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Bihar’s AES deaths avoidable

Last Updated 13 June 2019, 18:53 IST

An outbreak of Acute Encephalitis Syndrome (AES) in Bihar has claimed the lives of at least 48 children, 46 of them over the past fortnight. Scores of children suffering from the disease are said to be in critical condition and under treatment. Over 154 cases of AES have been reported from 11 districts in Bihar, and Muzaffarpur district seems to be the worst-hit. AES is a group of clinically similar neurological manifestations caused by several different viruses, bacteria, fungi, parasites and chemical/ toxins. Japanese Encephalitis, which is a variant of AES, is the most common in India. AES is a serious public health concern in the country. Outbreaks usually coincide with summer and the onset of monsoon, a period when a whole host of other diseases, too, strike people, making swift diagnosis of AES all the more difficult. It strikes children and young adults most often, especially those who are severely malnourished.

The large number of children who die annually in India from AES is of grave concern. In 2005, for instance, hundreds of children died of AES in Uttar Pradesh, and in 2014, 196 deaths from AES were recorded in Bihar. When and where AES outbreaks happen are well known. Scores of children die of Japanese encephalitis in the states of Uttar Pradesh and Bihar annually. We even know the districts where it is the most prevalent. Hence, AES outbreaks, and especially fatalities, should not be happening. Every year, doctors complain of shortage of vaccines in public health centres and hospitals. Studies reveal that pigs are often carriers of the disease. Eating raw litchis on empty stomach is another common cause of AES in India. Why are health authorities not educating people on these matters?

A part of the problem is that our health authorities are more intent on denying and downplaying the magnitude of the problem than on dealing with it. The Nitish Kumar government claims that most deaths in the state were due to hypoglycaemia, not AES. Besides, government figures are grossly understated. More shocking is the fact that an awareness drive on AES prevention was not conducted in Bihar this year. Bihar’s health minister has blamed the Election Commission for this. He said that government officials were on election duty, hence were not available for AES awareness drives. The low priority that the government accords to public health issues, especially those that affect the poor and malnourished, is deeply worrying. Several East Asian countries, including China, Japan and South Korea turned to mass vaccination drives to help bring down AES cases. India must explore this option.

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(Published 13 June 2019, 18:29 IST)

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