Uttar Pradesh among top 5 encephalitis prone states, suggests official data

Uttar Pradesh among top 5 encephalitis prone states, suggests official data


When more than 30 children died in Baba Raghav Das (BRD) Medical College due to Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) between 10th and 12th of August this year, it became a sensational news item for the media. However, one cannot assume that the Chief Minister of Uttar Pradesh Yogi Adityanath did not know that several districts of his state including Gorakhpur were among the JE/ AES endemic districts.

Why is this so? Almost three years ago, when Yogi Adityanath as a BJP MP posed a query in the 16th Lok Sabha related to districts prone to JE/ AES, the then Minister of Health and Family Welfare Dr. Harsh Vardhan in his reply said that there were 178 such districts spread across 20 states of India. The reply from the health minister dated 11 July, 2014, also revealed that UP had 36 such JE/ AES endemic districts including Gorakhpur.

Please click here and click here to access the question asked and reply received (related to JE/ AES) by the MP Yogi Adityanath. One must note that Shri Adityanath was re-elected to the 16th Lok Sabha (5th term) from Gorakhpur constituency before he became Chief Minister of Uttar Pradesh.

Number of encephalitis cases and deaths is high in Uttar Pradesh

Official data, which is available from the National Vector Borne Disease Control Programme, indicates that since the last 7 years, Uttar Pradesh has been among the top 5 states reporting AES and JE cases.

Out of the total 6,359 AES cases that have been reported in the country this year till 20th August, most were from Assam (1,609), followed by Uttar Pradesh (1,323), West Bengal (826), Manipur (800) and Tamil Nadu (659). Please check table-1.

In 2017, the death rate in case of AES (which is calculated by dividing number of deaths by number of cases multiplied by 100) at the national level stands at 6.9 percent, whereas the same for the states of Assam, Uttar Pradesh, West Bengal, Manipur and Tamil Nadu are 8.6 percent, 12.8 percent, 9.8 percent, 1.4 percent and zero percent, respectively. Therefore, among the top 5 AES prone states, the chances of survival is bleakest in Uttar Pradesh during 2017, suggests latest available data from the National Vector Borne Disease Control Programme.

Although the number of AES cases from Bihar (69) is low vis-à-vis the top 5 endemic states, death rate during 2017 is as high as 42 percent.    

Table 1: State-wise number of AES and JE cases and deaths during 2010-2017
 
Table 1 State wise number of AES and JE Cases and Deaths during 2010-2017 
 
Source: National Vector Borne Disease Control Programme, http://www.nvbdcp.gov.in/  

Out of the total 959 JE cases that have been so far reported this year, most were from Assam (498), followed by Manipur (161) and Uttar Pradesh (112). Please see table-1.

The death rate in case of JE at the national level stands at 10.8 percent, whereas the same for states of Assam, Manipur and Uttar Pradesh are 14.5 percent, 6.8 percent and 2.7 percent, respectively. Therefore, among the top 3 JE prone states, the chances of survival is bleakest in Assam during 2017, indicates latest available data.

Although the number of JE cases from Bihar (19) is low vis-à-vis the top 3 endemic states, death rate during 2017 is as high as 36.8 percent. In West Bengal, the death rate in JE cases during this year is 27 percent.     

It needs to be highlighted that in the year 2016, out of the 11,651 AES cases reported in India, most were from Uttar Pradesh (3,919), followed by West Bengal (1,839), Assam (1,713), Odisha (1,096) and Tamil Nadu (859). In 2016, the death rate in case of AES at the country-level was 11.2 percent, whereas the same for states of Uttar Pradesh, West Bengal, Assam, Odisha and Tamil Nadu were 15.8 percent, 13.9 percent, 10.9 percent, 10.5 percent and 0.4 percent, respectively. Please consult table-1.  

During last year, out of the 1,676 JE cases reported in India, most were from Assam (427), followed by Uttar Pradesh (410), Odisha (242), West Bengal (174), and Bihar (100). In the same year, the death rate in case of JE at the country-level was 16.9 percent, whereas the same for states of Assam, Uttar Pradesh, Odisha, West Bengal and Bihar were 21.5 percent, 17.8 percent, 17.4 percent, 22.4 percent and 25 percent, respectively. Please check table-1.  

About AES and JE

JE is a preventable disease if vaccination is provided, said the Minister of State in the Ministry of Health and Family Welfare Shri Faggan Singh Kulaste in a reply to a query on 2 December, 2016. Please click here to access.

On 28 July, 2017 while replying to another query related to JE in the Lok Sabha, he said that JE vaccination campaign among children (in the age group 1-15 years) has been completed in 207 out of 231 JE endemic districts. Please click here to access.

The minister’s reply also mentions that the Coordination Committee under the Chairmanship of Secretary (Health & Family Welfare), which was constituted on 15 March, 2013 for monitoring and supervision of the measures for implementation of intervention/ activities for prevention and control of JE/ AES, has identified two shortcomings:

1. Poor coverage for JE vaccination under Routine Immunization (RI), and
2. Identification of non JE aetiology of AES

In order to know more about JE, please go to the url: http://www.nvbdcp.gov.in/je-new.html
 
References

Japanese Encephalitis, Unstarred Question no. 2223 from Shri Dr. Kirit Premjibhai Solanki and Smt. Rama Devi, Answered in Lok Sabha on 28 July, 2017, please click here to access

Japanese Encephalitis, Unstarred Question no. 2827 from Shri Anurag Singh Thakur and Shri Rama Chandra Hansdah, Answered in Lok Sabha on 2 December, 2016, please click here to access

Japanese Encephalitis and Acute Encephalitis Syndrome Deaths, Starred Question no. 77 from Yogi Adityanath, Answered in Lok Sabha on 11 July, 2014, please click here to access

Annexure referred to in reply to Lok Sabha Starred Question. No. 77, dated 11 July, 2014, please click here to access
 
Death is the only certainty here, rest is just chance -Damini Nath, The Hindu, 19 August, 2017, please click here to read more
 
Beyond the lament -K Srinath Reddy, The Indian Express, 17 August, 2017, please click here to read more 

Japanese Encephalitis in Gorakhpur: A deadly disease explained -Vidya Krishnan, The Hindu, 13 August, 2017, please click here to read more 

30 children die in 48 hours in Gorakhpur hospital, The Times of India, 12 August, 2017, please click here to read more 
 
 
Image Courtesy: UNDP India



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