
Surveillance
Cases reported from Aalo Town. District RRT investigated
the outbreak. A total of 30 Serum samples were collected and
sent to IDSP-DPHL, BPGH Pasighat out of which 05 samples
found Ig M ELISA positive for Japanese Encephalitis. All
cases treated symptomatically. Health education given.

GJ/DAH/2019/31/0974 Gujarat Dahod
Chandipura Viral Encephalitis
01 01 fatality 05-07-19 Under
Control
Case reported from Village Surpur, SC Bor, PHC Kaliyavad,
Block Dhanpur. District RRT investigated outbreak. The
serum sample of the case was collected and sent to NIV Pune
and SSGH, Vadodara, result reported as positive for
Chandipura by CHPV PCR Test by NIV, Pune. A total of 6
contact serum samples collected and sent to NIV, Pune for
investigation, result awaited. Dusting and spraying done in 35
houses. Health education given

Arunachal Pradesh
(Follow up)
ArunachalPradesh Tezu
JapaneseEncephalitis
05 00 06-07-19 Under
Surveillance
Cases reported from Tezu town under Zonal GH Tezu.
District RRT investigated the outbreak. A total of 02 serum
samples were collected and both samples were Ig M ELISA
positive for Japanese Encephalitis.. All cases treated
symptomatically. Health education given.

Arunachal Pradesh
(Follow up)
ArunachalPradesh East Siang
JapaneseEncephalitis
43 00 09-07-19 Under
Surveillance
Cases reported from Pasighat town. District RRT investigated
the outbreak. A total of 43 samples were collected and sent to
IDSP DPHL, BP General Hospital Pasighat, all samples were
IgM ELISA positive for Japanese Encephalitis. All cases
treated symptomatically. Health education given.

Arunachal Pradesh
(Follow up)
ArunachalPradesh Papumpare
JapaneseEncephalitis
06 01 fatality 06-07-19 Under
Surveillance
Cases reported from various places of Itanagar. District RRT
investigated the outbreak. A total of 02 serum and 04 CSF
samples were collected and all samples found IgM ELISA
positive for Japanese Encephalitis. All cases treated
symptomatically. Health education given.

 

[Ronan Kelly]

Tamil Nadu

...
https://timesofindia.indiatimes.com...ies-of-fever-at-cmch/articleshow/71284293.cms

 

[Ronan Kelly]

Uttar Pradesh
Death of a young man suffering from encephalitis, family members created chaos
Moradabad BureauMoradabad Bureau Updated Sun, 29 Sep 2019 11:36 PM IST

Obari / Steady. A fever-stricken youth died in Obari village of Asmoli region. Knowing this, there is a furore in the family. The young man was suffering from fever for fifteen days. The family reached several hospitals for treatment. He died during treatment.
The family is talking about having meningitis. Shakir Hussain, 36, son of Sabir Hussain, a resident of village Obari, died on Saturday late night. The young man had a fever fifteen days ago. The family got first aid from the doctor of the village. But the family did not take any benefit to a private hospital in Moradabad. While treatment was done in three hospitals one after the other, but all said to have encephalitis and nowhere did benefit from the treatment.
The young man died late on Saturday night. When the family came to know about this, there was chaos. The father of the deceased told that fifteen days ago his son had fever. Got treatment from the village doctor.
Initially, viral fever was reported but treatment did not relieve it. He was treated at three private hospitals in Moradabad but nowhere was the relief. Physicians had reported to have encephalitis. He died on Saturday night. The deceased is survived by six children.
https://www.amarujala.com/uttar-pradesh/sambhal/death-to-encephalitis-sambhal-news-mbd323991716

 

[Ronan Kelly]

Karnataka
Teenager dies of Japanese encephalitis
The victim has been identified as Dhanamma Hugar (13), a resident of Shikarakane Layout in Vijayapura city.


Published: 02nd October 2019 05:58 AM | Last Updated: 02nd October 2019 05:58 AM | A+A A-
By Mahesh M Goudar Express News Service
VIJAYAPURA: After a teenager died due to Japanese encephalitis (JE), district health officials on Monday swung into action and collected blood samples of over 200 children of Shikarakane Layout in Vijayapura city.

