Bihar all set to check encephalitis

Open defecation along the Gandak in Uttar Pradesh causes the disease in Bihar, says study

By Alok Gupta
Published: Sunday 15 September 2013

TIRED of failures by researchers to identify the virus that causes acute encephalitis syndrome (AES), the Bihar government, along with Unicef and the Rajendra Memorial Research Institute of Medical Sciences (RMRI), has sent a proposal to the Centre to root out the virus at source.

A recent study by Girish Kumar Singh, director of the All India Institute of Medical Sciences (AIIMS), Patna, states that open defecation along the Gandak in Gorakhpur, Uttar Pradesh, causes AES in Muzaffarpur, Bihar. Using a virustracking software, Singh found that the virus flows into the Saryu, tributary of the Gandak, in Muzaffarpur. The study revealed in the extreme summer months of April and May, AES cases are first reported in Gorakhpur. The disease then spreads to Muzaffarpur in June and July.

plan blueprint

Researchers at AIIMS, Patna, have devised a simple technique to trap the infected feces flowing in the river (see ‘Plan blueprint’). Unclean water will be raised to a height using a barrier. This will be flown into a chamber where the water will be cleaned. Clean water will then be released back into the river.

Sixty such water traps will be set up at the cost of Rs.95,000 each. The estimated cost of cleaning water is Rs.30 crore. The state government has written to the health ministry and asked for funds for the purpose.

This apart, the state government, with help from Unicef, has prepared a protocol for treatment of AES patients keeping ready stock of medicines or AES kits at all government hospitals, and a rapid action programme to transfer patients from remote areas to district hospitals. “We have deputed a fleet of ambulances at public health centres to quickly transport AES patients to district hospitals,” says Vyas Jee, principal secretary of the state health department. Doctors, nursing staff and community workers will be trained to identify and handle AES cases.

“It is essential to implement steps to prevent spread of the virus. Medicines for its treatment are expensive,” says Ghanshyam Singh, medical officer, Unicef, Bihar. AES cases will reduce drastically with improved sanitation, say Unicef officials. The state government has launched a special sanitation drive in AES-prone areas to educate people about washing hands and preventing children from playing under scorching sun. “Peels of fruits like litchi and mangoes, can carry the AES virus. We need to inform people to wash fruits properly before consuming them,” says Singh.

Futile research
AES has killed at least 1,256 people in 2012 across the country. Till July this year, of the 264 AES cases in the state, 71 died. The country has invested more than Rs.4,000 crore in controlling AES and Japanese Enceph alitis. “But in the last seven years, premier research institutes like RMRI and the National Institute of Virology have not moved an inch in their work, while deaths continue unabated,” says Vyas jee. Whatever research has been done has not reached the state government.

But Pradeep Das, director of RMRI, says the institute submitted its research papers to the state government, though their hypotheses was wrong. Vyas jee, however, says RMRI did not submit its findings. “We asked RMRI to provide the finding but no one responded,” he says.

“We do not claim that the state government’s plan will completely end spread of AES virus, but death rate will definitely be controlled,” Singh says.

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