Bihar: Capital city reports its first JE case this year

A one-and-a-half-year girl from Mamrakhabad Imli village of Pandarak block in Patna on Wednesday was found JE positive following her cerebrospinal fluid (CSF) test report from ICMR-Rajendra Memorial Research Institute of Medical Sciences.

State capital Patna has reported its first of the total seven cases of Japanese Encephalitis (JE), a mosquito-borne flaviviral encephalitis, in the state so far this year, said officials aware of the development. One child has already died of the infection this year.

The new case comes close on the heels of an 11-year-old JE positive boy getting admitted to Sri Krishna Medical College Hospital in Muzaffarpur recently on September 5. (HT File)

A one-and-a-half-year girl from Mamrakhabad Imli village of Pandarak block in Patna on Wednesday was found JE positive following her cerebrospinal fluid (CSF) test report from ICMR-Rajendra Memorial Research Institute of Medical Sciences.

The girl’s blood serum sample had tested positive in August. She has since been discharged from Patna’s Nalanda Medical College Hospital (NMCH), said health officials, requesting anonymity.

The new case comes close on the heels of an 11-year-old JE positive boy getting admitted to Sri Krishna Medical College Hospital in Muzaffarpur recently on September 5. The condition of the boy, who hails from Bettiah in West Champaran district, was said to be critical.

Prior to these two recent cases, Bihar, where the disease mostly affects children up to 15 years of age, reported one JE case in January, three in July, and two in August this year. In the last five years, the state has reported a total of 419 JE cases and 78 deaths. It reported 135 JE cases and 27 deaths in 2019, the highest since 2016, when 100 children were infected , of which 25 died, as per government data.

Officials monitoring the case said they were taking steps to prevent further spread of infection.

“We have issued instructions to respective districts for malathion (an insecticide) fogging in areas where JE cases have been detected. Fogging will be done in around 500 dwellings near the infected house,” said an official.

The official added,“We have also asked the districts for house-to-house case detection survey, and to also check for immunisation of children.”

The prevention of JE is based largely on two interventions — mosquito control and immunisation.

Immunisation of children has been completed in 35 of the 38 districts. In the remaining three districts of Khagaria, Begusarai and Kaimur, immunisation was initiated in August-end. The JE vaccination has been included in the routine immunisation programme of the government, said officials, requesting anonymity.

The Bihar government has been struggling to declare JE a notifiable disease despite it being a disease of public health importance because of its epidemic potential and high fatality rate. Government sources said the file concerned to make JE and dengue a notifiable disease has been shuttling from one desk to another for the last three years.

When contacted, Bihar’s director-in-chief, disease control, Dr Naveen Chandra Prasad, was not certain about it. “I will find out from my office and let you know. Right now, I am out on an inspection,” he said on Thursday.

JE patients present vivid signs of acute encephalitic syndrome. The first signs of infection appear after an incubation period between six and 14 days. It usually begins with onset of fever above 38°C, chills, muscle pain, and meningitis-type headaches accompanied by vomiting.

Around 20% to 30% fatality has been reported in cases with signs of acute cerebral edema or severe respiratory distress from pulmonary edema. Recovery usually leaves serious behavioural and neurological disorders, epileptic seizures, and severe mental retardation in children.

Most government medical colleges are already facing capacity constraint in the wake of an early spike in viral fever cases among children. Any outbreak would put the state health system under further stress.