Published Date: 2013-06-10 13:32:32
Subject: PRO/AH/EDR> Japanese encephalitis & other – India (07): (BR) RFI
Archive Number: 20130610.1764062
JAPANESE ENCEPHALITIS AND OTHER – INDIA (07): (BIHAR) REQUEST FOR INFORMATION
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 6 Jun 2013
Source: Rediff News [edited]
The dreaded encephalitis, a mosquitoborne disease, has claimed the lives of over 20 children in Bihar, health officials have said.
A 2 year old and an 11 year old have died of the disease in Bihar’s Muzaffarpur district in the last 24 hours, taking the toll from the deadly disease in the past month to 20 in the state. More than a dozen have been admitted to hospitals in Muzaffarpur and other district headquarters, officials said on Thursday [6 Jun 2013].
“Both children died of suspected acute encephalitis syndrome [AES],” a district health official said [and] 2 days ago, a 5 year old and a 2 year old died due to AES, hours after they were admitted at the hospital in Muzaffarpur.
Earlier this week [week of 3 Jun 2013], 4 children died of suspected AES at the Sri Krishna Medical College and Hospital and Kejriwal Hospital in Muzaffarpur, about 70 km [43 mi] from Patna. Alarmed by the number of children dying of AES in Muzaffarpur, a team of experts from the National Centre for Disease Control and CDS [communicable disease surveillance] have arrived in Muzaffarpur on Wednesday [5 Jun 2013] to identify the cause of the AES.
“The team has begun studies to identify the cause,” BN Jha, a district health official said. Most of the victims of AES belong to the poorest families, who are living without basic facilities such as safe drinking water, shelter, and food.
According to health experts, AES is a severe case of encephalitis characterised by inflammation of the brain. The effect on the patient’s central nervous system results in fever and/or sudden onset of symptoms such as seizures, confusion, and disorientation. It can be caused by bacterial or viral infections of the brain, toxic substances, or complications of an infectious disease.
[byline: MI Khan]
[The report above as well as the 31 May 2013 ProMED-mail report (archive no. 20130601.1748963] provide no indication of the etiological agent responsible for these encephalitis cases in Bihar state. In previous reports, acute encephalitis syndrome [AES] in north eastern India has been attributed in part or entirely to Japanese encephalitis [JE] virus infections. However, in some instances, JE virus infections are reported to be responsible for a minority of the cases.
Without knowing the specific etiology of the encephalitis cases above, targeted control measures will not be possible. ProMED-mail would appreciate receiving reports of the conclusions of the team of experts from the National Centre for Disease Control. If some or all of the cases above are due to JE virus infections, administration of an effective JE virus vaccine would provide an opportunity for prevention of some of these cases, if applied before the main transmission season arrives.
So far this year (2013), AES has claimed lives and affected over 100 people even before the onset of the usual disease season in north eastern India. Interestingly, cases of encephalitis have occurred this year (2013) in several locations in eastern India. At the beginning of April 2013 a ProMED-mail post (archive no. 20130402.1615081) stated: “Encephalitis cases have already been reported from Andhra Pradesh, Assam, Uttar Pradesh, and West Bengal in India this year , totalling 228 cases and 49 fatalities up to 19 Mar 2013. Of those cases, 7, all from West Bengal, were classified as Japanese encephalitis [virus infections]. There have also been cases in neighboring Bangladesh this year (2013).”