AES in Bihar: Muzaffarpur officials focus on preventing outbreak rather than providing treatment later

The administration in Muzaffarpur and it neighbouring districts are rushing with last-minute efforts to prevent AES, as summer starts to peak

By Mohd Imran Khan
Published: Friday 22 April 2022
It is to prevent scenes like these that have occurred in the past decade in Bihar that the Muzaffarpur administration has focussed more on prevention than cure this time. Photo: Sonal Matharu / CSE
It is to prevent scenes like these that have occurred in the past decade in Bihar that the Muzaffarpur administration has focussed more on prevention than cure this time. Photo: Sonal Matharu / CSE It is to prevent scenes like these that have occurred in the past decade in Bihar that the Muzaffarpur administration has focussed more on prevention than cure this time. Photo: Sonal Matharu / CSE

Authorities in Bihar’s Muzaffarpur and its neighbouring districts, are working on strategies to prevent Acute Encephalitis Syndrome (AES) as rising temperature and humidity reignite fears of an outbreak.

The focus this time is very much on not letting the deadly disease, locally known as chamki bukhar spread, rather than rushing to provide treatment to children diagnosed with AES like in past years.

At least two children have officially died of the disease in the last 110 days. The first victim, a three-year-old boy died January 11, 2022, while the second, a five-year-old boy died April 13. They were from Sitamarhi and Vaishali districts.

Some 18 children — 12 boys and six girls — diagnosed with AES, have been admitted to the government-run Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur so far in 2022.

It was reported that around half-a-dozen children suffering from the disease were admitted at different private hospitals.

A health official in Muzaffarpur said the AES situation was likely to take a turn for the worse in May, when the summer would be at its peak. Usually, AES cases see a surge in May-June, when the mercury touches the 42 to 44 degrees Celsius mark.

Gopal Shankar Sahni, head of the SKMCH’s pediatric department, admitted that prevention messages will play a major role if they reach the doors of vulnerable groups, mostly the poorest of the poor.

“Parents must know three simple things. Children should not be allowed to play outside in the scorching sun. They should not sleep on an empty stomach. If a child develops high fever, s/he should immediately be rushed to a nearby hospital without delay. The first one or two hours can help minimise the rate of mortality,” Sahni, who has been treating children suffering from AES for years, said.

The state health department has trained nearly 25,000 volunteers comprising of medical officers, block level officers, auxilllary nurses and midwives, accredited social health workers, Jeevika Didis, Anganwadi workers, Vikas Mitras, Tola Sevaks, cluster resource centre coordinators, members of the Panchayats and ward members.

Medical and non-medical staff have been given clinical and non-clinical training respectively.

An information, education and communication campaign is underway for community awareness. So far, nearly 900,000 hand bills highlighting preventive measures have been distributed by trained volunteers.

More than 12,000 posters have also been distributed and 70 hoardings placed in the Mahadalit Tola and other prominent sites. About 500 stickers have been pasted on government vehicles and 500 on private auto rickshaws. A local radio station, 92.7 Big FM Muzaffarpur, is broadcasting information on preventive steps.

More than 17,000 pieces of wall art on AES dos and don’ts have been painted in schools and other government buildings.

Panchayat-level community meetings titled Chamki par Charcha (Discussion on AES) were started on a fortnightly basis in 270 Panchayats from early April and will become weekly in May and June.

The health department has developed facility preparedness at all levels, strengthened the modes of referral, surveillance of suspected AES cases and made it mandatory to report all AES cases.

Dr S P Singh, Muzaffarpur civil surgeon, said facility-level preparedness at district hospitals as well as primary (PHC) and community health centres (CHC) has been ensured through random inspection and monitoring.

This is apart from an awareness campaign underway at the grass root level to inform villagers on how to prevent their children from becoming victims of the disease.

Singh said two-bed AES wards had been set up in all CHCs and PHCs, along with 24X7 medical and paramedical staff. Sadar or district-level hospitals had been provided with 10-bed wards for referral cases, along with pediatricians and paramedical staff in AES wards.

Forty-bed AES wards had been set up at the institutional level, in addition to a 100-bed well-equipped paediatric intensive care unit at SKMCH.

Bihar’s health minister Mangal Pandey admitted April 20 that it was a big challenge to prevent the outbreak of AES instead of rushing to provide only treatment to children suffering from the disease.

“We are confident that prevention measures will help deal with AES. Data on AES from the last two years show that preventive measures did result in fewer cases and deaths due to the disease,” Pandey said.

Saurav Tiwari, team leader of Care India, a Muzaffarpur non-profit, claimed that prevention strategies worked in 2020 and 2021 during the COVID-19 pandemic as AES was under control.

In 2020, 43 children were admitted to SKMCH with AES and seven children died of the disease, according to official data. In 2021, 39 children were admitted to SKMCH and seven children died of the disease.

These figures were much less compared to 2019, when an AES outbreak in Muzaffarpur and its neighbouring districts hit the headlines. According to official data, 111 children died. More than 431 children suffering from AES were admitted to hospitals, including SKMCH.

More than 500 children have died in the last one decade due to AES, mainly in Muzaffarpur and its neighbouring districts of Vaishali, Sitamarhi, Samastipur, Sheohar, East and West Champaran.

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