Whose failure? Encephalitis kills 50,000 in 30 years

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

All pigs to be screened in capital for JE virus
PTI | 08:12 PM,Dec 21,2011
New Delhi, Dec 21 (PTI) To check spread of Japanese Encephalitis in the city, Delhi Government today ordered screening of all pigs which are primary reservoirs of virus causing the disease. Health Minister A K Walia, at a meeting with top officials of his department as well as civic agencies, also issued direction for regular lifting of blood samples of pigs to ascertain prevalence of the virus. Domestic pigs are primary reservoirs of the virus and the disease is mainly spread through mosquitoes belonging to Culex tritaeniorhynchus if they bite humans after drawing blood from infected pigs.

...
http://ibnlive.in.com/generalnewsfe...-screened-in-capital-for-je-virus/940752.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Inter-departmental panel to monitor Japanese encephalitis prevention plan
Aarti Dhar
Share ? Comment ? print ? T+ Centre and States will share cost of Rs. 3,355-crore on a 90:10 basis

The National Programme for Prevention and Control of Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES), proposed by the Group of Ministers, will be monitored and supervised by an inter-departmental committee chaired by the Union Health Secretary. The cost-sharing for the implementation of the programme between the Centre and States will be on a 90:10 basis.

The Rs. 3,355-crore programme, to be rolled out in phases, will be jointly implemented by the Ministries of Health and Family Welfare, Drinking Water and Sanitation, Social Justice and Empowerment, and Women and Child Development. The largest chunk of money will be spent by the Ministry of Drinking Water and Sanitation, amounting to Rs. 2,301.57 crore, followed by the Ministry of Health and Family Welfare's Rs. 864 crore. The estimated cost to the Women and Child Development Ministry will be Rs. 177 crore and the Ministry of Social Justice and Empowerment will shell out Rs. 11.5 crore.

To be set up with the goal of reducing morbidity, mortality and disability in children due to the JE and AES, which claim hundreds of lives every year and leave hundreds physically and mentally disabled, the programme will deal with strengthening and expansion of JE vaccination in affected districts, strengthening surveillance, vector control, timely referral of serious cases and increasing access to safe drinking water and proper sanitation facilities to the target population in affected rural and urban areas.

...

http://www.thehindu.com/health/policy-and-issues/article2745198.ece

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Rs 2,000cr budgetary sop likely to combat Japanese Encephalitis
Kounteya Sinha, TNN | Dec 26, 2011, 04.29AM IST

NEW DELHI: India will announce a national programme to the tune of nearly Rs 2,000 crore to combat Japanese Encephalitis and Acute Encephalitis Syndrome (AES) in the upcoming Union budget.

...

The health ministry would require about Rs 1,600 crore for the national programme over the five-year period. "The budget will for the first time announce a separate allocation for the targeted intervention for JE and AES," an official told TOI. Initially, the drive will be rolled out in 60 districts in five states - West Bengal, Bihar, Uttar Pradesh, Tamil Nadu and Assam, and would include expansion of JE vaccination in 62 new districts, establishment of ICUs in 60 priority districts and would be a multi-pronged strategy to include safe water, sanitation, nutrition, community education, medical attention and rehabilitation.

Shallow hand pumps will be replaced by deep bore hand pumps in AES-affected districts, while the most undernourished children will be identified and provided higher nutrition to fight the virus.

...


JE/AES is a major public health challenge, and mostly children below 15 years are affected. About 25% of affected children die and, among survivors about 30%-40% suffer from physical and mental impairment.

This year, 861 deaths have been reported so far, and 70%-75% of the disease burden is in Uttar Pradesh. (latest nvbdcp figures 1,064 fatalities with 51% in UP http://nvbdcp.gov.in/je-cd.html - Ro)

http://timesofindia.indiatimes.com/articleshow/11248911.cms

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Encephalitis campaign in the affected villages
Jan 02, 02:20 am

The specific plan
- The government's special efforts to protect children village Consolidated Plan
- Nutrition, hygiene, health and education will focus on
- Health Department in the current financial year the goal was to start
- Up to 15 villages selected blueprint instructions
- Will DM Coordinator, will be the cooperation of various departments
- Development will be the support of friends
Rakesh Kumar, Muzaffarpur: Encephalitis will no longer child's life. Protect children from the terror of meningitis in due course of time the government has stepped up the exercise. The plan will be specific to the affected villages. Health Department Principal Secretary, DM, SP and civil surgeon Skemsiac necessary direction in this regard - have directed.
प्रधान सचिव ने चालू वित्तीय वर्ष में ही समेकित योजना को प्रारंभ करने के लक्ष्य रखे जाने की जानकारी देते हुए 15 जनवरी 2012 तक योजना को तैयार कर लिए जाने की बात कही है। Have been told that district meningitis (encephalitis) to the affected villages will be a special village-level action plan. Children with nutrition - with clean, Mahadlit settlements vaccination, clean water, toilets, etc. It will focus on critical needs. Campaign for Mahadlit cluster development is planned to include friends. Principal Secretary, based on records of previous years were instructed to select the sensitive villages where patients suffering from the disease occur annually. They play a coordinating role in DM Plan is requested. The district also cooperate with other related departments have been asked to.
What's Encephalitis: This is a fatal disease in which the patient has fever with high-frequency vibrations. Body temperature drops to 104 degrees. The patient's mouth begins to foam. Whole body occasionally is too stiff. The disease is not treated properly and immediately life goes on. Outbreaks of the disease is more common in children. The 2011 outbreak in the district by June 11 to mid-July. The deaths of 66 children. Not only several blocks of the district close to the disease every year in a half-dozen villages that Brpata havoc. In 2011 to explore the unknown disease, Pune, Patna and core team members visited the affected areas. Consisting of patients symptoms. The team from many places mosquitoes, pig, rat, cat and took samples of many other animals. Even resort to the brain tissue was taken for detection of disease, but so far it is not traceable.
Block affected villages: District Kanti, MOOSHAHARY, Meenapur, Bochan, Motipur, Skra blocks many of the villages are affected. These villages mainly Gangapur, Bahadurpur, Snati, Bndhara, Siwaiptty Bangra, New Village, Snghri, old Dharari Turkey, Ganjti, Mithanapur, Manikpur, Mohamadpur Drdha, Raini, Nkta, Jingha, Phadhck, Madhopur Ahiapur, Blmi Sahebganj, Kfen , Baria, Mdhuvn, Mitnsray, Madhopur, Pirapur etc.. Motihari and Sitamarhi in 2011, many areas of patient treatment in the district were suffering from the disease.

http://in.jagran.yahoo.com/news/local/bihar/4_4_8711576.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Encephalitis on party manifestoes, not in their campaigns

SURBHI KHYATI : Gorakhpur, Thu Feb 02 2012, 00:06 hrs


After 4,000 deaths and 19,000 victims over seven years, encephalitis has made it to the election manifestoes of most parties in Uttar Pradesh in 2012. On ground zero in eastern Uttar Pradesh, however, it is still to figure in the candidates? campaign.
Voters are angry and frustrated but say they are not surprised. Some are determined not to vote at all on February 8 and 11, when the seats in these areas go to polls.