The victim has been identified as Dhanamma Hugar (13), a resident of Shikarakane Layout in Vijayapura city. She breathed her last at a private hospital on Sunday. Parents and relatives of the victim staged a protest alleging that it is due to negligence of doctors, the district administration and the Vijayapura City Corporation, the teenager died
...
http://www.newindianexpress.com/sta...er-dies-of-japanese-encephalitis-2042181.html

 

[Ronan Kelly]

National
From the latest NHM report to September (report date Oct 5); (+change since September 21 report)

18,678 tests for JE (+21) of which 2,612 (unchanged) were positive. Andhra Pradesh 0 positive form 1 test (unchanged), Arunachal Pradesh (165 (=)/245 (=)), Assam (1,924 (=) /9,184(=)), Chandigarh (0/55 (unchanged)), Delhi (0/1 (unchanged)), Goa (0/3 (unch)), Karnataka (0/68(+3)), Kerala (0/23(unch)), Madhya Pradesh (14/0 sic (unchanged)), Maharashtra (17 (unch) / 36 (unch)), Manipur (72 (unch)/164 (unch)), Meghalaya (138 (=) /377 (=)), Nagaland (15 (unch) /75 (unch)), Odisha (19 (unchanged) /62 (unchanged)), Tamil Nadu (3 (unch) /81 (=)), Tripura (115 (unch) /1,016 (+unch)), Uttar Pradesh (43 (unch) /6,158 (+18)), West Bengal (87 (=) /1,129 (=))

355 (=) AES deaths distributed as follows; Andaman and Nicobar Islands (1 (unchanged)), Andhra Pradesh (4 (unch)), Arunachal Pradesh (2 (unchanged)), Assam (117 (+8)), Bihar (4 (+3)), Chandigarh (37 (unchanged)), D&NH (1 (unchanged)), Gujarat (9 (unch)), Haryana (2 (unch)), Karnataka (11 (unchanged)), Kerala (3 (unch), Madhya Pradesh (6 (unch)), Maharashtra (47 (unch)), Meghalaya (6 (unchanged)), Odisha (7 (unch)), Rajasthan (35 (unch)), Tamil Nadu (12 (unch)), Telangana (5 (unchanged)), Uttar Pradesh (4 (unch)), West Bengal (42 (unch))

278 (-6) JE deaths distributed as follows; Arunachal Pradesh (1 (unch)), Assam (61 (=)), Chhattisgarh (2(-6)), Daman & Diu (1(unchanged)), Gujarat (5 (unch), Karnataka (3 (unch)), Kerala (7 (unchanged)), Madhya Pradesh (2(unchanged)), Maharashtra (6 (unch)), Meghalaya (1 (unchanged)), Nagaland (2 (unch)), Odisha (111 (unchanged)), Rajasthan (45 (unch)), Uttar Pradesh (30 (unch)), West Bengal (1 (unchanged)).


https://nrhm-mis.nic.in/hmisreports/...d_reports.aspx
https://nrhm-mis.nic.in/HMISReports...JCyutdNnrsnQEmP6wYR8EL/FYsCdp2EcFFqfhDteuCNI=


Comment: Bihar has reported 212 total AES deaths (157 in Muzaffarpur & 55 in other districts), Assam has increased the number of JE deaths to 154 (Sep 12) and AES to 139 (July 20) for a total of at least 293. A total of 318 deaths were reported from the state by the IDSP in the week of July 15-21. The overall number of AES/JE deaths in the state is probably close to 350. Uttar Pradesh media has reported 39 fatalities. There have also been reports of 5 deaths from Manipur , 4 deaths in Karnataka, 2 deaths in Jharkhand and 1 each in Tamil Nadu & Uttarakhand. These numbers should not be considered as complete - Ro

 

[Ronan Kelly]

Doctors graduating from govt medical colleges in UP will have to work in villages: Yogi
LUCKNOW  Updated: Sep 23, 2019 19:05 IST
HT Correspondent
Hindustantimes

Chief minister Yogi Adityanath on Monday said doctors graduating from state government-run medical colleges with an MBBS degree in Uttar Pradesh will have to work in the villages for two years.

The doctors completing post-graduation — MD and MS — will have to work in rural areas for a year, he said at a function here to mark the first anniversary of Ayushman Bharat Yojna.

During admission, medical students will have to fill up a bond that they will work in the rural areas, he said.
...
https://www.hindustantimes.com/luck...llages-yogi/story-kI6nysBCet3KNunwoh7ImJ.html




Union Health Ministry scales up Japanese Encephalitis vaccine in Bihar
The vaccine which was given in 231 endemic districts will be expanded to 37 more districts in the country that includes 11 new districts in Bihar.


Published: 11th October 2019 07:31 AM | Last Updated: 11th October 2019 07:31 AM | A+A A-

NEW DELHI: Rattled at the high number of children dying due to acute encephalitis syndrome in Bihar this year, the Union Health Ministry has scaled up Japanese Encephalitis vaccine in Bihar and other states.The vaccine which was given in 231 endemic districts will be expanded to 37 more districts in the country that includes 11 new districts in Bihar.

