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Wednesday, Oct 16, 2019

True to pre-poll promise, UP govt led by Yogi Adityanath focuses on encephalitis

The Yogi Adityanath government is reviving facilities to contain Encephalitis that has killed 50,000 kids in eastern UP in past 30 years.

india Updated: Apr 27, 2017 10:55 IST
Rajesh Kumar Singh
Rajesh Kumar Singh
Hindustan Times, Lucknow
Medical experts say the government should focus on complete immunisation of vulnerable patients and maintaining regular surveillance in encephalitis-sensitive districts.
Medical experts say the government should focus on complete immunisation of vulnerable patients and maintaining regular surveillance in encephalitis-sensitive districts. (HT File Photo)

True to his pre-poll promise, Yogi Adityanath has brought into focus the issue of killer disease Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) that has claimed the lives of 50,000 children in eastern Uttar Pradesh, especially his constituency Gorakhpur, in the last three decades.

Soon after Adityanath assumed charge as the CM, the health and family welfare department reviewed measures taken for the prevention and treatment of encephalitis patients in 37 districts known to be highly prone to the disease.

According to the department’s data, 128 patients have already been admitted to the Baba Raghav Das Medical College and Hospital, of which 40 have died.

Principal secretary, health and family welfare, AK Sinha said the state government has declared 20 districts Japanese Encephalitis and Acute Encephalitis Syndrome sensitive.

Before the onset of monsoon, the department has planned to launch vaccination and awareness drives.

The state government has also decided to set up encephalitis treatment centres in districts and to upgrade district hospitals for the treatment of JE/AES patients, Sinha said. Health and family welfare minister Siddharth Nath Singh said a training programme will be organised for doctors at community and primary health centres to handle the patients.

Yogi Adityanath has shifted the focus to revamping government efforts to cure and prevent encephalitis.
Yogi Adityanath has shifted the focus to revamping government efforts to cure and prevent encephalitis. ( Sonu Mehta/HT File Photo )

Beds and oxygen cylinders will be increased in district hospitals as well. Officials have been told to provide ambulance for transporting patients from villages to hospitals. The minister and officials will visit the districts to get a first-hand idea of the facilities provided to them.

For Adityanath, the fight has been on the top of his agenda for long. Since he won the Gorakhpur Lok Sabha seat in 1998, the ascetic has adopted ways to draw the attention of the government to the disease—handing memorandums to the ministers, organising dharna and raising the issue on the floor of Lok Sabha.

Last year in Lok Sabha, he attacked the state government, then ruled by Samajwadi Party, for neglecting the issue.

“For 36 years, the death of the children is being reported in Gorakhpur region. Around one lakh children have died, and majority of those who have survived are disabled. The state government has been insensitive to recurrent deaths even though central government has released much funds,” he said.

Demanding that JE/AES should be declared an epidemic, Adityanath had said a drive should be launched on a war footing for the eradication of the disease.

He had also pointed out that most child victims were from the lower strata of the society—Dalits and poor Muslims—and claimed that no treatment was available for the patients in district hospitals.

Looming danger
The Japanese Encephalitis (JE) virus invades the central nervous system, including the brain and spinal cord, claiming lives of 30% of those infected
Constant threat
Immunisation losing ground
Lifecycle of the virus
The JapaneseEncephalitis (JE) virus has acomplex lifecycle involving domestic pigsand the Culex tritaeniorhynchus mosquito, which breeds in flooded ricefields and standing wate r. After infection,the virus inva desthe central nervous system, includingthe brain and spinal co rd.Most infected persons develop mild symptoms or no symptoms at all.Inpeople whodevelop severe disease, JE usuallystarts with fl u-likefever, headache,nauseaand agitation. Next,the illness progresses to infe ction of the brain (e ncephalitis), killing 30%ofthose infected and causingbrain damage,including paralysis, in 30%ofthose who survive.
JE is endemic in 15 states andUTs.There’savaccine against JE, which is given free of cost to children under 15 yearsliving in endemic areas.
The assistance of international and national institutions, including Centre for Disease Control, Atlanta, National Centre for Disease Control, New Delhi, National Vector Borne Disease Control Programme, New Delhi, Indian Council for Medical Research, New Delhi, National Institute of Virology, Pune, National Institute of Mental Health and Neurological Science, Bengaluru, SGPGI, Lucknow, and KGMU, Lucknow has been taken to conduct research on the JE and AES.

Parents residing in rural areas as well as adjoining districts have no option but to rush encephalitis-infected children to BRD Medical College. Several patients die on the way, he said.

Social activist Manoj Singh noted that several encephalitis-caused deaths are not reported as the disease affects 0–15-year-old children in the villages and patients die en route hospital.

Adityanath made it a poll issue during the Uttar Pradesh assembly election. During campaigning, he attacked the SP government and charged it with neglecting encephalitis patients.

Addressing meetings in Gorakhpur and adjoining districts, he promised that if the BJP came to power, the eradication of JE/AES will be given prime focus, and the state government would open rehabilitation centres for children who survive encephalitis but remain handicapped for life.

The surprise choice for CM, the Gorakhpur MP has stayed true to the promise. But there is still much left to be done.

Scientists of National Institute of Virology (NIV), Pune, during a study in Gorakhpur, found that enterovirus (a virus that enters through gastrointestinal tract and attacks the nervous system) has caused the infections in children. While JE is mosquito borne disease, enterovirus is waterborne.

Milind Gore, an NIV scientist, said vast swathes of eastern UP remain waterlogged round the year. The villagers are hardly concerned about the hygiene and people defecate in the open.

During a survey, it was found that a majority of the hand pumps have been installed near drains. Vulnerable children fall victim to enterovirus after drinking contaminated water, he said.

Even as encephalitis patients flow into hospitals, the BRD Medical College that has been developed as nodal centre for the disease is awaiting release of funds for strengthening medical facilities.

The college principal, Professor Rajeev Misra, said they had sent a proposal of 37 crore for strengthening health facilities, which include maintenance of wards, ICU, medicine, ventilators, laboratory and human resource.

GM, national health mission, Dr AK Pandey, said the proposal has been forwarded to the Centre for approval and allocation of funds.

Former principal of BRD Medical College, Dr KP Kushwaha stressed the need to amend the policy regarding JE and AES to bring down the number of deaths.

Medical officials are not providing the correct figure of the encephalitis patients to the health and family welfare department, fearing that action will be taken against them, he said, adding that doctors who suppress the patient figures are promoted and those who highlight are being sidelined.

The state government should establish encephalitis management centre for patients. Rather than appointing doctors and paramedical staff on contract,

the health department should appoint permanent doctors and staff who work with commitment and have job satisfaction too.

The state government should also depute volunteers in villages who maintain vigil on encephalitis patients and sanitation drive as well. Ambulances in encephalitis-sensitive districts should be equipped with life saving devices, he suggested.

Kushwaha, who was earlier head of paediatrics department in BRD Medical College, said the focus should be on complete immunisation of vulnerable patients and treatment of patients. The research centre should be strengthened and regular surveillance should be maintained in encephalitis-prone districts, he said.

As activist Manoj Singh put it, besides being a health issue, JE and AES deaths are a social- economic issue as well.

First Published: Apr 27, 2017 07:16 IST

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