...
?In spite of the issue featuring in their manifestoes for the first time, the local candidates of parties are just not talking about the issue,? says Dr Singh. Blaming the people for not putting adequate pressure on candidates, Dr Singh has prepared a seven-point questionnaire for parties that is being distributed to villages for the public to raise.

The candidates are more content talking about the usual poll issue of infrastructure, like roads and electricity. In Dumrikhurd village of Chauri Chaura, Zulekha Bano?s 10-year-old son Shamsher is unable to hear or talk and do basic functions following a bout of encephalitis. Both Rahul and SP state president Akhilesh Yadav have been to Chauri Chaura the past month, holding poll meetings. Zulekha says she never heard of them.

Says Bindu Awadhesh Singh, a social activist of Chauri Chaura: ?Like previous times, voting will be on caste equations. Local issues will not decide who wins or loses the seat.?

In the Pipraich constituency, where encephalitis has killed three in the past month, local issues of electricity supply and sanitation dominate the poll debates. ?The candidates are not talking of encephalitis, and the people are not bothering to raise the issue either,? said Sumeshwar Prasad, one of the ward members of Pipraich.
...

http://www.indianexpress.com/news/encephalitis-on-party-manifestoes-not-in-their-campaigns/906701/0

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Patna high court seeks government report on encephalitis
Nishant Sinha, TNN | Apr 7, 2012, 02.46AM IST

PATNA: The Patna high court on Friday directed the state government to file a detailed report on the steps taken to check the break out of encephalitis in Gaya district this summer. The disease breaks out every year in Gaya and its surrounding districts and had last year claimed the lives of around 80 children.

In November 2011 too, the court had asked the state government to submit a detailed report on the measures it had taken to treat and control encephalitis cases, especially in Magadh region.
...
http://timesofindia.indiatimes.com/...port-on-encephalitis/articleshow/12564063.cms

`Coordinated efforts needed to tackle water-borne diseases`
Last Updated: Friday, April 06, 2012,20:43

New Delhi: Concerned over the contamination of water by arsenic and other elements, the Ministry of Drinking Water and Sanitation has sought "greater convergence? with the Ministry of Health to deal with the menace.

Rural Development Minister Jairam Ramesh, who also holds the portfolio of Drinking Water and Sanitation, has written to Health Minister Ghulam Nabi Azad seeking "greater convergence" between two Ministries to prevent the water-borne diseases.
...
"I would like to focus the additional resources we get sharply on projects that deal with water-quality issues like arsenic and fluoride contamination, that have public health
impacts as well as in areas where water-borne diseases like Acute Encephalitis Syndrome/ Japanese Encephalitis have assumed serious dimensions," the Minister said.
...
http://zeenews.india.com/news/healt...ded-to-tackle-water-borne-diseases_16398.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Measures to prevent AES/JE
PTI | 07:04 PM,Apr 24,2012
Patna, Apr 24 (PTI) Bihar government has decided to launch measures for prevention and control of the Acute Encephalitis Syndrome (AES) and Japanese Encephalitis (JE) in the state with focus on Gaya and Muzaffarpur districts where 118 deaths were reported last year due to the twin diseases, an official said today. Under an action plan to control AES in Muzaffarpur and adjoining areas, it has been decided to adopt a standard treatment protocol for early diagnosis, treatment and referral Principal Secretary (Health) Amarjeet Sinha told reporters.
...
http://ibnlive.in.com/generalnewsfeed/news/measures-to-prevent-aesje/990017.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

From Karnataka 2005-2007;

Emerg Infect Dis. 2010 November; 16(11): 1780?1782.
doi: 10.3201/eid1611.100672
PMCID: PMC3294525

Enterovirus 75 Encephalitis in Children, Southern India

Penny Lewthwaite, David Perera, Mong How Ooi, Anna Last, Ravi Kumar, Anita Desai, Ashia Begum, Vasanthapuram Ravi, M. Veera Shankar, Phaik Hooi Tio, Mary Jane Cardosa, and Tom Solomon
...
Enteroviruses are a diverse group, and preferred samples for their diagnosis differ. Species B enteroviruses such as coxsackie virus A9 and Echo viruses B1?6 are usually readily isolated from CSF, unlike species A enteroviruses such as EV71. Although EV75 is a species B enterovirus, we were unable to isolate enterovirus from CSF from any of the patients, although throat swabs specimens were positive. This finding is similar to that for EV71, which has been isolated more frequently from throat swab specimens than from CSF or vesicles (4). In a study from Spain, EV75 was isolated from the CSF of 5 patients and nasopharyngeal swab specimens of 3 patients (3). However, throat swab specimens are rarely obtained in rural hospital settings with limited diagnostic facilities.
Although EV75 infection may have been a coincidental finding for the patients, we believe that this possibility is unlikely because results for other common causes of encephalitis were negative. Results of CSF testing were negative for other circulating viruses, including JEV, dengue virus, and herpes simplex virus, and patients also showed negative results for JEV and dengue virus by ELISA.
Our results illustrate the need to confirm diagnoses of EV75 in a range of specimens and by a range of laboratory investigations. This confirmation is required in India where encephalitis is often diagnosed clinically and recent outbreaks have been attributed to JEV. Laboratory diagnosis is hampered by single samples and high cost and low reliability of diagnostic tests currently available. Our study also shows that EV75 can cause encephalitis, in addition to aseptic meningitis and acute flaccid paralysis. Thus, as for other enteroviruses, throat swab specimens may be especially useful for diagnosis of infection with EV75.
...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294525/

Encephalitis ? a possible solution?

Issue 11: 22 October ? 7 November, 2011 | Dr Apeksha Rao

In this article:

Encephalitis in Gorakhpur
The Holiya model of water purification
The hilly regions of Gorakhpur, Uttar Pradesh look beautiful in the monsoons ? deceptively beautiful, because the rains bring with them an increase in cases of encephalitis, an acute infection and inflammation of the brain.