More than 100 children had died due to AES - a rare but serious form of brain fever - in Bihar this year and Muzaffarpur district in the state was the worst hit. JE vaccine that has limited effect on AES is given to children between 1-15 years. AES including JE is a group of clinically similar neurological manifestation caused by several different viruses, bacteria, parasites, spirochetes, chemical or toxins. AES cases are usually reported starting April-May, while JE cases are reported post monsoon except some parts where children contract the fever throughout the year.
...
http://www.newindianexpress.com/nati...r-2045971.html

 

[Ronan Kelly]

Uttar Pradesh
AES confirmed in child with fever
Hindustan Team, Lakhimpurkheri
Last updated: Sat, 12 Oct 2019 01:41 AM IST
AES confirmed in child with fever
Diseases like AES and fever started in the rainy season have not reduced even in the changing season. Rather, the change in weather has increased the outbreak of mosquito-borne diseases. AES has been confirmed in another child admitted to the district hospital on Friday. This child has been admitted to the ICU ward.

There is an outbreak of mosquito-borne diseases in the district at this time. The OPD of the District Hospital attracts a large number of patients suffering from fever every day. Children are most prone to fever. Shobhit, son of Mihilal, a resident of village Sisaiya Purva of Nighasan area, was admitted to the district hospital due to fever. Even after being admitted for two days, he did not recover. The investigation confirmed AES in Shobhit. Subsequently, Shobhit has been admitted to the ICU ward of the district hospital.
https://www.livehindustan.com/uttar...es-confirmed-in-child-with-fever-2793541.html

 

[Ronan Kelly]

National
From the latest NHM report to September (report date Oct 12); (+change since October 5 report)

19,496 tests for JE (+818) of which 2,689 (+77) were positive. Andhra Pradesh 0 positive from 1 test (unchanged), Arunachal Pradesh (165 (=)/253 (+8)), Assam (1,936 (+12) /9,336(+152)), Chandigarh (0/55 (unchanged)), Chhattisgarh (0/22 (+22)), Delhi (0/1 (unchanged)), Goa (0/3 (unch)), Karnataka (1 (+1) /131(+63)), Kerala (0/23(unch)), Madhya Pradesh (14/0 sic (unchanged)), Maharashtra (17 (unch) / 36 (unch)), Manipur (111 (+39)/264 (+100)), Meghalaya (143 (+5) /395 (+18)), Nagaland (15 (unch) /75 (unch)), Odisha (19 (unchanged) /62 (unchanged)), Tamil Nadu (3 (unch) /88 (+7)), Tripura (115 (unch) /1,016 (+unch)), Uttar Pradesh (56 (+13) /6,456 (+298)), West Bengal (94 (+7) /1,129 (=))

380 (+25) AES deaths distributed as follows; Andaman and Nicobar Islands (1 (unchanged)), Andhra Pradesh (4 (unch)), Arunachal Pradesh (2 (unchanged)), Assam (130 (+13)), Bihar (4 (=)), Chandigarh (37 (unchanged)), D&NH (1 (unchanged)), Gujarat (9 (unch)), Haryana (2 (unch)), Karnataka (16 (+5)), Kerala (3 (unch), Madhya Pradesh (6 (unch)), Maharashtra (49 (+2)), Meghalaya (8 (+2)), Odisha (7 (unch)), Rajasthan (36 (+1)), Tamil Nadu (12 (unch)), Telangana (5 (unchanged)), Uttar Pradesh (5 (+1)), West Bengal (43 (+1))

302 (+24) JE deaths distributed as follows; Andhra Pradesh 3 (+3), Arunachal Pradesh (1 (unch)), Assam (63 (+2)), Bihar (6 (+6)), Chhattisgarh (2(=)), Daman & Diu (1(unchanged)), Gujarat (5 (unch), Karnataka (3 (unch)), Kerala (7 (unchanged)), Madhya Pradesh (6(+4)), Maharashtra (9 (+3)), Meghalaya (1 (unchanged)), Nagaland (2 (unch)), Odisha (111 (unchanged)), Rajasthan (45 (unch)), Uttar Pradesh (36 (+6)), West Bengal (1 (unchanged)).

https://nrhm-mis.nic.in/hmisreports/...d_reports.aspx
https://nrhm-mis.nic.in/HMISReports/...cFFqfhDteuCNI=



Comment: Bihar has reported 212 total AES deaths (157 in Muzaffarpur & 55 in other districts), Assam has increased the number of JE deaths to 154 (Sep 12) and AES to 139 (July 20) for a total of at least 293. A total of 318 deaths were reported from the state by the IDSP in the week of July 15-21. The overall number of AES/JE deaths in the state is probably close to 350. There have also been reports of 5 deaths from Manipur , 2 deaths in Jharkhand and 1 in Uttarakhand. These numbers should not be considered as complete - Ro

 

[Ronan Kelly]

Week 33 IDSP report: https://idsp.nic.in/WriteReadData/l892s/74743699461571052888.pdf

