Tag: Acute Encephalitis Syndrome

162 children died of encephalitis in Bihar, 63 in seven other states: Govt

Source: indiatoday.in

s many as 162 children died due to acute encephalitis syndrome (AES) in Bihar till July 2 this year, while 63 fatalities were reported from Assam, Jharkhand, Maharashtra, Manipur, Odisha, Uttar Pradesh and West Bengal till June 30, MoS Health Ashwini Choubey said on Tuesday.

Responding to a question over whether lychees were the cause of deaths, the minister, in his written reply in Rajya Sabha, said consumption of lychee was safe for healthy individuals, but in “malnourished children, it triggers hypoglycaemia and leads to seizures or AES”.

“A research study was conducted by the National Centre for Disease Control (NCDC), along with partner institutions, in the year 2013-14 wherein it has been found that when lychee is consumed by malnourished children, it triggers hypoglycaemia and leads to seizures or AES like picture,” Choubey said in his written reply.

On the basis of the study, an intervention strategy for awareness and nutritional supplementation was recommended to the state, the minister said.

A comprehensive study incorporating various other aspects of aetiology has been initiated by the Ministry of Health under Indian Council of Medical Research (ICMR).

“In 2019, a total of 162 deaths of children have been reported from Bihar till July 2 due to AES. As per information received from the National Vector Borne Disease Control Programme (NVBDCP), 63 deaths have been reported due to AES till June 30 from other seven states of the country — Assam (25), Jharkhand (2), Maharashtra (1), Manipur (1), Odisha (1), Uttar Pradesh (17) and West Bengal (16),” his reply stated.

He also elaborated on a number of measures that the Centre has initiated to support the Bihar government in the containment of AES, while adding that “as per constitutional provisions, health is a state subject”.

Choubey, in his reply, said Union Health Minister Harsh Vardhan had reviewed the situation with his counterpart in Bihar and also with officials from the ministry.

A team of experts, consisting of public health specialists from various central government institutes, was deputed to assist the Bihar government in taking immediate measures to contain AES, he said.

Vardhan had also visited Shri Krishna Medical College and Hospital (SKMCH) at Muzaffarpur in Bihar, Choubey said.

The Health Ministry had sent another high-level multi-disciplinary team, which included senior pediatricians from various central government institutes, to Muzaffarpur.

Epidemiologists from the National Centre for Disease Control (NCDC), senior pediatricians, laboratory technicians are in Muzaffarpur since June 12.

The NCDC’s Strategic Health Operations Centre (SHOC) was engaged to monitor the situation in Muzaffarpur and co-ordinate tasks at the field level, Choubey said.

He said the Health Ministry had deputed five teams of doctors, along with technicians from central government hospitals, to SKMCH to support clinical management.

“A central team, consisting experts from Indian Council of Medical Research (ICMR), was also deployed at SKMCH. The team is also scrutinising and reviewing the case records of discharge and deceased patients using a standardised tool to know the reasons for mortality,” he added.

AES in Bihar: Providing all support to contain it, Centre tells SC

Source: business-standard.com

The Centre told the Supreme Court Wednesday that it was proactively providing all support to Bihar in containing and managing Acute Encephalitis Syndrome (AES) in which more than children have died.

In an affidavit filed on a plea seeking measures for containment of the disease, the Centre said Union Health Minister Harsh Vardhan had visited Bihar on June 16, to review the situation in Muzaffarpur.

It said that after the visit several decisions were taken including construction of a 100 bed Paediatric Intensive Care Unit (ICU) at SKMCH hospital in Muzaffarpur by the state government in one years from the funds of National Health Mission (NHM).

“The land for the same (100-bed Paediatric ICU) is available in the premise of the SKMCH hospital and will be provided by the state,” the affidavit said.

It said a decision has been taken to set up five virology labs in different districts of the state from the NHM funds and the location of the districts will be decided in consultation with the state government.

Detailing further decisions taken, the Centre said: “In the adjoining districts, 10-bed Paediatric ICUs to be setup so that such cases can be treated early and there is no unnecessary load on the facilities available at SKMCH. Funds for this are to be provided through NHM.”

The ministry said that to enable early detection and treatment of the hypoglycemia cases, a dedicated team of doctors will be placed in endemic Primary Health Centres with required facilities, at least for three-four months before and during expected onset of disease.

“As for present, the concerned PHCs and CHCs (Community Health Centres) should take prompt corrective measures for hypoglycemia at the facility itself to utilize the golden hour”, the affidavit said.

