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Lucknow:
The mosquito-borne Japanese encephalitis has claimed several lives
in Uttar Pradesh this year but there are other infectious agents -
called enteroviruses - that are believed to have caused over 200
fatalities, health officials say.
Only 18 people have died due to Japanese encephalitis Jan 1-Sep 9,
says V.S. Nigam, joint director of the encephalitis eradication
programme (Uttar Pradesh), but enteroviruses have been blamed for
234 deaths, which includes many children.
The deaths that took place in various districts, including
Gorakhpur, Kushinagar, Siddharthnagar, Basti and Sant Kabir Nagar,
have been recorded under Acute Encephalitis Syndrome (AES), which
experts say could be spurred by enteroviruses.
Enteroviruses are a class of viruses that thrive in the intestine
of patients and attack their nervous system.
AES is a generic term given for a disease whose symptoms resemble
that of encephalitis, but the causative agent is not the Japanese
encephalitis Virus (JEV) and may or may not be detected.
The union health ministry had, however, put the Japanese
encephalitis toll in eastern Uttar Pradesh at 103 in a written
reply to the Rajya Sabha.
Health officials here say this could be because AES might have
been bracketed under the larger encephalitis umbrella.
"Of the 1,250 children who were admitted to hospital following
encephalitis symptoms this year, only 139 tested positive for JE.
Others were said to be afflicted by AES. At present, the number of
children affected by AES is around 285," K.P. Kushwaha, head of
the paediatrics department of the Baba Raghav Das (BRD) Medical
College, told IANS over phone from Gorakhpur, some 300 km from
Lucknow.
BRD Medical College runs a nodal centre to deal with the rampant
encephalitis menace in large parts of Uttar Pradesh.
"Ongoing research indicates that enteroviruses could be
responsible for the AES cases. But we are yet to understand the
nature of the viruses completely," Kushwaha said.
Significantly, officials of the field laboratory in Gorakhpur set
up by Pune-based National Institute of Virology (NIV) two years
ago have also blamed enteroviruses for the deaths of people
showing encephalitis symptoms but didn't tested positive for JEV.
According to experts, the high-mutation rate of enteroviruses
makes them difficult to study and therefore there's no specific
medicines or vaccination available to treat these infections.
Unlike JEV that spreads from mosquitoes, enteroviruses spread
through contaminated water and enter the body through the faecal-oral
route.
"The annual vaccination drive against JE undertaken by the state
government in assistance with the central government has
definitely controlled it to a considerable extent. But as no
vaccination is available to counter enteroviruses, more and more
people are being affected by them," said R.N. Singh, a Gorakhpur-based
doctor and chief campaigner of the Encephalitis Eradication
Movement (EEM).
After a major Japanese encephalitis outbreak in 2005, the state
governmnet undertook a vaccination programme in 2006 with help
from the central government. This year the vaccination drive
starts in November.
"Enteroviruses can be countered only by adopting hygienic
sanitation facilities. Faecal material can be ingested via
contamination of water supply, poor hand-washing and poor hygiene.
Usually poor people who don't have access to proper sanitation
facilities get affected by enteroviruses," said Singh.
"Enteroviruses can be checked if the government makes arrangements
for proper disposal of excreta and provision of clean drinking
water in the affected regions. There's a dire need to spread
awareness about the importance of hygiene in tackling
enteroviruses," he added.
Singh and others involved in the EEM had adopted Holia village in
Kushinagar district last January and initiated drives to make
people aware about the ill-effects of poor hygiene.
"The awareness drives have made an impact. Last year, there were
nearly 300 cases of AES and JE in the village, but till now not
even a single case has been reported," Singh claimed.
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