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Newborns immune to Japanese encephalitis, say experts amid Gorakhpur child deaths debate

The expert view assumes significance as the Uttar Pradesh government blamed the disease for the death of at least 60 children at the state-run Baba Raghav Das Medical College in Gorakhpur last week.

lucknow Updated: Aug 18, 2017 18:50 IST
Anupam Srivastava
Anupam Srivastava
Hindustan Times, Lucknow
Gorakhpur deaths,Baba Raghav Das Medical college,BRD hospital
Children hospitalised in the encephalitis ward at the Baba Raghav Das Medical College in Gorakhpur on August 15, 2017. (Deepak Gupta/HT Photo)

Newborns cannot catch Japanese encephalitis since they remain immune to the mosquito-borne virus responsible for widespread deaths in India, experts said on Friday.

The comments assume significance as the Uttar Pradesh government blamed the disease for the death of at least 60 children at the state-run Baba Raghav Das Medical College in Gorakhpur within a week this August. The victims included neonates, or infants less than four weeks old.

“Newborns cannot catch the JE virus since they are born with immunity against such diseases for at least three months,” said professor UK Mishra of Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS) in Lucknow.

Mishra has done extensive research on the disease and published 25 research papers.

Also, he has recommended measures to control Japanese encephalitis and dengue to the Council of Science and Technology and the state government.

“It’s wrong to say JE caused the deaths of neonates in Gorakhpur as they cannot catch the disease. They may be suffering from neonatal sepsis or septicemia,” said the doctor, who visited Gorakhpur between 2010 and 2016 and suggested ways to prevent deaths.

VK Paul, the head of paediatrics in New Delhi’s All India Institute of Medical Sciences (AIIMS), offered a similar opinion.

“It’s true that babies have antibodies against many illnesses that the mother has experienced. So, if the mother has experienced JE, the child will not get it for about three to six months,” he said.

Japanese encephalitis and acute encephalitis syndrome (AES) became national buzzwords after 30 children died between August 9 and 11 in Gorakhpur’s largest government hospital amid allegations that a private company contracted to supply oxygen cylinders cut supply over a payment dispute.

The state’s BJP government admitted the shortage but dismissed allegations that an interruption in oxygen supplementation, which is crucial for critical care patients, caused the deaths.

It said the vector-borne disease and other complications were responsible. However, opposition parties blamed government apathy for the tragedy.

According to hospital records, 49 neonates died between August 9 and 16. If professor Mishra is right, Japanese encephalitis cannot be the cause.

Former principal of BRD Medical College, RP Kushwaha, seconded Mishra’s comments.

“Neonates cannot suffer from JE as they are immune to it. So anyone saying neonates died due to JE is wrong. Newborns can die because of encephalopathy, which is caused by asphyxia and neonatal sepsis or septicaemia,” he said.

Like much of eastern UP, Gorakhpur is a Japanese-encephalitis-prone area and chief minister Yogi Adityanath wants a research centre in the area.

But experts believe previous studies were good enough to reduce the number of deaths.

A Centre of Excellence in Encephalitis Research was opened in Lucknow’s SGPGIMS in 2010 for research and training in clinically relevant areas of the disease, Mishra said. The state’s Council of Science and Technology supported the endeavour.

“I visited encephalitis-endemic areas of Gorakhpur almost every year and brought out research papers with my team.”

The centre trained around 100 paediatricians and doctors in diagnosis and treatment.

The experts proposed low-cost intensive care units for encephalitis treatment. The technique was adopted by tropical countries such as Vietnam, which has controlled the disease significantly.

But in 2016, the science council withdrew its aid for research and no SGPGIMS expert went to Gorakhpur for field study since then.

The experts advised that the government should implement their recommendations, instead of setting up local research centres.

First Published: Aug 18, 2017 18:42 IST