Till 2006, Japanese Encephalitis (JE), a deadly, mosquito-borne, viral illness, was the reigning terror and the cause of most of the deaths during monsoon, especially in children. Since 2006, the government has been carrying out an extensive vaccination drive against this illness. So the incidence of JE started falling.

Now, the monster has a new face. Since July 2011, there has been a virulent outbreak of encephalitis in Uttar Pradesh, Bihar, Assam, Andhra Pradesh, Karnataka and Tamil Nadu. In the Gorakhpur region itself, over 2,300 people have been admitted to the hospital and over 400 have succumbed to the illness, most of them, children.

According to Dr K P Kushwaha, the head of Paediatrics at the B. R. D. Medical College in Gorakhpur, Uttar Pradesh, this year, it?s worse than before because of a new virus. It is a waterborne virus, an enterovirus, which is released in the faeces, and the faeces contaminates drinking water, or potable sources. This encephalitis is chiefly seen in children, because they don?t clean their hands well and are prone to using contaminated water. There is no vaccine available for this virus.
...
Can it be prevented?

Yes, it can be prevented, and very easily. Dr R N Singh, Chief Campaigner, Encephalitis Eradication Movement, has implemented a very simple water purification method in the village of Holiya, Uttar Pradesh. It is called the Holiya model of water purification, and is based on Solar Water Disinfection (SODIS). It is a method of disinfecting water using only sunlight and plastic PET bottles.

SODIS is a free and effective method for decentralised water treatment, usually applied at the household level and is recommended by the World Health Organization (WHO), as a viable method for household water treatment and safe storage. It requires about 6 hours of midday summer sunshine.

Here?s how it works:

UV-A (Ultra Violet-A) interferes directly with the metabolism and destroys cell structures of the bacteria.
UV-A having wavelength 320-400 nm (nanometre), reacts with oxygen dissolved in the water and produces highly reactive forms of oxygen (oxygen free radicals and hydrogen peroxide), that can damage pathogens (disease-causing microorganisms).
Cumulative solar energy (including the infrared radiation component) heats the water. If the water temperature rises above 50?C, the disinfection process is three times faster.
At water temperatures higher than 45?C (113?F), synergistic effects of UV radiation and temperature, further enhance the disinfection efficiency.
...
http://sation.in/?page_id=1093


SODIS - Safe drinking water in 6 hours


Solar water disinfection - the SODIS method - is a simple procedure to disinfect drinking water. Contaminated water is filled in a transparent PET-bottle or glass bottle and exposed to the sun for 6 hours. During this time, the UV-radiation of the sun kills diarrhoea generating pathogens. The SODIS-method helps to prevent diarrhoea and thereby is saving lives of people. This is urgently necessary as still more than 4000 children die every day from the consequences of diarrhoea.

SODIS (abbreviation of Solar Water Disinfection) is an initiative of Eawag. We facilitate the dissemination of the SODIS-method in developing countries. Thereby people in the south get access to safe drinking water and can improve their health in the long term.
...
http://www.sodis.ch/index_EN

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

The model village

Since 2003, Holiya village in Kushinagar has seen five deaths and four cases of handicap due to Acute Encephalitis Syndrome (AES).
In 2007, 15-year-old Sanju survived the viral infection but could not recover fully. She was unable to move her limbs, her speech was impaired and she would scream for no reason. After months in hospitals, she can now walk. But her arms are still stiff and speech is affected.

Another victim is Shailesh, a standard III student. Like Sanju, his arms are also twisted and speech is impaired. His ability to learn and understand in the classroom is poor. He often cries in school.

People in the village figured out how to fight the disease. They got rid of stagnant water, opened clogged drains and spread awareness.

In the battle to save their children, they improved the methods of sanitation and hygiene with help from R N Singh, a paediatrician from Gorakhpur. They collected water from handpumps sunk by government. This water, when stored in buckets, covered with white cloth and kept under the sun for six to eight hours becomes good for drinking. ?The ultra violet rays of the sun kill the virus,? says Singh.

Parents were also asked to make their children wear full sleeves clothes, use mosquito nets at nights and ensure they did not go near paddy fields. With these basic preventive measures, Holiya did not get any case of AES this monsoon.
...
http://www.downtoearth.org.in/content/fever-stalks

NDMA impressed solar water purifier designed by doc
WEDNESDAY, 23 NOVEMBER 2011 21:51 FAISAL FAREED | LUCKNOW
An indigenous model of solar water purifier designed by a Gorakhpur doctor will be adopted across the country for providing safe drinking water.

Vice-Chairman of National Disaster Management Authority (NDMA), Shashidhar Reddy, during his visit to Gorkhpur on Tuesday, announced adoption of the model.

Reddy was asked by Congress general secretary Rahul Gandhi to visit the poorvanchal region of the state and he visited Gorakhpur.
...
http://www.dailypioneer.com/state-e...sed-solar-water-purifier-designed-by-doc.html

Sun as water purifier a hit in encephalitis-hit Gorakhpur

SURBHI KHYATI : Lucknow, Mon Oct 24 2011, 06:18 hrs
...
?We have decided to adopt a village which is worst hit by encephalitis in the season. Dr Singh will provide technical expertise and we will arrange for all the funds required,? said Jaiswal, president of Sanyukt Vyapar Mandal, Gorakhpur.

The campaign is expected to begin in the new villages in January. ?As this is the encephalitis season, we will not be able to start the campaign in other villages now. After winter sets in, we will be able to start the campaign and take all measures to prevent the spread of the virus for the next six to eight months,? said Singh.
...
http://www.indianexpress.com/news/sun-as-water-purifier-a-hit-in-encephalitishit-gorakhpur/864663/2

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

After Ward began the construction of Encephalitis
May 15, 01:13 am

Gorakhpur: Medical College of encephalitis patients in the ward for the treatment of one hundred Bedon had to be ready by this month, the building began to go now. Nearly six months after receipt of funds in November on Monday laid the ground work on the college campus has begun. Although construction has been delayed and that under no circumstances is this year expected to benefit patients.
According to sources, officials at the recent meeting in Lucknow with Principal Secretary in the carrying case was a delay in the construction of the ward. The government began to intervene. CMO Dr. RN Mishra, the first day of water pipelines were built as well as the site office.
Tell the September 24 last year 2011, the then Chief Secretary of the State Medical College, visiting Anoop Mishra and lack of equipment on a bed looking at three to four patients in Medical College Campus hundred Bedon said construction of the encephalitis ward was. That same evening, two hundred million rupees to the then Chief Minister Mayawati Encephalitis ward declared to be released. It also twelve crore for construction of wards, 6 million to 88 million devices and the rest were for other purposes. Chief Secretary to the requirements relating to the ward on September 29 with Dr. KP Kushwaha of the called Lucknow. On November 5 after a week the amount of 20 million account came to Gorakhpur District Health Committee. Ward to build 12 million were transferred to the Public Works Department. December 23 of the Divisional Commissioner of Gorakhpur. Ravindra Naik, Medical College Campus hundred Bedon has laid the foundation stone of the encephalitis ward, but it was not until the arrival of the ward.
...