MH/NAG/2019/33/1017 Maharashtra Nagpur
Acute Encephalitis Syndrome
01 case 01 fatality13-08-19 16-08-19
Under Surveillance
Cases reported from Village Rethi, Kursapar,
PHC Khapa, Taluk Soner. District RRT
investigated the outbreak. The case was a 10 year
old female, expired on 08-08-2019. Additional 4
cases were identified with similar complaints, 04
CSF samples were collected and sent to NIV,
Pune. All samples were negative for Japanese
Encephalitis, Dengue and Chandipura virus. All
cases treated symptomatically. Health education
given

AP/SAG/2019/33/1029 Arunachal
Pradesh Siang
Japanese Encephalitis
01 case 01 fatality 08-07-19 Under
Control
Case reported from Village Lokpeng, CHC Pangin. District
RRT investigated the outbreak. Case presented with high
fever, headache, pain abdomen followed by unconsciousness.
Serum sample was collected and sent to DPHL, Pasighat and
was found positive for Japanese Encephalitis. Case treated
symptomatically. Health education given.

AS/SNT/2019/33/1031 Assam Sonitpur
(Tezpur)
West Nile Fever
04 00 27-06-19 Under
Control
Cases reported from Village Bihaguri UPHC, SC Sonabil
Bosti Dhekiajuli, SC Alisinga Behali TInisuti Karbi Jinjia,
Block Hiru. District RRT investigated the outbreak. Serum
samples collected sent to Apex laboratory at RMRC
Dibrugarh, result of all 04 samples positive for West Nile
Virus by Ig M ELISA. All cases treated symptomatically and
recovered. Mass blood slide collection done. Fogging done,
ITBN distributed. No epidemiologically linked cases
identified so far. Health education given

(Follow up of 29th week,
outbreak 859)
Arunachal
Pradesh Tezu
Japanese
Encephalitis
05 00 06-07-19 Under
Control
Cases reported from Tezu town under Zonal GH Tezu.
District RRT investigated the outbreak. A single serum
sample collected and sent to AMC, Dibrugarh, it was found
positive for Japanese Encephalitis by IgM ELISA. All cases
were treated symptomatically. Health education given.

(Follow up of 28th week,
outbreak 849)
Arunachal
Pradesh Papumpare
Japanese
Encephalitis
06 cases 01 fatality 06-07-19 Under
Control
Cases reported from various places of District Itanagar.
District RRT investigated the outbreak. A total of 02 serum
samples and 04 CSF samples collected and all were found
positive for Japanese Encephalitis by IgM ELISA. All cases
were treated symptomatically. Health education given.

Week 34 IDSP report: https://idsp.nic.in/WriteReadData/l892s/28267138261571216400.pdf

GJ/PAN/2019/34/1050 Gujarat Panchmahal
Chandipura (Viral Encephalitis)
02 cases 01 fatality 22-08-19 22-08-19 Under
Surveillance

MH/AMR/2019/34/107 5
Maharashtra Amravati
Japanese Encephalitis 06 cases 00 13-08-19
Under Surveillance
Cases reported from Village Chincholi, PHC Nimboli, Block
Dhamangaon Railway. District RRT investigated the outbreak.
House to house survey done. Out of 06 blood samples were
sent to MGIMS Sewagram Wardha: 04 sample was found positive for JE (IgM ELISA). All cases treated
symptomatically. Entomological survey done. Source
reduction activity and fogging done in the affected area. Health
educa [sic]

 

[Ronan Kelly]

Uttar Pradesh
Woman dies of high fever
Gorakhpur BureauGorakhpur Bureau Updated Wed, 16 Oct 2019 11:06 PM IST


Sikanderpur (Basti). A woman suffering from high fever died during treatment in Rajavapur village. The relatives say that the death is due to encephalitis. Dr. Bhaskar Yadav, Medical Officer Incharge of Parshurampur CHC, says that the girl was not brought for treatment at CHC. Nor has there been any investigation report related to it. In such a situation, it is difficult to give a clear reason for death. If there is a report of encephalitis from Lucknow then preventive action will be taken in the village.
Anjal, 18-year-old daughter of Brijlal, a resident of Rajwapur village, suffered from high fever on September 8. The family underwent treatment by a private doctor, but did not benefit. On 13 September, he was admitted to the district hospital Ayodhya. On the morning of October 14, doctors saw the girl's condition serious and referred Dr. Ram Manohar Lohia Hospital Lucknow. Aanchal fainted due to fever, in the same condition family members took him to Lucknow. He died on the night of 15 October. According to the family, doctors in Lucknow had told Anchal to suffer from meningitis. According to the investigation report, doctors say that Anchal has been found to have symptoms of jaundice, anemia and meningitis. It is reported that Anchal's mother Indravati is also suffering from high fever in the village.
https://www.amarujala.com/uttar-pradesh/basti/woman-dies-of-high-fever-basti-news-gkp3257651126

Teenager dies of brain fever, panic in village
Publish Date: Wed, 16 Oct 2019 10:58 PM (IST)

Basti: A teenager died of brain fever on Wednesday. After death, there is panic in the village. The victim's investigative report has found symptoms of jaundice, anemia with meningitis.

