Amid the media frenzy, public outcry and fearful silence of government authorities, I have not been able to ascertain or understand the exact causes that led to the death of children in the BRD Medical College in Gorakhpur. Whatever the actual reason be, 70 children dying over a span of a few days in a medical college hospital cannot be taken casually.
Some reports say that a few children had Japanese Encephalitis and were ventilator dependent (which requires oxygen supply). But none of the reports clearly states why in the first place 70 children became oxygen dependent. It is the responsibility of the authorities to investigate the cause and provide justice to the affected families.
In addition to all this, spreading awareness about a potentially fatal disease like Japanese Encephalitis is essential. We should not hesitate to learn from our mistakes. This article is all about simple preventive measures that could be adopted to combat it.
What is Japanese Encephalitis (JE)?
It is the inflammation of the brain caused by a virus - the JE virus - which is transmitted by female Culex mosquitoes to human beings. This virus mainly survives in pigs, ardeid birds and in mosquitoes. Man is an accidental host and is considered as the dead end in transmission because the virus cannot spread from one individual to another.
In a document released by the Indian Council of Medical Research, it has been stated that JE affects children below 15 years in south Indian states, whereas it affects people of all age groups in north India. It is one of the leading causes of encephalitis in Asia. Uttar Pradesh and Bihar are the two states which have witnessed an increasing number of encephalitis-related deaths over the past few years.
Uttar Pradesh chief minister Yogi Adityanath and Union health minister JP Nadda during a press conference after visiting BRD Medical College in Gorakhpur on Sunday, August 13. (Credit: PTI photo)
What are the clinical features?
It can present with fever, headache, vomitting, fits and can have rapid progression to disorientation and even coma over a span of hours or days. If the patient survives the acute stage, long-term sequelae in the form of permanent neurological damage can occur. In an area where encephalitis is known to occur, it is important to seek medical advice at the onset of any of these symptoms.
Can JE be prevented?
The mosquitoes that transmit the virus to human beings live in dirty stagnant water, paddy fields and ditches. If measures are taken to eliminate the proliferation of these mosquitoes, especially after the onset of monsoon season, then the spread of the virus can be curbed to some extent. Only if there is a very high-density of the mosquitoes, it can result in transmission of the virus to human beings. This is specifically the reason why we should focus on preventive measures.
Just by decreasing the breeding of the mosquitoes, the spread of the disease can be reduced. Taking personal precautionary measures against mosquito bite is essential. This can be achieved by wearing fully covered clothing and using mosquito repellents.
An effective vaccine is available for Japanese Encephalitis since 2006. This vaccine is not recommended to be given as part of the national immunisation schedule. But two doses of the vaccine are recommended in children residing in endemic areas under 18 years of age.
The vaccine is also recommended for individuals travelling to areas with higher number of cases of Japanese Encephalitis, with two doses of vaccine completed at least one week before travelling. In our country, with enough anti-vaccine campaigns, making vaccines available for children and adults in endemic areas and motivating people to get vaccinated, looks like a Herculean task.
As we progress in the field of medicine, finding cure and treatment for diseases, every outbreak of an infectious disease tries to teach us the same lesson: prevention is always better than cure.
Instead of playing blame game, let us shift our focus to taking small steps towards our goal of prevention.