http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_9255023.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Gates foundation to invest in UP?s health, agri sectors
Lucknow, May 30, 2012, DHNS:
Co-chairman of Bill and Melinda Gates Foundation, Bill Gates assured Uttar Pradesh  Chief Minister Akhilesh Yadav on Wednesday that the Foundation will work in partnership with the state to develop the latter?s health and agriculture sectors.

Official sources said the issue of health occupied centre stage of the discussions. The problem of Japanese Encephalitis (JE) and TB, which have afflicted large parts of the state, were discussed.
...
http://www.deccanherald.com/content/253380/gates-foundation-invest-ups-health.html

Akhilesh ropes in Gates Foundation for healthcare

SPECIAL CORRESPONDENT

The Akhilesh Yadav government and the Bill & Melinda Gates Foundation have agreed to work in tandem on maternal, neonatal and child health care, as well as in agriculture-related programmes in Uttar Pradesh. The Foundation will provide technical management and programme design support.
...
According to an official spokesman, Mr. Yadav apprised Mr. Gates of the poor health indicators, particularly the maternal mortality rate, the infant mortality rate, low level of immunisation and malnutrition among children. He also mentioned about the incidence of vector-borne tuberculosis, Japanese encephalitis and the Acquired Encephalitis Syndrome in some regions.

...

Mr. Gates assured the Chief Minister of full support in developing innovative solutions. Catalytic, technical, managerial and advocacy support would be provided. He indicated the Foundation's keenness to develop partnership in the priority areas of maternal and neonatal health, nutrition, routine immunisation, introduction of new life-saving vaccines, consolidating the gains of polio immunisation and family planning through access to modern contraceptive methods.
...
http://www.thehindu.com/news/states/other-states/article3474078.ece

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Uttar Pradesh:

JE in the war were unarmed innocent
Jun 11, 10:47 pm

Gorakhpur: Purvanchal during the war of the Japanese Encephalitis again innocent will be unarmed. To be the most effective way to combat the disease by vaccination has been deprived Purvanchal this time. JE vaccination in May this year, the government said, but he has put paid to this plan. This area has once again increased risk of disease.
This year, 34 districts in the province, including Gorakhpur Medical College, all 5581 patients admitted to public hospitals, of which the number of mosquito-borne Japanese encephalitis patients in 1042 (around 19 per cent) of these patients in which three-quarters of more than just Purvanchal
Gorakhpur - the township board. JE vaccine the first time the government decided in May 2006 - June Gorakhpur Purvanchal - Township Board has seven districts vaccination. The effect of vaccination, the number of patients this year compared to 2005 saw the half fell down. The 2007 and 2008 were lower in patients of Japanese Encephalitis. Vaccination reduced the number of patients after the government closed in Purvanchal. The result is that once again the number of patients of Japanese Encephalitis in 2009 reached 11 percent. The 2010 also are not looking at the number of patients with JE, the government in November, Gorakhpur - Basti on the board once again be vaccinated. Showing the effect of the campaign last year, down only ? the number of JE patients, six per cent.
Given the impact of vaccination for control of JE vaccine in May this year the figure spoke. Purvanchal people expected the government to move once again get relief from this deadly disease, but this time for the government to make up.
http://in.jagran.yahoo.com/news/local/uttarpradesh/4_1_9359227.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Plan for potable water in 15 encephalitis-hit districts
Faizan Ahmad, TNN | Jun 18, 2012, 05.08AM IST

SITAMARHI: The Union rural development ministry has identified 60 districts in five states, including 15 in Bihar, hit by Japanese Encephalitis (JE) or Acute Encephalitis Syndrome (AES). Hundreds of children die due to the disease in these states every year.

The medical experts have suggested that this disease is largely because of unhealthy drinking water supply and lack of cleanliness in rural areas, said Union rural development minister Jairam Ramesh on Sunday. "If the state governments give proper attention to supply of potable water, this epidemic can be checked to a great extent," he said, adding that he has asked the state governments to send proposal to his ministry for additional assistance.
...
The JE or AES affected 15 districts identified by the centre are: Araria, Darbhanga, Gaya, Gopalganj, Jehanabad, Muzaffarpur, Nalanda, Nawada, West Champaran, Patna, East Champaran, Saran, Siwan, Vaishali and Samastipur. The other states to be benefited are: UP (20 districts), Assam and West Bengal (10 each) and Tamil Nadu (5).
...
http://timesofindia.indiatimes.com/...alitis-hit-districts/articleshow/14222649.cms

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

INDIA: An ode to 'lesser' people's death

July 10, 2012

Avinash Pandey

Come June, and Indian media has a welcome break from the dearth of positive news. They do not need to repeat telecast the same scams, neither they are forced to fill their 'news programs' with this soap opera or that comedy show running on countless entertainment channels. They get their OB vans chasing monsoons right from Kerala all the way down to foothills of Himalaya with their young and chirpy reporters getting drenched in the pours.

In a country where most of the agriculture is rain-fed, the obsession with the onset of Monsoon is completely understandable. Here, monsoon cannot be anything other than most welcome. Unfortunately, that is not the case everywhere. In some parts of the country, any news of its onset makes people tremble with fear. That is despite the fact that even their agriculture is dependent upon monsoons. Monsoon, for them, is harbinger of death and destruction. In these parts of the country, it does never come alone. It brings in Acute Encephalitis Syndrome (AES) and the Japanese Encephalitis and takes their children away.

It had killed more than a thousand children last year, 884 of them by 15 November, as admitted by the minister of state for health and family welfare Mr. Sudeep Bandhopadhyay in the Rajya Sabha. 501 of them are from Uttar Pradesh alone. The government, on its part, made all the noises it had made the year before, and the year before that. It promised to develop an 'indigenous' vaccine that would reach areas where the disease is endemic, by February this year. Just that the vaccines did not reach all the needy children and death count was pegged at 492 by 30 June. That is well before the monsoon reaching eastern Uttar Pradesh, the area worst affected by the disease.