Anchal (18) daughter Brijlal of Rajwapur village in Parasurampur block was taken to a private doctor on October 8 with high fever. Seeing that the health does not improve after treatment, the family decided to take him to Lucknow. On Sunday, October 13, he was admitted to the district hospital Ayodhya. On Monday morning, doctors saw the situation of the teenager serious and referred him to Dr. Ram Manohar Lohia Hospital Lucknow. Families were admitted to Lohia Hospital in an unconscious state. Where Anchal died during treatment on Tuesday. The family said that doctors told them that Anchal was suffering from meningitis. Investigation report has also found symptoms of jaundice, anemia as well as meningitis in the region. Aanchal's mother Indravati also suffers from high fever. He is undergoing treatment. Chief Medical Officer Dr. AK Gupta said that the information was done. Preventive action will be taken in the village by sending a local team. Blood sample of the victim's family will be done.
https://www.jagran.com/uttar-prades...of-brain-fever-panic-in-village-19673994.html

 

[Ronan Kelly]

Uttar Pradesh
Female fever worsens, death
Kanpur BureauKanpur Bureau Updated Wed, 23 Oct 2019 01:18 AM IST

Chaklavanshi. In Makhi village, the condition of the student worsened due to brain fever. The girl, who was knocked unconscious due to shock, was admitted to the Halat Hospital in Kanpur. Where he died on Monday night.
Sarai Singh, a resident of Makhi, said that her daughter Nandani (8) was a Class IV student in a village council school. He had a high fever three days ago. He took medicine from the doctor of the village itself. The daughter's condition deteriorated on Monday evening and she started having tremors. After some time she fainted. At which he rushed her to the district hospital. Seeing the condition of the doctors here, he referred him to Kanpur Halat Hospital. The meningitis was confirmed by doctors at Halat Hospital in Kanpur. He died during treatment here. CMO Dr. KP Singh said that death has been reported. On Wednesday, the Health Department team will reach the village and investigate the case history.
https://www.amarujala.com/uttar-prad...-knp5214492174

Girl child dies of fever, dead body buried by donations (Shahjahanpur)
Publish Date: Tue, 22 Oct 2019 11:55 PM (IST)

Dialogues, Nigohi: The girl died of brain fever. The mother did not even have so much money that she would be able to arrange the shroud for the dead body. With the help of the locals, collected the donations, then the body could be buried.

Late in the village Pachdevra of the area. Suresh's 12-year-old daughter Kajal had high fever on Monday afternoon. His mother Anita went to CHC with him. From where he was referred to the district hospital. He died on the way from ambulance to the district hospital. Anita brought the daughter's body back home. His body was buried with the help of locals. Kajal was a student of class six in a government school in the village. Three years ago his father Suresh also died in Delhi due to fever.
https://www.jagran.com/uttar-pradesh/shahjahanpur-girl-died-due-to-fever-19692241.html

 

[Ronan Kelly]

Infectious diseases increase havoc, two deaths due to fever
Publish Date: Thu, 24 oct 2019 06:20 AM (IST)

Jagran Correspondent, Unnao: With the changing weather, the havoc of infectious diseases is killing people. Two people died of fever at the district hospital on Wednesday. The situation is that 17 people have died of fever in 23 days in the district. At the same time, the condition of the district hospital is that more than three hundred patients are coming to the OPD for treatment after suffering from infection. Regarding this, doctors say that special attention is needed at this time. The fluctuations of weather and outbreak of mosquitoes are making people sick in every household.

In October, the weather has cooled down after many years, which is affecting the health of the people. At the same time, after the rain in September, waterlogging and inundation have spread the outbreak of infectious disease. Also, mosquito-borne diseases are adding to the problem. On Wednesday, Shambhu Ratan (70) son Lalaunu resident Manpur Achalganj and Rahisun (80) wife Shahid resident Civil Line died in the district hospital due to fever. The situation in the district hospital is that there are a lot of patients suffering from infectious diseases every day. In the district from October 1 to 23, 17 people have died of fever. In this, 11 people died in the district hospital. In Bangarmau, Ganjamuradabad, Auras, six people died of fever.

The effect of infectious diseases is that the pathology of the district hospital is crowded since early morning and there is a ruckus at the blood sample counter. The situation is worse for the last 15 days. There is a huge rush to report at the block sample counter from morning to afternoon.


More effects of meningitis

- The mind has more influence in the district. Most of the deaths occurred in one month were patients suffering from meningitis. Also, a boy died of dengue in Shuklaganj on Tuesday. Also Shuklaganj has treated the most patients suffering from dengue.

