How an incurable Japanese encephalitis threatening India

How an incurable Japanese encephalitis threatening India
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Highlights

 A few days later, the virus claimed its second victim, an adult.  These deaths were enough to close school until the end of July in the district of Churachandpur and spark a reaction in Parliament a fortnight ago. JE is the leading cause of viral encephalitis or brain inflammation in Asia. While mild cases of JE experience fever with headache, much like any other viral fever,

Panic gripped Manipur in July, 2016 when a four-year-old girl -- after suffering high fever, convulsions, and slipping in and out of consciousness over a few days succumbed to Japanese encephalitis (JE), the state's first death from the viral brain infection transmitted by the Culex mosquito since 2010.

A few days later, the virus claimed its second victim, an adult. These deaths were enough to close school until the end of July in the district of Churachandpur and spark a reaction in Parliament a fortnight ago.

JE is the leading cause of viral encephalitis or brain inflammation in Asia. While mild cases of JE experience fever with headache, much like any other viral fever, severe infections are associated with neck stiffness, stupor, disorientation, coma, tremors, convulsions and spastic paralysis. Fatality rates for severe infections hover between 20 per cent and 30 per cent, according to the World Health Organisation (WHO).

Even with treatment, JE can leave significant neurological effects, especially in children. About 30 per per cent to 50 per cent of the survivors can struggle to walk or suffer cognitive disabilities. JE is caused by a virulent virus. Much like Manipur this year, the virus made a comeback in Odisha in 2012, after two decades, with 272 cases reported and 24 dead.

JE has a tendency to invade new areas that host its traditional habitat -- stagnant water in paddy fields and even develop new habitats. "Sub-groups of the Culex species of mosquito have been found in vegetation growth along the Yamuna, from where they are infecting people," said A.C. Dhariwal, Director, National Vector Borne Disease Control Programme (NVBDCP).

In March 2016, IndiaSpend reported a 3 per cent decline in allocations to the National Vector-Borne Disease Control Programme, which covers malaria, dengue, chikunguniya and JE, kala-azar and lymphatic filariasis, from Rs 482 crore in 2011-12 to Rs 463 crore in 2015-16. Over this time, JE – so called because it was first reported in Japan in 1871 – cases rose 210 per cent, the death toll 181 per cent.

JE cases could be many times the officially reported data, according to a 2016 study in the Journal of Paediatrics, because the testing method popularly used to detect the virus infection in the patient's blood and cerebrospinal fluid may be missing cases of JE among patients of acute encephalitis syndrome, a brain fever.

We estimated 626 symptomatic JE cases in Kushinagar, a district in Uttar Pradesh, in 2012, while the state reported 139 confirmed cases during the same transmission season," said Manish Kakkar, study leader, senior public health specialist, communicable diseases and adjunct associate professor with the Public Health Foundation of India (PHFI).However, as we said, JE finds new targets. With children better protected, the virus is striking more adults. (Courtesy: IndiaSpend.org)

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