That a curable disease could kill more than thousand children every year should in it be enough to shame the governments, both at the provincial and central level? The fact that it is one that has a vaccine makes government's inaction nothing less than criminal. Seen in this light, the children are not dying, they are getting killed. And the government of India is complicit in the crime on account of its failure in providing the affected areas with vaccination and quality medical service to save the lives it is duty bound to protect.

Worse even, the story is going on unabashedly for 34 years now and even the most conservative estimates put the number of total deaths at nothing less than 34000. And these estimates are really conservative as they do not factor in the massive underreporting of cases for many of the victims do not even get to reach the hospitals. Neither do they take inaccessibility of many villages during rainy season into account. This is why that social activists and local media put the estimates on a staggering high 50000, and then add a note of caution. For them, even this figure is a conservative estimate though not the most conservative one.

All this happens when the government has all that takes to control this annual dance of death. It has 54 Sentinel and 12 Apex Referral Laboratories dedicated for maintaining surveillance and prevent deaths scattered across the country. That the set up has failed terribly is evidenced by the sheer volume of deaths this year, 492 to repeat, that too by 30 June, or before the onset of proper rains. Getting to why of this failure, opens up a Pandora box of apathy, inaction and ignorance of those in power. All their initiates do not fail after all. There had been instances of outbreaks of diseases where the powers of the Indian state had much to not only control such outbreaks but also almost eradicate it.

The recurrent outbreaks of Dengue in Delhi in the last decade are proof to this. The government went on an overdrive to control the menace and brought down instances of Dengue to a considerable extent in a short span. It has kept itself prepared ever since. There are regular cleanliness drives with a team of dedicated officers to deal with the disease. There are mobile squads to check sources where mosquitoes could breed. These mobile squads go even inside private houses to check the electric coolers, flower pots and all that could contain stagnant water and are authorized to fine the household if they could find mosquitoes.

Why do, then, the authorities not show the same enthusiasm for controlling the disease in places like Gorakhpur, Deoria or Kushinagar? Are these places any less part of the Union of India than Delhi? Or the people living in such poor and impoverished places any 'less citizen' than those who live in flashy metropolitan cities? What then explain the authorities' overzealous reaction to the woes of one of them and an almost criminal negligence of the other? The point begets another question about the media's silence over the issue.

Well, nothing to deny that media does report this. In fact, all the data I have here is found through media reports. But then, there is a definite pattern in the way media reports this issue. They would run a stray editorial in the print. All those channels would run a few stories. And then they will bury it all to run it roughly the same time next year. All that would change would be the names of the victims with even the theaters of this tragedy remaining the same.

Compare this with the same media reporting cases that are close to its heart. Remember all those Justice for Jessica campaigns that the same media ran. Or the outrage it carried in its reports while Delhi was slowly becoming the rape capital of India. Or the anger that resonated through our television sets when a top cop found guilty of sexually molesting a young player to the extent of driving her to commit suicide was let off with almost no punishment. The media do not get silent over these cases, it should not, either.

Everyone deserves justice in a country where the rule of law prevails. All just causes should be taken up with the same intensity and media is well within its rights to shape a national conscience against such injustice, such ghastly violations of our fundamental rights.

Why does, though, the same media get so eerily silent over these deaths, killings to be precise? Why does it not shame the authorities into action? Why does it not organize panel discussions with experts debating the issue and the middle classes watching it with all that horror on their faces that the enormity of the issue generates? Are these people any less than the one the media is concerned about? Perhaps yes, for these people are not the ones who become 'us' to the media. They are not their people. They are neither from their class nor their caste. Their deaths should still concern the media as killings in faraway places like Syria bother it, does not it? Why does it remain silent on this one then?

The answer lies in the fundamental flaws that define our deficient democracy. It lays in those structures of inequality that have produced a political culture where some people are more equal than the others. It lies in that phantom limb of caste that has gotten engrained into the fa?ade of all those democratic mechanisms, which form the base of our claims of being the largest democracy of the world.

It lies in the idea of hierarchy that dehumanizes certain sections of our society to the extent that they become easily expendable. They remain invisible for all practical purposes. Their lives come real cheap. The only thing that matters about them is their labour that this future super power needs. The problem is that even this labour comes in abundant supply. Death of a few thousand every year does not matter much; there is always plenty of replacement. That is why a state like Uttar Pradesh can afford to spends 685 crores on a park and 18 crores on Japanese Encephalitis.

For the authorities they are not human beings, they are population. Have they not been taught, then, all their lives that population is a problem, in fact the biggest problem of India? And if they are the population, then they are the biggest problem and dispensable therefore. That explains the silence and the absence of all that anger that should be generated by such criminal loss of human lives. The explanations, though, do not absolve anyone. The media, the civil society and the government, all remain complicit in these murders most foul.

Mr. Pandey, alias Samar is Programme Coordinator, Right to Food Programme, AHRC. He can be contacted at avinash.pandey@ahrc.asia
http://www.humanrights.asia/news/ahrc-news/AHRC-ART-066-2012

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Government releases more funds to fight Japanese Encephalitis


New Delhi, Aug 28 (IBNS) The Ministry of Drinking Water and Sanitation has allocated additional Rs 525 crore ($94.5 million - Ro) in 2012-2013 to the states facing the problems of chemical contamination in drinking water and which have Japanese Encephalitis and Acute Encephalitis Syndrome(JE/AES) affected high priority districts.

Rural Development Minister and the Minister of Drinking Water and Sanitation Jairam Ramesh said in reply to a question in the Rajya Sabha on Tuesday that this allocation is in addition to the normal allocation under NRDWP to the States including Uttar Pradesh and Bihar from which upto 67% of the budget can be used for provision of safe drinking water, including in these districts.

The Minister said, in JE/AES affected districts, states can take up activities like conversion of public shallow hand pumps to India Mark 11/111 hand pumps, provision of mini-water supply through Stand posts, regular chlorination of affected sources, providing proper platforms for hand pumps/ borewells, soakage pits etc, apart from awareness generation and solid and liquid waste management.


2012-08-28
http://www.newswala.com/Internation...nds-to-fight-Japanese-Encephalitis-15850.html

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Uttar Pradesh fails to tame encephalitis
TNN | Sep 2, 2012, 04.14AM IST


LUCKNOW: It seems that the Uttar Pradesh government has failed to save children in eastern districts of the state from the clutches of the deadly encephalitis this year too. And if, official figures of the state health department are to be believed, then since January, 210 lives have been lost to the disease this year. Out of this as many as 189 are children, while rest are adults. The count of those taken ill has crossed 1,000 and has settled at 1,023.