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

- Patients with meningitis are also coming with viral infections due to changing seasons. If the fever is coming up and there are tremors, then the patient should be hospitalized immediately. If the fever persists for two days, the patient should be taken to the hospital.

- Dr. Alok Pandey, Senior Physician, District Hospital
https://www.jagran.com/uttar-pradesh/unnao-two-people-died-of-fever-19695989.html

 

[Ronan Kelly]

Investigating the Muzaffarpur Outbreaks in the Backdrop of Western Uttar Pradesh Experience: The Way Forward
INDIAN PEDIATRICS VOLUME 56__OCTOBER 15, 2019 P885

The death of more than 130 children in Muzaffarpur, Bihar during the summer months of 2019 due to Acute encephalitis syndrome (AES) has raised an intense debate on the probable etiology of the killer disease. The recurrent outbreaks of the disease are reported since 1995, and several attempts have already been made by the different teams to clinch the exact etiology [1,2]. The key recent investigations were performed by three sets of expert-groups – John, et al. [3], the Natioal Center for Disease Control (NCDC), India, and Centre for Disease Control (CDC), United State (US) group [4], and by the pediatrician in-charge of Shri Krishna Medical College Hospital (SKMCH), Muzaffarpur [5]. While the first two groups identified litchi toxins, namely methylene cyclopropylglycine (MCPG) and methylene cyclopropylalanine (MCPA or hypoglycin A), responsible for the development of an acute hypoglycemic encephalopathy (AHE) amongst malnourished, poor, rural children [3,4], the latter suggested extremely high environmental temperature and humidity in the region resulting in ‘heat stroke’ that led to encephalopathy [5]. Due to the lack of documented hyperpyrexia in all the cases, and early morning onset of symptoms, there were few takers for the heat stroke theory. The litchi-toxins theory was more acceptable and the Bihar State Health Ministry started following the preventive measures as suggested by the groups who put forward this theory. The number of cases and deaths declined sharply in the following four years, 2015 to 2018 only to resurface in a much significant number in 2019.

A previous similar recurrent epidemic in many districts of Western Uttar Pradesh (UP), the so-called ‘Saharanpur encephalitis’ [6], was investigated by an independent group of investigators and the etiology was identified as toxicity due to oral ingestion of a local weed [7]. There are many similarities between the western UP and Muzaffarpur outbreaks; yet the approach, investigations and the outcomes are quite different (Table I).

In the Western UP outbreak, step-wise investigation approach was adopted and as a first step a proper ‘case definition’ with exclusion and inclusion criteria was formed. Based on its strict application, the disease was initially identified as an encephalopathy [6]. The next step was the histopathological examination of few target organs, which hinted toward toxin-mediated necrosis of liver and muscles (thus the term (acute hepatomyoencephalopathy (HME) syndrome) [6,7]. The differences in approaches in the two outbreak investigations are presented in (Table I).

With the re-emergence of the outbreak in Muzaffarpur this year, the debate on the exact etiology has reignited. While the role of any microbiological agent as the main trigger has been abandoned by most investigators, the focus is now on the litchi toxins and heat stroke as probable theories. Despite many ‘missing links’ like inconsistent findings of hypoglycemia and hyperthermia, lack of profuse vomiting (a hallmark of MCPA toxicity), ‘mismatched’ seasonality (paucity of unripe fruits at the peak of the outbreaks when the entire crop is matured), no clarity on toxic levels (LD50) of toxins that cause dosedependent toxicity, occurrence in children too young to eat the fruit, lack of hepatic dysfunctions despite mitochondrial involvement, flawed selection of controls in case-control study, lack of study of toxins in the body fluids of healthy siblings and peers living in the same household or village, the doubtful role of rapid correction of hypoglycemia on prevention of deaths, the litchi toxin theory was considered as the most plausible one.

A detailed case-control study in western UP helped in identifying the putative toxin which turned out to be anthraquinone derivatives contained in the beans of the weed, Cassia occidentalis [7]. Previous published literature confirmed the biological plausibility of causation in vertebrates. The cause-effect relationship of the Cassia occidentalis with acute HME syndrome in Wistar rats was subsequently demonstrated [8]. These detailed studies also helped in further outbreaks like the one in Sylhet, Bangladesh (2007-08) [9] and another in Malkangiri, Orissa (2016).

