As floods continue to batter the Indian frontier regions of the northeast, most state governments there are gearing up to prevent the further spread of Japanese encephalitis, which has already taken a heavy toll in human lives.
As many as four states in the region have been hit by the disease in the last couple of months with Assam suffering the most, with the death toll there reaching 101, according to a bulletin issued by the National Health Mission. More than 20 cases have also been detected in neighboring Meghalaya and Arunachal Pradesh.
Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus that belongs to the same genus as dengue, yellow fever, and the West Nile viruses. The first case of Japanese encephalitis was documented in 1871 in Japan. According to WHO, 24 countries in Southeast Asia and the Pacific regions suffer from JEV transmission risk, covering more than 3 billion people overall worldwide.Enjoying this article? Click here to subscribe for full access. Just $5 a month.
Japanese encephalitis is transmitted to humans through bites from infected mosquitoes of the Culex species (mainly Culex tritaeniorhynchus). It causes inflammation of the brain resulting in reduced levels of consciousness, seizures, headache, photophobia, vomiting, and death in some cases.
Mosquito-borne Diseases in India’s Northeast
India’s Northeast has had a long tryst with mosquito borne diseases with the earliest case of Japanese encephalitis recorded in 1978 in Assam and, since then, cases and deaths have been reported in each consecutive year. Formerly endemic in the eastern zone of the state, it is spreading fast with confirmed cases and a high case-fatality rate affecting all ages. On July 19, the union minister of state, health and family welfare, Ashwini Kumar Choubey, told Parliament that over 600 people had died in Assam due to Japanese encephalitis since 2014.
There is no dearth of mosquito-borne diseases in the region, which include malarias, lymphatic filariasis, and dengue. The incidence of malaria is reported to be gradually receding, with a consistent decline in cases over the past few years. According to the Indian Council of Medical Research (ICMR), deaths due to malaria in India’s Northeast account for about 13-15 percent of all cases in the country.
Research reveals that paddy cultivation in the region, domiciliary surroundings with adjacent water bodies, high temperature and humidity contribute to the abundance of the potential mosquito vectors responsible for transmission of the virus among the rural communities. Also, ignorance about the disease, communication bottlenecks, and loopholes in the government delivery mechanisms have contributed to an escalation of these diseases.
Danger From Floods
Government officials are apprehensive over the current wave of flooding in Assam and in parts of Meghalaya, Mizoram, and Arunachal Pradesh, as it could create the conditions for the further spread of Japanese Encephalitis. Assam, which is centrally located in the region, continues to reel under water with 18 districts affected out of a total of thirty-three. So far, 69 people have died and more than 2,800,000 have been affected according to information, according to a release from the government.
In view of the danger, Assam Chief Minister Sarbananda Sonowal has directed the health department to collect blood samples from all the inmates putting up at relief camps set up for flood victims to contain Japanese encephalitis. A vaccination program covering children between the ages of one and 15 has also been initiated by the government in the state. All doctors and paramedics have been instructed to cancel their vacations through September following the outbreak of the disease.
The neighboring state of Arunachal Pradesh has plunged into action with fogging and focal insecticide spray to prevent the disease from spreading further. A statewide drive has been launched for the early detection and cure of Japanese encephalitis with a focus on East Siang, Upper Subansiri, and the Papum Pare districts where cases of the disease have been detected.
In Meghalaya, two deaths in the western districts of Garo Hills spurred an emergency meeting chaired by Chief Minister Conrad Sangma to take stock of the situation and ensure better preparedness against the disease. In Tripura as well, the health department has begun an awareness campaign in vulnerable and inaccessible zones and medical officers have been directed to ensure a stock of medicines.
Rajeev Bhattacharyya is a senior journalist in Assam, India.