Patna The health scare, which gripped Bihar with the surge in cases of acute encephalitis syndrome (AES) last month, is far from over as four new cases of Japanese encephalitis (JE) and another of dengue were detected at the viral research diagnostic laboratory at the Patna Medical College Hospital (PMCH) on Tuesday.The four JE cases were reported from Supaul, Saran, Bhojpur and Nalanda districts, triggering fears of an epidemic outbreak post-monsoon (August to November). The six cases of dengue reported so far at PMCH are of migrant population, according to state’s health officials.The total number of JE cases, predominantly beginning with the onset of monsoon, had gone up to 51 in the state, with eight deaths being reported so far this year. Five of these deaths had been reported from Muzaffarpur, two from Patna and one from Bhojpur, an official said.The state is already grappling with the management of acute encephalitis syndrome (AES), which had spread across 24 of the total 38 districts of Bihar, and claimed lives of 162 children, most reported last month. Muzaffarpur alone accounted for around 130 child deaths due to AES.“JE is one of the several diseases, which can cause AES. While AES is a syndrome, which manifests with convulsion and unconsciousness in children, JE is a disease, which can cause AES. Every hour is very crucial in saving lives of children affected by AES or JE and point of care management prescribed as per standard operating procedure (SOP) prepared by our task force can save children from dying,” said Dr Nigam Prakash Narain, retired professor of paediatrics, Patna Medical College Hospital (PMCH), who was also instrumental in drafting the state’s SOP on AES.Ten districts have been affected by JE so far. These include Muzaffarpur, where 26 cases and two deaths have been reported, Patna (nine cases, two deaths) and Bhojpur (one case, one death). Sporadic cases have also been reported from East Champaran (six), Vaishali (4) and a case each from Aurangabad, Bhojpur, Gaya, Nalanda, West Champaran, and Sitamarhi, said the officer.In Patna, eight patients have so far tested positive for JE at the PMCH. The first patient tested positive for JE from Gaya on March 26. Thereafter, three samples, including those from West Champaran and Vaishali, tested positive in June, after which four other cases were confirmed on Tuesday, said PMCH medical superintendent Dr Rajiv Ranjan Prasad.All the six cases of dengue reported at the PMCH so far this year were of migrant population, largely students or migrant labourers, residing outside the state.“Of the six dengue cases, three were from Bangalore, and one each from Chennai, Mumbai and Jharkhand. Three of these cases were reported in May, two in June and one on July 2,” said Dr Sachchidanand Kumar, medical officer of the virology laboratory at the PMCH.“We have issued an alert for dengue and chikungunya and already planned and rolled out extensive IEC (information, education and communication) activities in the 10 districts affected by dengue last year. We have also asked sadar hospitals to earmark 5-5 beds each for dengue and chikungunya patients. They have been advised to keep ready testing kits and necessary drugs for treatment of the two diseases,” said Manoj Kumar, executive director of Bihar’s State Health Society.“We have also identified six centres as sentinel surveillance hospitals for the two diseases. These include the PMCH, Nalanda Medical College Hospital (both in Patna), Darbhanga Medical College Hospital (Darbhanga), Anugrah Narayan Magadh Medical College Hospital (Gaya), Jawaharlal Nehru Medical College Hospital (Bhagalpur) and the Rajendra Memorial Research Institute of Medical Sciences (Agamkuan in Patna),” he said.JE and dengue are both vector-borne diseases caused by mosquito.