Currently, the outbreak investigations in India are at the crossroads. The need is to conduct investigations which are detailed and comprehensive, and performed in a coordinated and step-wise manner without any fixed notion

VIPIN M VASHISHTHA
Director and Consultant Pediatrician,
Mangla Hospital and Research Center,
Shakti Chowk, Bijnor, Uttar Pradesh, India.
vipinipsita@gmail.com

REFERENCES
1. Yewale VN. Misery of mystery of Muzaffarpur. Indian Pediatr. 2014;51:605-6.
2. Vashishtha VM. Encephalitis outbreaks in Muzaffarpur: Five blind men describing an elephant! Indian Pediatr. 2014; 51:936.
3. John TJ, Das M. Acute encephalitis syndrome in children in Muzaffarpur: hypothesis of toxic origin. Curr Sci 2014;106:1184-5.
4. Shrivastava A, Kumar A, Thomas JD, Laserson KF, Bhushan G, Carter MD, et al. Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: A case-control study. Lancet Glob Health. 2017;5:e458-e466.
5. Sahni GS. Recurring epidemics of acute encephalopathy in children in Muzaffarpur, Bihar. Indian Pediatr 2012;49:502-03.
6. Vashishtha VM, Nayak NC, John TJ, Kumar A. Recurrent annual outbreaks of a hepato-myo-encephalopathy syndrome in children in western Uttar Pradesh, India. Indian J Med Res. 2007;125:523-33.
7. Vashishtha VM, Kumar A, John TJ, Nayak NC. Cassia occidentalis poisoning causes fatal coma in children in western Uttar Pradesh. Indian Pediatr 2007; 44:522-5.
8. Panigrahi G, Tiwari S, Ansari KM, Chaturvedi RK, Khanna VK, Chaudhari BP, et al. Association between children death and consumption of Cassia occidentalis seeds: clinical and experimental investigations. Food Chem Toxicol. 2014;67:236-48.
9. Gurley ES, Rahman M, Hossain MJ, Nahar N, Faiz MA, Islam N, et al. Fatal outbreak from consuming Xanthium strumarium seedlings during time of food scarcity in northeastern Bangladesh. PLoS One. 2010;5:e9756.

https://indianpediatrics.net/oct2019/885.pdf

 

[Ronan Kelly]

Uttar Pradesh
Havoc of encephalitis: four innocent victims in one day
Hindustan team, Maharajganj
Last updated: Fri, 25 Oct 2019 11:45 PM IST

Encephalitis has started to wreak havoc in the last week of October. Four innocent people succumbed to the disease on Friday. He was admitted to the encephalitis ICU of the district hospital. Seeing the serious condition of two, the doctors referred him to a medical college. In this way, the district has so far suffered 146 diseases, of which 10 have died during treatment. The health administration has been stirred by the suffering of four innocent people from this disease in one day. Instructions have been given to intensify preventive action in affected wards and villages.

Ranjit (6), a resident of Shiv Nagar Pari ward of Nagar Palika Parishad Maharajganj, was rushed to the district hospital on Friday after he suffered a high fever. Seeing the symptoms of encephalitis, the doctor admitted him to the encephalitis ICU and started treatment. Acute encephalitis syndrome (AES) has been confirmed in Ranjith's serum examination. Similarly, Nandni (3) resident of Maupakad of Municipality area, Divyansh (one and half year) resident of Pipra Sonadi in Chowk area and Nandani (3) resident of Rani Terhi of Purandarpur area were admitted to ICU on Friday with a high fever. Got done. AES has been confirmed in all these investigations.

When the condition did not improve after the primary treatment, the doctors referred Nandani and Safia to the medical college. Ranjith and Divyanshu's condition is improving. Health administration has been stirred when four patients with encephalitis are admitted simultaneously. Instructions have been given to intensify preventive action in the wards and villages of the victims.
https://www.livehindustan.com/uttar...four-innocent-victims-in-one-day-2818088.html

 

[Ronan Kelly]

Kerala
One JE Death reported from KLM: Manikuttan,49/M, D.o.D:25.10.2019, Mancode chithara.
http://dhs.kerala.gov.in/pdf2019/drcd_25102019.pdf

10 confirmed cases, 1 fatal and 61 suspected cases with 6 fatalities.

 

[Ronan Kelly]

GJ/PAN/2019/34/1050 Gujarat Panchmahal
Chandipura
(Viral
Encephalitis)
02 cases 01 fatality 22-08-19 22-08-19 Under Surveillance
Cases reported from Village/SC/PHC Malu, Block
Ghoghamba and Village Bahi, Block Shahera.
District RRT investigated the outbreak. House to
house survey done. Out of 3 blood samples
collected and sent to NIV, Pune; 2 samples were
positive for Chandipura virus (IgM ELISA).
Malathion dusting done in the affected area. Health
education given.