It said that a Super Speciality Block is being constructed at SKMCH hospital, Muzaffarpur and it would start functioning by first week of December.

Besides these steps, the affidavit said that Ministry of Earth Sciences has been requested to upgrade its IMD Observatory facility for improved monitoring of climate related parameters such as temperature humidity, rainfall and share it with the state government for better preparedness and management of AES.

It said the minister has decided to constitute inter-disciplinary, high quality research team for ascertaining the case of AES with specific reference to Muzaffarpur.

“The vacant positions of district epidemiologist and entomologist in Muzaffarpur to be filled up immediately by the state government,” the health ministry said added that health is a state subject as per the Constitutional provisions.

The apex court is hearing a petition filed by advocate Manohar Pratap who has said that he was deeply “pained and saddened” by the deaths of more than 126 children, mostly in the age group of one to 10 years, in Bihar due to AES.

Besides Centre, the apex court had also asked Bihar government to file its response on the issue.

In a shocking revelation about medical care facilities in Bihar, which is facing an outbreak of acute encephalitis syndrome, the state government Tuesday told the Supreme Court that there are only 5,205 doctors in government-run health centres against the sanctioned strength of 12,206.

The state government, in an affidavit filed in the apex court, said that only 5,634 nurses were there in government run hospitals and health centres against sanctioned strength of 19,155.

The court had on June 24 directed the state to apprise it about the status of public medical care facilities, nutrition and sanitation within a week in view of deaths of over 100 children in Muzaffarpur due to the outbreak of AES.

Regarding AES cases, the state government said 824 cases have been reported and the number of deaths was 157.

It, however, said that it was not known whether 24 deaths out of 215 cases were due to AES.

“State of Bihar had already taken all possible steps to prevent the spread of the disease by providing additional medical facilities at the affected region, public awareness campaign at the village level, involving various agencies to assist the government etc,” it said.

Symptoms of AES include high fever, convulsions and extremely low blood sugar levels. Among the factors said to trigger the syndrome are malnutrition.

There were more than 44,000 cases and nearly 6,000 deaths from encephalitis in India between 2008 and 2014, said a 2017 study published in The Indian Journal of Medical Research (IJMR).

Researchers said the patients often report acute onset of fever and altered consciousness, with a rapidly deteriorating clinical course, leading to death within hours.

Litchis grown in Muzaffarpur, the country’s largest litchi cultivation region, are said to contain a toxin which can cause a drop in blood sugar levels if consumed by a malnourished child.

‘Nation Responsible for Dying Kids in Bihar, Time For Child Survival Policy That Fixes Accountability’

Source: news18.com

New Delhi: With over 100 children dead due to Encephalitis in Bihar since June 2019, the biggest question that remains to be answered is who is to be held responsible?

“Children, obviously, cannot be held responsible for either ‘bringing’ or ‘allowing’ their death. So, there are two parties that could be held responsible – the State (including public health care system) and parents/guardians,” says Ali Mehdi, senior fellow of Health Policy Initiative at Indian Council for Research on International Economic Relations (ICRIER).

“By State, with a capital S, I do not exclusively mean the present state or Central government, but we as a nation. Present governments in state and Centre should accept their shares of responsibility, but we as a nation are primarily responsible for the pattern of child deaths in the country,” he adds.

Every year, Acute Encephalitis Syndrome (AES) or Chamki fever returns to haunt one of India’s poorest and most malnourished states, Bihar, leaving hundreds of children dead and others with permanent neurological damage.

From litchi to heat wave, various factors have been pointed out as the cause behind the deaths. However, one thing that gets consistently overlooked is the fact that it is a collective failure.

“Even if the role of the State was limited to tackling the shortfall in parental capability to save their children, most child deaths would still be the responsibility of the State since most parents would have done their best, as they deem fit, to keep their children alive,” says Mehdi.

“Every preventable child death is unjust, and the State is responsible for it… it is a collective failure,” he adds.

The recent AES outbreak also brought back to spotlight the public healthcare system in Bihar, which is struggling with poor infrastructure, shortage of manpower and administrative failure.

The situation is so bad that National Human Rights Commission (NHRC) was forced to send a notice to the Union Health Ministry and Bihar government over the rising number of children dying due to AES.

But can the public health care system be blamed for this medical crisis? “With efficient and equitable health systems and doctors, especially at the primary health care level, many deaths could have been prevented.

However, the challenges which surround it are reflective of the challenges of ‘structural’ causes,” says Mehdi, adding that blaming the medical system alone would be ‘unfair’ as it’s a ‘systemic failure’ of the Indian State.

