Children bear brunt of Indian encephalitis outbreak

With tears in his eyes, Indian farmer Ram Kumar Dwivedi rushes to the side of his convulsing son Vimal and begins pumping his chest with his hands to help the nine-year-old breathe.

Vimal is one of thousands of Japanese encephalitis patients in the impoverished, northern state of Uttar Pradesh, where more than 700 people have died over the past few weeks.

The disease, first identified in Japan, is caused by a virus spread by mosquitoes and affects the brain. Symptoms include high fever, severe headaches and convulsions and can lead to paralysis, coma and death.

Most of the victims are children belonging to poor families—they account for 80 percent of the deaths so far in northern India.

The state-run King George’s Medical College hospital in the state capital Lucknow is the best medical facility in the region. But there were no doctors or nurses to immediately attend Vimal in the crowded pediatric ward.

They were busy coping with newer cases pouring in from the state’s eastern districts.

“He used to play and run around and was full of life. Now look at him,” Dwivedi said, pointing to his scrawny, almost lifeless son who lay naked on a metal cot in the ward, the paint peeling off the walls.

Dozens of children lie on metal cots around him, their exhausted parents holding them in their arms or pumping air through manual ventilators for hours on end.

The doctors are not sure how many will survive. Of the 172 children admitted to the hospital with the disease in little more than the past month, 43 have died.

VACCINATIONS NEGLECTED

The outbreak is the most serious in India in more than two decades.

It could have been prevented, or at least minimized, with an early and thorough vaccination campaign for children, who are more susceptible to the infection because their immunity levels are low.

But Uttar Pradesh neglected vaccination drives despite smaller outbreaks nearly every year for more than two decades, experts said. Thousands of vaccine doses are now arriving but they are of little use for the hundreds already infected.

“The nature of the epidemic this year shows that it cannot be left for chance that the cases will not be many,” said Eimar Barr, UNICEF’s deputy director for India.

“Some years you get lucky, sometimes you don’t.”

Vaccinations would have also prevented survivors suffering awful side-effects of the disease.

Health officials say Japanese encephalitis has a fatality rate of between 30 and 60 percent. But many who survive are physically or mentally handicapped because of damage to the brain and other parts of the nervous system.

The disease is not new to Uttar Pradesh but authorities noticed a spike in cases during the middle of the monsoon season in late July.

Nearly 3,000 cases have been officially reported since. But voluntary groups say the number would be higher as children in rural areas often die before they are brought to hospital.

Encephalitis is common in China and Southeast Asia but the number of cases have fallen sharply in China because of a vigorous vaccination program during the past decade.

UNICEF says Indian authorities should import millions of vaccine doses or sharply increase local production to prevent another outbreak in 2006 during the monsoon season when stagnant water makes it easier for mosquitoes to breed.

Mahendra Bhandari, head of King George’s hospital, said was deeply saddened to see so many children dying. But with limited resources and his staff overwhelmed, there was little he could do.

“It is a calamity of the worst kind,” he said.

Print Version
Tell-a-Friend