Interestingly, the arrangements promised to curb the disease and deaths are yet to see light of the day.
...

Sample this: The government had directed to procure 102 ventilators to set up ten-bed intensive care unit in district hospital of the affected districts. But, the procurement is still underway. Then, the state government directed officials in the Panchyati Raj department to re-bore 13,950 India Mark-II hand pumps to ensure that the drinking water supplied to the people is safe. But, so far only half the target has been achieved.

...

The facts came to fore at a meeting to review state's preparedness to fight encephalitis. Chief secretary Jawed Usmani, who presided over the meeting, pulled up officials for showing insensitivity and laxity towards the problem. On May 22, state government cleared projects worth Rs 602 crore to check the dreaded encephalitis, which has claimed more than 5,000 lives in the past seven years. The government acted after Centre agreed in principle to allocate funds generously to save children from the Acute Encephalitis Syndrome (AES) and Japanese Encephalitis. A month later, funds came but officials in UP failed to implement plans and deliver results. What ever little has happened is because of the efforts undertaken by local administration for vector control.

"The peak season when ambulances can actually play a life-saving role would be over in October. This shows poor planning," said Dr RN Singh, Gorakhpur-based paediatrician who has been working to eliminate encephalitis for the last 32 years.

...

http://timesofindia.indiatimes.com/...to-tame-encephalitis/articleshow/16169474.cms

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Encephalitis deaths in India - The same story of poverty, neglect, disaster and disease, but for how long?
Submitted by aarti on December 2, 2011 - 10:15
Guest post by : Aarti Kelkar-Khambete

The encephalitis episode aptly indicates that temporary solutions that do not seek to address the root of the problem cannot help and that there is a risk that one problem gets replaced by another, like Japanese encephalitis being followed by viral encephalitis. The time has certainly come to end the long wait and the plight of the poor who continue to be deprived of basic health and sanitation needs in the area
Following the news on extensive rainfall in the north and south of the country and reports of heavy flooding in the north and the east, the story that has been making headlines has been that of the rapid spread of viral encephalitis in the northern parts of the country, with the most severely affected being Gorakhpur district in Uttar Pradesh, which has witnessed one of the worst outbreaks.
Current figures indicate that the cumulative death toll of encephalitis in Purvhanchal and adjoining regions of Gorakhpur, Uttar Pradesh has reached 488 with a majority of them being children [9] according to the October 25th 2011 figures while, 3088 patients have been admitted to the hospital since January this year [9] with between 30 to 40 patients being brought in for treatment everyday [11].
At present, over 280 encephalitis patients are undergoing treatment at Baba Raghav Das (BRD) Medical College and in the nearby district hospitals [9]. 10 deaths have been reported in the last four days [9] according to the 25th October 2011 figures.
What is encephalitis?
Encephalitis is an acute inflammation or swelling up of the brain caused mostly due to a viral infection. Acute encephalitis syndrome generally includes two types of infections, Japanese encephalitis, which occurs due to mosquitoes, and enteroviral encephalitis [1]. Enteroviruses include various viruses that enter the body through the gastrointestinal tract. They account for between 10 - 20% of viral encephalitis cases. Enteroviruses can spread through food or water contaminated by trace amounts of faecal material and through sneezing and coughing [4] The viral encephalitis infections that have been reported in Gorakhpur in Uttar Pradesh have been suspected to be due to contaminated water.

Encephalitis can begin with flu-like symptoms such as:
High temperature
Headache
Nausea and vomiting
Joint pain
More serious symptoms can include:
Changes in mental state, such as confusion, drowsiness or disorientation
Seizures (fits)
Changes in personality and behaviour
Other symptoms of encephalitis can include:
Sensitivity to bright lights
Inability to speak
Inability to control physical movements
Stiff neck
Hallucinations – seeing and hearing things that are not actually there
Loss of sensation in certain parts of the body
Partial or total vision loss
Involuntary eye movements, such as moving the eyes from side to side
Involuntary movements of the face, arms and legs [5]
Infants and the elderly are particularly at risk of severe illness [6]. The severity of viral encephalitis depends on the particular virus and how quickly treatment is given. The acute phase of the illness lasts around one or two weeks, and the symptoms either disappear quickly or subside slowly over a period of time. However, if the person does not get prompt treatment, then he or she can be left with varying degrees of brain damage, which may require long-term supportive care and therapy [7].

Encephalitis in Gorakhpur: The context

There are three peculiarities in the context of encephalitis in Gorakhpur. Firstly, this is not the first time that cases of encephalitis have been detected in Gorakhpur. The first case was detected as far behind as 1978 and nearly 6,000 children have died of encephalitis in the hospital since then.
However, until 2005, the majority of deaths were caused by Japanese encephalitis, caused by a mosquito-borne virus. But in the past six years, these cases have dropped and children have been dying of another form of viral encephalitis, which has been feared to be transmitted through contaminated water. Thus, the type of virus and the mode of transmission have changed.

Secondly, children in the age group of six months to 15 years are the worst affected and most of the victims have been found to be from poor economic backgrounds and from rural areas [2]. Also, most of the deaths this year have happened since July. The disease occurs regularly during the monsoon in the Gorakhpur region bordering Nepal in the foothills of the Himalayas. The low-lying areas are prone to floods and water-logging.
Lack of adequate sanitation facilities coupled with the regular habits of defecating out in the open often leads to the possibility of water getting contaminated with faecal matter. This increases the possibility of drinking water getting contaminated where water is consumed by people in the village using shallow hand pumps [8]

It has proved to be a tough challenge to deal with viral encephalitis as compared to Japanese encephalitis, since controlling it will require a vast improvement in sanitation and drinking water supply in rural areas [2]. The collapse of the health system and water and sanitation mechanism in the area has further complicated matters making it necessary to deal with the situation on an urgent basis [1].
Experts inform that around 30,000 people may have been left disabled by the diseases since they were first detected in 1978 and government records show that 15,000 have died, and another 15,000 are permanently disabled [10].

Concerns raised by the epidemic

The intensity of the epidemic this year has raised a number of uncomfortable questions that shed light on the government apathy towards dealing with the problem in a systematic manner. For example, the very fact that the problem is not a new one and that it has been repeating every year during the monsoons indicates the lack of efforts made at understanding the problem and planning coping mechanisms to deal with the problems due to flooding and water logging in the area.

