Ability to deliver

Andhra Pradesh has a better record at controlling JE Since 1979, Andhra Pradesh (AP) has been recording JE cases. The 1990s saw a change in the disease behaviour: instead of peaking every fifth year, it was peaking every second year. The state decided to focus on improved surveillance and vaccination. 98 per cent cases came from just 10 districts; 46 per cent came from just two districts: Kurnool and Ananthapur.

From 1999-2000, AP got a limited supply of JE vaccine from the Central Research Institute (CRI), Kasauli, to vaccinate children between 1-12 years. The vaccine was distributed to districts based on cases reported in the last 11 years. Only village folk were immunised. Villages were chosen on the basis of presence of positive human and animal sera, death reports, reports of suspected cases, high vector density villages, areas having migratory birds and paddy cultivation.

Finding CRI’s supply inadequate, AP began importing vaccines from 2001. In 2003, 200,000 doses were sourced from CRI and 800,000 from Vietnam. Initial results show that the vaccine is effective in controlling the disease and preventing the outbreak. It’s worth noting that AP didn’t wait for the Centre’s approval to import vaccine.

Surveillance has been strengthened in AP and JE has been made a notifiable disease. An epidemiology centre with capacity to conduct ELISA tests has set up in Kurnool Medical College. Specific surveillance forms have been made in 2001 to get more information to devise preventive measures. The private health sector has also been involved in surveillance. Known vector control measures have been stepped up. Under a 2003 action plan to deal with a JE outbreak, each district was sanctioned Rs 25 lakh.