Health ministry goes all out to combat brain fever

[RoRo]

Health ministry goes all out to combat brain fever
Kounteya Sinha, TNN, Jul 29, 2010, 03.35am IST

NEW DELHI: After years of failed attempts to pinpoint exactly what has been causing brain fever and Acute Encephalitis Syndrome (AES) in India, specially in Uttar Pradesh, the health ministry has chalked out a massive programme to detect and control the annual outbreak of AES and Japanese Encephalitis (JE) once and for all.

Indian Council of Medical Research DG Dr V M Katoch, who led a team of experts to Gorakhpur on July 23 on instructions from health minister Ghulam Nabi Azad, is scanning 30 scientific research projects on AES and JE -- 12 of which are based around Gorakhpur.

On July 30, a meeting headed by Dr Katoch will decide which projects will be given a go-ahead, to be funded by ICMR.

"The idea will be to first identify the viruses in circulation, then work out a new vaccine strategy and finally to see which viruses respond to which medicines best. We will then inform the new protocol to physicians where AES and JE is a problem," Dr Katoch told TOI.

"We have already constituted a taskforce to combat JE and AES. Modern diagnostic and testing tools like molecular diagnosis machines have been put in hospitals where AES and JE are a problem. We will search for all virus strains in circulation. We will conduct vaccine and management studies and see what are the main causes of AES," he added.

A review by Azad on July 19 showed that India has already recorded 749 cases of AES and JE and 115 deaths this year. The worst affected states have been UP with 425 cases of AES/JE and 74 deaths and Assam with 146 AES/JE cases and 29 deaths, even though the season for JE has not even arrived.

"Azad on July 19 asked Dr Katoch to visit UP and create a verifiable directory of vaccinated children for JE which should include address and phone number of all vaccinated children," a source said.

Scientists till now don't have a clue what virus is actually causing AES -- a severe neurological condition associated with significant morbidity and mortality in India.

ICMR estimates show that only about 15% of all cases and deaths are being caused by the JE virus. The presentation given to the minister showed that JE sero-positivity in UP has been 35.88% in 2005, 14.2% in 2006, 10% in 2007, 8% in 2008, 10% in 2009 and 2% till now in 2010. According to National Institute of Virology, Pune, in 2006, Enerovirus 76 was isolated in 20% of samples and throat swabs. Thereafter, the detection reduced to 4%. In 2009, various entrero viruses belonging to groups A and B were detected in 34% of the samples of rectal swabs.

The mystery virus has been causing brain fever and killing people in UP for the past few years but no breakthrough has been made regarding the virus's identity and nature.

Experts from Centre for Disease Control and Prevention (CDC) Atlanta had also picked up 150 samples from UP to help identify the virus. But they too failed to make any headway.

AES is characterised by inflammation of the brain, seizures and convulsions among children.

International NGO PATH's senior programme officer for JE Dr Pritu Dhalaria had told TOI, "Usually, around four to five enteroviruses work in tandem, in clusters in particular areas. It is therefore difficult to identify exactly which virus is the deadly one."

Enteroviruses can be found in the respiratory secretions and stool of an infected person. Other persons may become infected by direct contact with secretions from an infected person or by contact with contaminated surfaces or objects.

AES/JE cases and deaths in UP since 2005

2005 -- 6061 cases and 1500 deaths

2006 -- 2320 cases and 528 deaths

2007 -- 3024 cases and 645 deaths

2008 -- 3012 cases and 537 deaths

2009 -- 3073 cases and 556 deaths

2010 -- 425 cases till now and 74 deaths

AES/JE in India in 2010

AP -- 20 cases and no deaths

Assam -- 146 cases and 29 deaths

Bihar -- 23 cases and no deaths

Manipur -- 67 cases and 10 deaths

Tamil Nadu -- 68 cases and 2 deaths

UP -- 425 cases and 74 deaths

Total -- 749 cases and 115 deaths
http://timesofindia.indiatimes.com/i...ow/6228891.cms

Comment: The numbers are a little out of date UP is now 486 cases and 85 deaths. http://nvbdcp.gov.in/je-cd.html