Lack of existing water and sanitation systems have been found to exacerbate the problem in an area that is already a rural, poor and neglected one, where people still continue to practice open defecation. Flooding has been found to worsen the situation where water contaminated with faecal matter contaminates water sources used for drinking purposes by people in the area. This calls for a need to improve the existing water and sanitation systems in the area with plans in place to deal with the situation in cases of disasters such as floods.

Efforts made by the government to tackle the situation have been found to be equally ineffective and directionless. For example, the state government had disbursed millions of rupees from a federal (central government) health programme for treatment of patients at the state-run BRD Medical College in 2009. Part of this money was spent in hiring 135 researchers, doctors and paramedical staff to beef up treatment. However, most of the money ran out by August, leaving only 36 of them receiving regular salaries, say authorities [2].
Recent news indicates that following criticism from the National Disaster Management Authority (NDMA), a high-level committee of experts has now been constituted in the Ministry to deal with the encephalitis problem. Following discussions between the Union Health and Family Welfare Minister who visited the site and the State and Central government officials, it has been realised that the acute encephalitis syndrome (AES) needs to be dealt through a multi-pronged strategy that would require involvement of mainly the Ministries like Drinking Water and Sanitation as well as Social Justice and Empowerment and Women and Child Development [12]. The Ministry of Drinking Water and Sanitation has recently released guidelines on the course of action to be undertaken for Provision of safe drinking water in districts affected with Japaneses encephalitis in the state. According to the latest information, an Inter-departmental panel chaired by the Union Health Secretary has been constituted to monitor the Japanese encephalitis prevention plan [13].
The encephalitis episode thus calls upon an urgent need to set right a number of lacunae in the public health system in the area that include:
Setting right the already broken down systems such as sanitation and provision of pure drinking water in the area
Dealing with the regular problem of water logging and flooding in the area by establishing and planning of disaster management systems to cope with problems arising in case of such events
Establishing regular monitoring systems to take care of and deal with the epidemics arising during the floods
Strengthening the already existing public health system to deal with such emergency situations, better preparation against water-borne and vector-borne diseases
Time and again, evidence has indicated that providing temporary fixes to deal with situations such as this epidemic in Gorakhpur cannot help in finding long term solutions because they often do not address the root cause of the problem. For example, vaccines cannot be found to be the only solution to the problem in the area where long term efforts should also focus on mechanisms to take care of the poor water and sanitation situation in the area, which gets exacerbated during natural events such as floods.

This case amply indicates that temporary solutions that do not seek to address the root of the problem cannot help and one problem gets replaced by another, like Japaneses encephalitis being followed by viral encephalitis. The time has certainly come to end the long wait and the plight of the poor who continue to be deprived of basic health and sanitation needs in the area, but for how long?
(The author is a public health researcher based in Trivandrum, and also works with the India Water Portal)
The author is grateful to Dr Shiraj Wajih, President, Gorakhpur Environmental Action Group (GEAG), for his valuable insights, while writing this article.
References
1. Asia Calling (2011) India Encephalitis Outbreak Kills Hundreds of Children . Downloaded from the site http://www.asiacalling.org/en/news/india/2276-india-encephalitis-outbreak-kills-hundreds-of-children on 19th October 2011
2. Biswas Soutik (2011) India encephalitis outbreak kills 400, mainly children, BBC News, South Asia. Downloaded from the site: http://www.bbc.co.uk/news/world-south-asia-15269441 on 19th October 2011
3. Yahoo News (2011) Encephalitis kills at least 430 in India.
Downloaded from the site: http://news.yahoo.com/encephalitis-kills-least-430-india-004959246.html on 19th October 2011.

4.University of Maryland Medical Centre (2011) Viral Encephalitis: Causes. Downloaded from the site: http://www.umm.edu/patiented/articles/what_causes_encephalitis_000096_2.htm on 19th October 2011.

5. NHS Choices Information (2011) Encephalitis Information: Downloaded from the site : http://www.nhs.uk/Conditions/Encephalitis/Pages/Symptoms.aspx on 19th October 2011.

6. World Health Organisation (2011) Encepahlitis, Viral. Downloaded from the site: http://www.who.int/topics/encephalitis_viral/en/ on 19th October 2011.

7. Better Health Channel (2011) Viral Encephalitis. Downloaded from the site: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/viral_encephalitis?open on 19th October 2011.
8. Midnight Watchers Bligspot (2011) India: Encephalitis Outbreak Kills 400, Mainly Children. Downloaded from the site:
http://midnightwatcher.wordpress.co...ephalitis-outbreak-kills-400-mainly-children/ on 19th October 2011.
9. Deccan Herald (2011) Encephalitis toll climbs to 488. Downloaded from the site: http://www.deccanherald.com/content/200325/encephalitis-toll-climbs-488.html on 1st November 2011
10. Dhar Aarti (2011) In eastern Uttar Pradesh, a season of death. The Hindu, 29th October 2011, p 12. Downloaded from the site: http://www.thehindu.com/news/national/article2577631.ece on 29th October 2011
11.Medical Express (2011) Encephalitis kills at least 430 in India. Downloaded from the site: http://medicalxpress.com/news/2011-10-encephalitis-india.html on 1st November 2011.
12. The Hindu (2011) Azad for GoM to deal with Japanese encephalitis. Downloaded from the site: http://www.thehindu.com/news/national/article2568496.ece on 1st November 2011.
13. Dhar, Aarti (2011) Inter-departmental panel to monitor Japanese encephalitis prevention plan. The Hindu, 25th December 2011. Downloaded from the site:http://www.thehindu.com/health/policy-and-issues/article2745198.ece on 26th December 2011.


Source: http://www.indiawaterportal.org/post/20838

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Implementation of Intervention/ Activities for Prevention and Control of Japanese Encephalitis (JE)/ Acute Encephalitis Syndrome (AES)

The Cabinet today approved a proposal for a comprehensive multi pronged strategy for the prevention and control of Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES).
The proposal of the Ministry of Health and Family Welfare for the implementation of the intervention/activities recommended by the Group of Ministers (GoM) for prevention and control of Japanese Encephalitis (JE) / Acute Encephalitis Syndrome (AES) will be implemented in 60 priority districts for a period of 5 years from 2012-13 to 2016-17 by the Ministries of Health & Family Welfare, Drinking Water & Sanitation, Social Justice & Empowerment, Housing & Urban Poverty Alleviation and Women & Child Development. Focussed interventions will be done in five States namely Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal.
The major activities include public health interventions, expansion of JE vaccination, improved case management, medical and social rehabilitation, improved provisions of drinking water and sanitation in rural and urban areas and improved nutrition.

