Children falling prey to the disease

A recent survey reveals shocking numbers in rise of encephalitis cases in the city especially in children; more than 200 cases have been reported in the city just in the last year

Helping Hand Foundation, a city based NGO conducted a survey on the rising incidence of Paediatric Meningoencephalitis in Hyderabad. According to the survey, the recent years have seen a dramatic rise in the incidence of the disease.

Several leading paediatricians were interviewed and data was collected from private hospitals which specialise in Paediatric Care and also from government run hospitals which have exclusive Paediatric Units.

The report sites lack of immunisation, poor hygiene, open drains, mosquito menace and poor nutritional intake among children as leading causes.
The report was submitted to Health Minister, C Lakhsma Reddy with an appeal to actionse some of the observations from the study.

“In South India and more so in Hyderabad Encephalitis or Meningoencephalitis is generally caused by viruses, like Herpes Simplex Virus (HSV), Measles, Mumps and chicken Pox and all these diseases are vaccine preventable to a great extent,” according to Dr Altaf Naseem Professor and HOD Paediatrics at Deccan College of Medical Sciences.

The Dengue virus the incidence of which is again very high in the city of Hyderabad and which is transmitted through mosquitoes, can also cause Meningoencephalitis in children and a significant number of cases of Meningoencephalitis, reported in the City have been caused by Dengue Virus alone.

Encephalitis or Meningoencephalitis generally begins with fever and headache. The symptoms rapidly worsen, and there may be seizures (fits), confusion, drowsiness and loss of consciousness, and even coma. According to Mujtaba Hasan Askari, President of Helping Hand Foundation (HHF), HHF embarked on a plan to collate data from the medical record centres of paediatric hospitals in the city in 2015.

This include names like Rainbow Children’s Hospital and Research Centre with 43 cases, Niloufer Children’s Hospital with 80 cases, Deccan College of Medical Sciences with 17 cases, Gandhi Hospital, Paediatric Unit with 24 cases, Aditya Children’s Hospital with 25 cases and Princess Durre Shehvar Children’s Hospital with nine case the total cases reported in 2015-16 are 203.

“It can be safely assumed that many more such cases might have been reported in other Corporate hospitals, as our survey took into scope only top paediatric centres in the city,” said Mujtaba Hasan Askari. The key diagnostic procedure is a lumbar puncture (LP) to take some of the fluid bathing the brain and spinal cord (cerebrospinal fluid CSF) for laboratory analysis.

“If therapy with a drug called Acyclovir (which reduces replication of the virus) can be started during the first few days of the illness, there is a dramatic reduction in the mortality rate from around 70-80 per cent down to 10-20 per cent. The provision of high levels of nursing care and the management of complications such as brain edema are also key factors, which influence the outcome of encephalitis,” said Dr Arif Ahmed, Senior Paediatrician from Aditya Children’s Hospital.

Need of the hour Following the findings of the survey, a list of points for authorities’ attention was released. “Awareness about immunisation in Urban slums is important,” noted Mujtaba Hasan Askari. Creating awareness about hygienic factors in low socio-economic strata is another major issue to undertake.

“The government needs to immediately ramp up critical care facilities at the state run paediatric hospitals,” urged Mujtaba, who added, “Ventilators need to be setup according to need, the nursing staff needs to be increased, infusion pumps have to be setup to deliver drugs accurately, neuro physicians and neuro surgeons should be made available especially in government hospitals.”

“Most of the cases need about four to eight weeks of hospital stay, which may cost anywhere between Rs 4 lakh to 8 lakh. The poor and middle class can’t afford such heavy bills. Encephalitis is covered under Aryogyasri. However, the total coverage as per the latest amendment is Rs 25,000 only,” he informed “There is a need to enhance the present package amount under the Rajiv Aryogyasri Health Scheme, so that escalating cost in private hospitals for all economically backward families can be covered,” he said.