Water-borne encephalitis is the killer, not JE

Contrary to popular perception, it is Acute Encephalitis Syndrome (AES) and not Japanese Encephalitis (JE) that has for years been claiming the lives of children in Gorakhpur and adjoining districts in eastern Uttar Pradesh.

“The main killer is not Japanese Encephalitis. JE accounts for only 7% of the deaths, 90% are caused by the entero virus, which causes Acute Encephalitis Syndrome, for which there is no vaccine,” says Dr R N Singh.

The Gorakhpur-based doctor, who has been waging a battle against encephalitis in the region and is the chief convener of the Encephalitis Eradication Campaign (EEC), said that earlier, JE was the main culprit. “Regular fogging, large-scale vaccination of children under the age of 15, removal of piggeries from the villages helped combat JE,’’ he said. Japanese Encephalitis is caused by a virus that enters mosquitoes from pigs and from mosquitoes into the human body. On the other hand, AES is water-borne, Dr Singh said. “If the water source is contaminated with faeces, it can cause AES. Open defecation is therefore a reason.’’

The patients suffer from acute onset of fever with manifestation of mental confusion, disorientation and delirium. “Prevention is the only cure for AES. Sanitation is key to preventing the disease,’’ he added. About a third of those who contract the virus die, but the disease leaves even those that survive scarred for life. “Those who survive are left with behavioural and functional problems,” experts said.

Many patients who survive suffer from chronic irritability, for instance, and become very short tempered, they pointed out. Such patients require rehabilitation, but there are no facilities for it. Experts also lament that not much research has been undertaken on AES. ‘’A full-fledged research centre is needed at Gorakhpur to undertake a thorough study of the disease. Unfortunately, one hasn’t materialised,’’ said Dr Singh. He does not think that the proposed AIIMS in Gorakhpur is the answer. “AIIMS may provide specialised care to patients but it is not the right body to undertake research,’’ he remarked.

He welcomed, however, the announcement by Union Health Minister J.P. Nadda that the Centre would set up a Regional Research Centre at Gorakhpur. On whether the death of the children at BRD Medical College hospital on August 10-11 had been caused by the cut off in oxygen supplies or by varied other causes, Dr Singh said that the lack of oxygen alone might not have been responsible for such a large number of deaths.

‘’While it is true that in many of these cases oxygen supply is vital for patients, it is also true that children have been dying at the medical college from encephalitis for the past several decades,’’ he said.

Holiya model: A ray of hope

A team of volunteers led by Gorakhpur’s Dr R.N. Singh have successfully implemented a water purification model to prevent the dreaded water-borne Entero Viral Encephalitis. The model was implemented at Holiya village in Kushinagar district.

It is a natural method of water purification, which costs no money. Water collected from reliable sources is poured into P.E.T bottles, which are capped tightly. The bottles are exposed to the sun for six hours on sunny days and for over 24 hours on cloudy or rainy days. The bottles can be kept on any hard metallic surface or concrete roof painted black.

This sun-exposed water, the doctor says, is fit for drinking and can be used over two days. Anyone can adopt such a simple and no-cost method and save themselves from water-borne encephalitis as the virus becomes inactive after long exposure to sunlight, Dr Singh said.