The Cabinet approved the implementation of interventions/activities for JE/AES for the following Ministries out of the budget available during the 12lh Plan. Ministry-wise estimated costs of interventions/activities as approved by the Cabinet are summarized below:

Sl.
No.
Ministry / Department
Estimated Cost (Rs. in crore)
1.
Ministry of Health and Family Welfare
1131.49
2.
Ministry of Drinking Water and Sanitation
2301.57

(Drinking Water - 750.23 Sanitation- 1551.34)
3.
Ministry of Social Justice and Empowerment
9.19
The Ministries of Housing & Urban Poverty Alleviation and Women & Child Development will obtain requisite additional funding as per table below for implementing the interventions as per GoM recommendations within two months of the Cabinet approval.

Sl.
No.
Ministry/ Department
Estimated Cost (Rs. in crore)
1.
Ministry of Housing and Urban Poverty Alleviation
418.00
2.
Ministry of Women and Child Development
177.85
The implementation of the proposal will substantially reduce the cases of JE through strengthening of JE vaccination and vector control. It will also reduce AES cases by checking the transmission of entero-virus in children through the supply of safe drinking water and enhanced nutritional status of children. This will also reduce burden of disabilities due to AES in young children.

Background:
With the approval of the Prime Minister of India, a Group of Ministers (GoM) was constituted to evolve a multi-pronged strategy encompassing preventive, case management and rehabilitation measures to address the problems relating to Japanese Encephalitis (JE)/ Acute Encephalitis Syndrome (AES). The members of GoM included Minister of Health and Family Welfare, Minister of Urban Development, Minister of Social Justice & Empowerment, Minister of Rural Development, Minister of Drinking Water & Sanitation and Minister of State (Independent Charge) of the Ministry of Women & Child Development. Vice Chairman, National Disaster Management Authority (NDMA) was included as a Special Invitee.
***
SH/SK

(Release ID :88512)
http://pib.nic.in/newsite/erelease.aspx?relid=88512

Govt earmarks Rs 4,000 crore for encephalitis
TNN | Oct 19, 2012, 03.09AM IST


NEW DELHI: The government on on Thursday cleared a Rs 4,000 crore multi-pronged plan for prevention and control of Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES), which have claimed nearly 1,000 lives so far in 2012.

The Union Cabinet cleared the proposal of the Ministry of Health and Family Welfare for implementation of the activities recommended by a ministerial panel for prevention and control of the disease. Initially, the plan will be rolled out in 60 priority districts.

The plan will implemented in Uttar Pradesh, West Bengal, Tamil Nadu, Bihar and Assam within five years from 2012-13 to 2016-17, the government said in a statement.
...
http://timesofindia.indiatimes.com/...ore-for-encephalitis/articleshow/16871813.cms

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Incidence Rate of Acute Encephalitis Syndrome without Specific Treatment in India and Nepal

Nagabhushana Rao Potharaju
Department of Neurology, Osmania Medical College/ Niloufer Hospital/Osmania General Hospital, Hyderabad, India

Date of Submission 14-Mar-2011
Date of Acceptance 15-Jun-2012
Date of Web Publication 15-Nov-2012
Correspondence Address:
Nagabhushana Rao Potharaju
10-3-185, St. John's Road, Secunderabad, Andhra Pradesh - 500025
India


DOI: 10.4103/0970-0218.103473




Abstract
Background: A performance target (PT) for the incidence rate (IR) of acute encephalitis syndrome (AES) was not defined by the World Health Organization (WHO) due to lack of data. There is no specific treatment for ~90% of the AES cases. Objectives: (1) To determine the IR of AES not having specific treatment (AESn) in two countries, India and Nepal. (2) To suggest the PT. Subjects and Methods: This was a record-based study of the entire population of India and Nepal from 1978 to 2011. The WHO definition was used for inclusion of cases. Cases that had specific treatment were excluded. IR was calculated per 100,000 population per annum. Forecast IR was generated from 2010 to 2013 using time-series analysis. Results: There were 165,461 cases from 1978 to 2011, of which 125,030 cases were from India and 40,431 were from Nepal. The mean IR of India was 0.42 (s 0.24) and that of Nepal was 5.23 (s 3.03). IRs of 2010 and 2011 of India and that of 2011 of Nepal were closer to the mean IR rather than the forecast IR. IR of 2010 of Nepal was closer to the forecast IR. The forecast IR for India for 2012 was 0.49 (0.19-1.06), for 2013 was 0.42 (0.15-0.97) and for Nepal for both 2012 and 2013 was 5.62 (1.53-15.05). Conclusions: IRs were considerably different for India and Nepal. Using the current mean IR as PT for the next year was simple and practical. Using forecasting was complex and, less frequently, useful.
...
Potharaju NR. Incidence Rate of Acute Encephalitis Syndrome without Specific Treatment in India and Nepal. Indian J Community Med [serial online] 2012 [cited 2012 Nov 16];37:240-51. Available from: http://www.ijcm.org.in/text.asp?2012/37/4/240/103473

 

[Ronan Kelly]

Re: Whose failure? Encephalitis kills 50,000 in 30 years

Encephalitis battle: Tied in reams of red tape
Last Updated: Sunday, November 18, 2012,16:42
IANS

Lucknow: Has the battle of the Uttar Pradesh government against Japanese Encephalitis (JE) and AES (Acute Encephalitis Syndrome) in its eastern part been lost to red tape? The answer, shockingly, seems to be yes.

Even as the death toll of kids falling to the deadly viral disease mounted to 555 up to Saturday, the health department has been busily engaging in `processes,` admitting that "lots of things still need to be done."

Sources reveal that while the state government had ordered the construction of a 100-bed hospital for AES patients - to be built at a cost of Rs.18 crore - the tendering for the same is still on. According to government timelines, the "lenter of the ward" would be up by March 2013.

The story is the same with paediatric wards to be set up in the nine districts affected by AES. The wards are still not complete. There is thus no place where ventilators (124 of them, according to an announcement by the Samajwadi Party government in June) can be installed.

Of the 22 ventilators installed at the Baba Ram Das Medical College in Gorakhpur, most are on lease from other medical colleges of the state, said principal secretary (Health) Sanjay Agarwal, who also candidly admitted that apart from statistics which show a marginal decrease in JE deaths from 5.97 percent last year to 4.02 percent in the corresponding period till November this year, a lot was still to be done.
...
http://zeenews.india.com/news/healt...s-battle-tied-in-reams-of-red-tape_19692.html