At least 60 children have lost their lives in the last five-days at the state-run Baba Raghav Das Medical College Hospital in Gorakhpur, Uttar Pradesh due to various reasons, among them infections arising out of encephalitis. The deaths have prompted the BJP-led state government to order a magisterial inquiry into the incident. The deaths are being blamed on infections and possible disruption of oxygen supply in medical wards. But the hospital staff has rejected oxygen shortage as the reason.
So what is encephalitis?
Encephalitis is a potentially life-threatening but rare disease causing “acute inflammation” of the brain. According to the Medical News Today website, the term “acute”, in medicine, is used when a disease appears abruptly and grows at a fast pace. A person afflicted with encephalitis requires serious medical attention.
What are the causes of encephalitis?
The disease can occur in people of all ages, but children and the elderly are more at risk of being afflicted with the disease. The usual cause of the rare disease is either a viral inflection. Sometimes it is caused when the brain’s own immune system mistakenly attacks brain tissue. According to a New York Times report, in rare cases, encephalitis is caused due to bacterial infection, parasites, or may be prompted from other infectious diseases. It is a non-communicable disease.
What is Japanese encephalitis?
One of the most common form of viral encephalitis in Asia is the Japanese encephalitis virus (JEV), caused by mosquito-borne flavivirus. The disease belong to the same genus as dengue, yellow and West Nile viruses.
JEV primarily affects children as most adults tend to attain natural immunity from the disease, according to the World Health Organisation (WHO).
The disease usually shows mild symptoms such as fever and headache. In about 1 out of 250 cases, the disease takes a bad turn accompanied by sudden high fever, headache, stiffness, disorientation, coma and seizures. The fatality rate for patients showing symptoms is approximately 30 per cent.
What are the treatments available?
Almost every type of encephalitis shows similar systems, although it is difficult for doctors to determine through clinical features the cause of the onset of disease. When diagnosing the disease, the doctors aim to determine whether it is caused due to viral infections or any other factor.
According to an NYT report, the viral forms of encephalitis are not treatable and doctors usually try to cure the symptoms being caused by the disease via medications. Reducing the fever down and ease the pressure caused by the swelling of the brain are highly important when treating a patient suffering from the disease. NHS UK says doctors often prescribe steroid injections, antibiotics or painkillers based on the cause.
How can the disease be prevented?
There are several vaccinations that are effective in preventing the disease, including vaccines for measles, mumps, rubella. In areas known to have mosquitoes carrying encephalitis-causing viruses, one must carry mosquito repellent ointments and apply it especially while going out. People should also use proper clothing to prevent being bitten by mosquitoes in mosquito-infested areas.
Is the disease prevalent in India? How severe is it?
Japanese Encephalitis is recognised as the leading cause of the disease in India. According to a report by Indian Council of Medical Research, JEV was first recognised in 1955 in the country, when cases of encephalitis were reported in North Arcat district of Tamil Nadu. The report further states that since 1972, the disease has spread to newer regions including West Bengal, Uttar Praesh, Assam, Bihar, Manipur, Andhra Pradesh, Goa, Pondicherry and Karnataka.
While the age group of people affected by the disease in southern areas remain children below 16 years of age, in North India, citizens of all age group are affected. In 2012, at least 272 cases of the disease were reported in Odisha, including 24 deaths. By 2014, at least 550 cases of deaths due to encephalitis were reported in the country. At least 102 people died in West Bengal and 43 deaths were reported in Assam in 2014.
Uttar Pradesh and Bihar are two states, which have seen the most number of encephalitis cases in recent years. The Uttar Pradesh government in May this year launched a vaccination campaign in 38 sensitive districts of the state to combat the JE virus.