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Journalism of Courage
If Gorakhpur’s 330 encephalitis cases, mostly among children, and 99 deaths have unsettled the authorities, there’s more bad news: the situation can get worse because the peak season for encephalitis stretches from July to October.
But what’s baffling health care specialists is the government’s reluctance to go for vaccination though the vaccine for encephalitis, eradicated from developed countries, is produced in Kasauli, Himachal Pradesh.
The vaccine, being produced at the Central Research Institute, Kasauli, is a mouse brain killed vaccine. Three doses are required for primary immunisation. Two doses are administered within a gap of 7-14 days followed by a third dose any time after a month and before one year of the second dose. A booster is required after three years.
The vaccine is procured directly by state health authorities. Vaccination is not recommended as an outbreak control measure because it takes at least a month after the second dose to develop antibodies and outbreaks are usually short-lived.
‘‘It is not a vaccine that can be given during an epidemic. It can be given to build immunity before the epidemic season starts, much before the rains. But the government is not considering it even in endemic areas like Gorakhpur and Saharanpur,’’ said an official.
Sources said vaccine production is way below the requirement. The government, however, has a different take. ‘‘Mouse brain technology has limitations when it comes to huge production. We produced about two lakh vaccines last year and it has been doubled this year. About 70 to 80 per cent of the vaccines go to UP but mass innoculation is not possible,’’ said P.K. Hota, Secretary, Health.
Officials say tissue culture vaccines with the feasibility of mass production are the only option. ‘‘There’s a South Korean tissue culture vaccine which can be considered. We also need to develop our own vaccines,’’ said Hota.
Dr N K Ganguly, Director General ICMR, says tissue culture vaccines are under various phases of development, standardisation and/or commercialisation. ‘‘It will take time to develop tissue culture vaccines,’’ he said.
The official website of the National Vector Borne Disease Control Programme says annual incidence of encephalitis in the country is between 1765 to 3428 cases. Deaths range between 400 and 700 each year. Two years ago, some 1,000 children died due to the disease.
While an epidemic always leads to a blame game—the Centre blames the state for not taking preventive measures and the state gets back saying they don’t receive adequate help—the fact remains that encephalitis has been a regular worry since it was first reported in 1955.
‘‘It has been eradicated from Japan where it was first reported. The problem with India is it has never been taken seriously,’’ said Dr C.M. Gulati, former WHO drug expert and editor of MIMS India.
