Japanese Encephalitis outbreak in Assam, next two months crucial

After Bihar, it is Assam. Even as doctors, researchers and government officials try to unravel the 'mystery' behind the deaths of over 150 children in Bihar due to Acute Encephalitis Syndrome (AES), the state of Assam has been hit by an outbreak of Japanese Encephalitis (JE). Japanese Encephalitis is the one of the most common causes of Acute Encephalitis Syndrome (AES) in many states of India, and has high mortality rates. Last year, the disease claimed 182 persons, out of the 1,678 reported cases.

In the current outbreak, at least 21 deaths have already been reported; the next two months are bound to be crucial as the disease occurs mainly in the rainy season, particularly the months of July-August.

The viral disease is transmitted by the bite of the female mosquitoes belonging mainly to Culex tritaeniorhynchus, Culex vishnui and Culex pseudovishnui group.

These mosquitoes breed mainly in rice fields and large water bodies rich in aquatic vegetation. Migratory birds, along with pigs in the community, play an important role in the transmission of JE from one area to the other.

Infection caused by the JE virus causes a range of illnesses that begin with flu-like symptoms, neck stiffness, disorientation, coma, seizures, spastic paralysis and eventually death. The disease mainly affects children, and clinically, it is hard to differentiate it from any other viral encephalitis, experts say. The states with highest burden include Andhra Pradesh, Assam, Bihar, Haryana, Karnataka, Kerala, Maharashtra, Manipur, Tamil Nadu, Orissa, Uttar Pradesh and West Bengal. Epidemics due to JE virus have been reported from union territories of Goa and Pondicherry as well.

A team of experts from the union health and family welfare ministry has been dispatched to “review” the Japanese Encephalitis (JE) situation in the Assam, and logistical and technical support to the state government for surveillance and diagnosis is being given, the health ministry has said. The most effective strategy to deal with JE virus is vaccination in endemic areas. Though all 27 districts of Assam (children from the ages 1-15 in these districts) have been covered under the vaccination campaign, outbreaks are frequently reported from the state.

Data from the Union health ministry suggests that, last year, the state reported 94 deaths due to JE virus (about 50 per cent of the total death count in the country); in 2017, there were 87 deaths, and in 2016, the number stood at 92. According to the health ministry, 10 high-endemic districts of Assam—Shivsagar Barpeta, Nagaon, Sonitpur, Darrang, Udalguri, Bongaigaon, Cachar, Morigaon, Nalbari—have been included in the multi-pronged strategy for prevention and control of JE. Even adults are covered under the vaccination programme. Funds have been provided for setting up 7 pediatric ICUs, and four of them are already functional. Those who survive the disease suffer varying degrees of disability, and the ministry has claimed that two centres have been set up at the Dibrugarh Medical College and Guwahati Medical College for their rehabilitation.

Besides vaccination, experts say that participation of community is crucial in preventing the disease.