Comparing Uttar Pradesh’s encephalitis prevention campaign to the pulse polio programme that led to India being declared polio-free by the World Health Organization in 2014, state health minister Sidharth Nath Singh said the state had an elaborate plan to contain a disease that has been killing hundreds of children with seasonal regularity for the past four decades.
“We are working on a mission mode; 38 districts in Uttar Pradesh are endemic for encephalitis,” Singh said. Seven districts of Basti and Gorakhpur division are highly endemic, contributing up to 75% of total cases of Acute Encephalitis Syndrome in UP.
“In terms of effort, it’s quite like the pulse polio campaign that ended polio in India, but encephalitis is a more complex disease. There was a vaccine against polio, which made eradication possible, and though we just have a vaccine against Japanese encephalitis, there is none for AES and we can work to prevent and treat it to reduce disability and save lives,” said Singh.
AES, mainly blamed on viruses, is characterized by fever and neurological manifestations like mental disorientation and delirium. The disease has killed over 100 people in recent days in Bihar, mainly in Muzaffarpur.
Data shows the AES and JE numbers in UP have been falling since 2017, when there were 4,724 AES cases and 654 deaths, and JE cases 693 and 93 deaths. In 2018, there were 3,080 AES cases and 230 deaths and 323 JE cases and 25 deaths, but it’s early to predict how it will unfold this year. “So far, we are better off than last year, when we had 84 deaths from January to June. In 2019, we had 16 deaths till June 17,” Singh said.
{{/usCountry}}Data shows the AES and JE numbers in UP have been falling since 2017, when there were 4,724 AES cases and 654 deaths, and JE cases 693 and 93 deaths. In 2018, there were 3,080 AES cases and 230 deaths and 323 JE cases and 25 deaths, but it’s early to predict how it will unfold this year. “So far, we are better off than last year, when we had 84 deaths from January to June. In 2019, we had 16 deaths till June 17,” Singh said.
{{/usCountry}}Identifying gaps was the first challenge, as there were no state-specific guidelines for AES, which led to an uncoordinated response. Ignorance about signs and symptoms of the disease (among the affected population) was high and initial treatment was provided by quacks, which led to delays in treatment.
Training, cleanliness and awareness campaigns are being done in partnership with external partners, such as the World Health Organisation (WHO), and close to 350,000 district malaria officers (for JE vector control), village-level healthworkers, ASHA workers, anganwadi workers, teachers and gram pradhans have been trained on prevention and control.
“WHO Country (Office) provided technical support and monitored coordination across 12 government departments and NGOs,” Madhup Bajpai, regional team head for UP at the WHO Country Office, said.
“All 38 AES-endemic districts are open defecation free and high-risk villages in Gorakhpur and Basti division are down from 617 to 417,” said Bajpai.
The state has established 96 encephalitis treatment centres and existing 104 centres have been upgraded with equipment, essential drugs and trained staffs, with three medical officers and four staff nurses.