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Dr. Anbumani Ramadoss, Union Minister of Health and Family Welfare made the following statement in the Lok Sabha today in response to the Calling Attention Motion regarding situation arising out and steps taken by the Government in regard thereto:
“Brain fever due to Japanese Encephalitis (JE) is caused by a virus and is transmitted through mosquitoes. While there is no specific treatment for this disease, early symptomatic management is important. In case of JE and other viral encephalitis, the management of the critically ill children is directed at minimizing risk of death and complications. The main reservoirs of the JE virus are pigs and water birds and its natural cycle, virus is maintained in these animals. Man is an accidental host and does not play role in JE transmission. The outbreaks occur where there is close interaction between these animals and human beings. The vectors of JE breed in large water bodies such as paddy fields. The mosquitoes are outdoor rester and therefore measures such as indoor residual spray are not very effective.
Clinical management of JE is supportive and in the acute phase it is directed at maintaining fluid and electrolyte balance and control of convulsions, if present. Maintenance of airway is crucial. The state governments have been advised that in the endemic districts, anticipatory preparations should be made for timely availability of medicines, equipment and accessories as well as sufficient number of trained medical, nursing and paramedical personnel. The Government of India supports training programmes and provides technical support for outbreak investigations and control. Insecticides used under the National Vector Borne Disease Control Programme are used for the control of JE outbreaks, wherever required.
The preventive measures for Japanese Encephalitis are directed at reducing the vector density and in taking personal protection against mosquito bites. The reduction in mosquito breeding requires ecological management particularly water management and irrigation practices, as the role of insecticides is limited. JE vaccine is produced in limited quantities at the Central Research Institute, Kasauli, through mouse brain inoculation technique. Three doses of the vaccine provide immunity lasting a few years and repeated booster doses are required every 3 years. The vaccine is procured directly by the state health authorities. Vaccination is not recommended as an outbreak control measure.
During 2004, 1695 cases and 367 deaths due to suspected JE were reported in the country from 12 states. Majority of cases were reported from Uttar Pradesh, Andhra Pradesh, Maharashtra, Karnataka, Haryana and Assam. The state wise cases and deaths due to JE as reported by State Health Authorities are given in Annexure-I, being laid on the Table of the House. In Uttar Pradesh, during 2004, 1030 cases and 228 deaths have been reported. District wise details are given in Annexure-2, being laid on the Table of the House.
Central support is provided as technical guidance, support for outbreak investigations and control, insecticide, laboratory diagnostic support through identified institutions like National Institute of Virology, Pune, National Institute of Communicable Diseases, Delhi, Regional Medical Research Centre, Dibrugarh, NIMHANS, Bangalore etc. In addition, support is also provided for training and Information Education and Communication. In view of the higher incidence of disease, workshop on JE was conducted at NVBDCP, Delhi and Saharanpur, Uttar Pradesh. Five training courses for Medical Officers to Uttar Pradesh and one each to Haryana, Karnataka and Assam were also arranged to improve the skills of peripheral doctors in case management and prevention and control of JE.”
Annexure 1
STATE-WISE CASES AND DEATHS DUE TO JAPANESE ENCEPHALITIS
Sl.
No.
Affected States/UTs
2000
2001
2002
2003
2004 (P)
2005(P) *
C
D
C
D
C
D
C
D
C
D
C
D
1
Andhra Pradesh
343
72
33
4
22
3
329**
183
7**
3
2
Assam
158
69
343
200
472
150
109
49
235
64
18
4
3
Bihar
77
19
48
11
8
1
6
2
85
28
4
Chandigarh
0
0
0
0
4
0
0
0
0
0
5
Delhi
0
0
0
0
1
0
12
5
17
0
1
0
6
Goa
15
3
6
2
11
0
0
0
0
0
7
Haryana
74
43
47
22
59
40
104
67
37
27
8
Karnataka
438
45
206
14
152
15
226
10
181
6
9
0
9
Kerala
164
2
128
5
0
0
17
2
9
1
10
Maharashtra
2#
0
126
1
119
16
475
115
22
0
11
Manipur
0
0
0
0
2
1
1
0
0
0
12
Punjab
0
0
0
0
10
2
0
0
0
0
13
Tamil Nadu
4
0
0
0
0
0
163
36
69
9
4
0
14
Uttar Pradesh
1170
253
1005
199
604
133
1124
237
1030***
228
15
West Bengal
148
50
119
21
301
105
2
1
3
1
6
0
Total
2593
556
2061
479
1765
466
2568
707
1695
367
38
4
C= Cases D=Deaths
* = Cases as reported by respective states up to June, 2005 Provisionally
** = Suspected viral encephalitis
*** = As per revised report from the state
Note # = State reported additional 80 cases for 2000 as suspected JE
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