MH/AMR/2019/34/1074 Maharashtra Amravati
Japanese
Encephalitis
06 00 13-08-19 Under
Surveillance
Cases reported from Village Chincholi, PHC Nimboli, Block
Dhamangaon Railway. District RRT investigated the outbreak.
House to house survey done. Out of 06 blood samples were
sent to MGIMS Sewagram Wardha: 04 sample was found positive for JE (IgM ELISA). All cases treated
symptomatically. Entomological survey done. Source
reduction activity and fogging done in the affected area. Health
education given.

https://idsp.nic.in/WriteReadData/l892s/29559503671572417006.pdf

MH/WDH/2019/35/1094 Maharashtra Wardha
Japanese
Encephalitis
01 case 01 fatality 23-08-19 30-08-19 Under
Control
Cases reported from Sindhi (Meghe) Dharka
Nagar Ward no 03, PHC Waifad, Taluk Wardha.
District RRT investigated. Case presented with
complaints of moderate to high grade fever with
chills & rigor followed by irrelevant talk with
episodes of convulsions. Serum sample and CSF
samples were collected and tested at MGIMS,
Sevagram and serum sample was found positive
for Japanese Encephalitis by IgM ELISA, CSF
sample found negative for Japanese Encephalitis.
A total of 07 serum samples of the contacts, were
tested for Japanese encephalitis and Dengue and
all were negative. Sanitation around patients house
was poor. Entomological survey done. Fogging
done and advised to monitor the sanitation
regularly. Health education given.

MH/WDH/2019/35/1126 Maharashtra Wardha
Acute Encephalitis Syndrome
09 cases 01 fatality 16-08-19 Under
Control
Cases reported from Railway Colony Wagholi, PHC Allipur,
Block Hinganghat. District RRT investigated the outbreak.
Case presented with moderated to high grade fever with chills
and rigor, followed by irrelevant talking and altered sensorium,
eventually succumbed. The sibling of the case presented with
fever and convulsions, is stable. A check for absenteeism was
done at school and it was found that 13 students were absent, a
total of 04 samples were collected from school. Serum sample
and CSF samples were collected and tested at MGIMS,
Sevagram. CSF samples were negative for Japanese
Encephalitis.
Serum sample was found positive for Japanese
Encephalitis by IgM ELISA. All cases were treated
symptomatically. It was observed the railways quarter is
surrounded by bushes and shrubs, tanks in all residence were
positive for larval breeding and sanitation was very poor. Rapid
fever survey conducted in the area. Station master advised to
keep the area around quarters clean. Health education given.

 

[Ronan Kelly]

India’s worst-hit state for encephalitis turning a tide

By Biswajeet Banerjee | AP
November 1, 2019 at 10:17 p.m. EDT
...

Dr. R.N. Singh, who has battled the disease in the state for the last 25 years, said there was no way to independently verify the government’s claims, but that a decline in encephalitis cases was visible.

“Earlier, I used to examine two to three encephalitis cases in a week, but now one case comes in a month or so,” he said.
...
https://www.washingtonpost.com/worl...6185ec-fd16-11e9-9e02-1d45cb3dfa8f_story.html

To me - this important independent evidence of success in Uttar Pradesh. Dr. Singh has been an advocate of better care for years, - Ro

 

[Ronan Kelly]

https://nvbdcp.gov.in/WriteReadData/...1571401755.pdf

Comment: A&N islands have reported 1 AES death, Andhra Pradesh 4 AES & 3 JE, Arunachal Pradesh 2 AES & 1 JE , Chhatisgarh 2 JE, D&NH 1 AES, D&D 1 JE, Gujarat 9 AES and 5 JE, Chandigarh 37 AES, Haryana 2 AES, Karnataka 16 AES and 3 JE, Madhya Pradesh 6 AES and 6 JE, Kerala 3 AES and 7 JE, Maharashtra 49 AES and 9 JE, Meghalaya 8 AES and 1 JE, Nagaland 2 JE, Odisha 2 AES and 111 JE, Rajasthan 36 AES and 45 JE, Tamil Nadu 12 AES and Telengana 5 AES in NHRM reports to October 12. Media in Bihar has reported 212 total AES deaths (157 in Muzaffarpur & 55 in other districts), There have also been reports of 1 death Uttarakhand. Combined, this brings the total number of fatalities to 1,072. These numbers should not be considered as complete - Ro

 

[Ronan Kelly]

Google translation: अंकंडे छुपा कर बीमारी ख़त्म करने के प्रयास में बच्चों को वह इलाज नहीं मिला जो मिलना चाहिए था मिले दस्तावेजों से पता चलता है कि इस वर्ष जनवरी से अब तक AES के 492 केस हुए जिसमें जेई पाजिटिव 116 थे और AFI के 1563 केस रिपोर्ट हुए जिसमें जेई पाजिटिव 215 पाए गए

In an effort to end the disease by hiding the marks, the children did not get the treatment that should have been received.
Documents found show that since January this year, 492 cases of AES were reported in which JE positives were 116 and AFI 1563 cases were reported in which JE positives were found 215.

https://twitter.com/drkafeelkhan/sta...80250215780352

Again suggestions that many AES cases in Uttar Pradesh are not being reported as such but are being classified as Acute Febrile Illness. Very sad if this is the case. Politically motivated lies do not help save lives. - Ro