Uttar Pradesh battles viruses, over 200 dead

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.

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.