Going by the magnitude of the AES outbreak, which returns every year during summers, there’s a desperate need for concrete steps to save children from this deadly disease.

“Given the endemic nature of child mortality in India – it has been the world’s largest contributor to child deaths since 1953 – it is high time for India to have a National Child Survival Policy with clearly delineated responsibilities,” Mehdi stresses.

He believes that there is a need to fix responsibility for child survival in the constitution for things to change in “any major way”.

“A ‘New India’ has to shed its world leader status in backwardness. And that has to begin with the humble acknowledgment of the challenge itself – nationalist chest-thumping isn’t going to help save lives or reduce poverty in the country,” Mehdi adds.

Every child deserves to lead a reasonably long, healthy and productive life to be able to realise their full potential, and for that, “shots of vaccinations would not be enough – children deserve a shot of justice to survive.”

“The Central and state governments have to stand up and assume responsibility for children’s survival and development up to a particular age at least. This should be included in the Constitution and a national policy be developed,”Mehdi says.

He goes on to add that people should be allowed to take the governments to court over harm to their own / children’s health and survival due to defined structural factors, such as air pollution, lack of sanitation and inadequate nutrition.

In addition to framing clear national policy for child survival, Mehdi says Indian health care system needs an urgent overhaul.

Some of the changes Mehdi recommends include developing ‘public health cadre to address social determinants of health’ (The Mudaliar Committee of 1959 recommended an ‘All India Medical Service cadre along the lines of the Indian Administrative Service (IAS)), ‘sustainable financing’ mechanisms to address child deaths and malnutrition, more ASHA / ANM level workers to tackle the problem at the local level, as well as a strong regulatory mechanism for private health services and price control on medicines.

In the end, shifting the blame on the state vs central government won’t serve the purpose unless “we as citizens, as a nation have to stand up and own responsibility.”

People vs Govt: The Bihar Residents Arrested for Demanding Water

Source: thecitizen.in

NEW DELHI: Today we kick off a series of stories revolving around the Fundamental Rights guaranteed by the Constitution of India. Through field reports, interviews, photo essays, histories and analysis, we discover these rights of strength and their shortcomings.

On June 25 police lodged an FIR against 39 people in Harivanshpur village in Bihar’s Vaishali district for carrying out the protests over the lack of water supply and the deaths of several of their children from the Acute Encephalitis Syndrome.

Residents of the village have been booked under IPC Sections 147, 148 and 149 (rioting and unlawful assembly), 188 (disobedience of orders), 283 (obstruction of public ways), 353 (assault) and 504 (breach of peace).

Even the parents of encephalitis victims have been charged with these crimes.

It was following the deaths of seven children from AES over two weeks that the residents of Harivanshpur staged a protest on June 23 and again two days later.

They also staged a protest demanding water tankers for their village, reports say, as there is an acute shortage of drinking water in the area and all the hand pumps have dried up.

The farmers and livestock of Vaishali district are the worst affected. There is no irrigation water available in the region, and with no groundwater left to tap, standing crops in the farms are drying up according to several reports.

Article 19(1)(b) of the Constitution of India guarantees the right “to assemble peaceably and without arms”. Freedom of peaceful assembly resembles the idea of a democratic government.

It is also reported that the residents of Harivanshpur have announced a missing person award of Rs.15,000 for Union Minister Ram Vilas Paswan.

Speaking to The Citizen, Amresh Kumar the area’s Block Development Officer said, “On June 23 the villagers staged a protest when the Hajipur MP Pashupati Kumar Paras and Lalganj MLA Rajkumar Sah came to the area and tried to hold them hostage. Following the incident, orders were given to the local officers to keep vigil and report any form of nuisance in the area.”

Ashok Kumar Singh, the Block Panchayati Raj Officer told The Citizen that “villagers blocked the highway for four hours and created nuisance. Most men have fled the village fearing rule of law after an FIR was filed against them.”

According to The Hindu “most of the children who died in Harivanshpur belong to the extremely backward Mallah community and the Dalit Musahar community.” One among them, Ganesh Manjhi, lost two sons within 24 hours due to suspected AES. They were 7 and 2 years old.

Tejashwi Yadav finally surfaces in Patna but still can’t make it to Bihar assembly

Source: theprint.in

Patna: Under fire for the Rashtriya Janata Dal’s (RJD’s) dismal campaign in the Lok Sabha elections, Tejashwi Yadav is still to return to the political arena even though he was back in Patna Sunday evening after spending a month in New Delhi.

Yadav’s absence is all the starker as he is the leader of opposition in the Bihar assembly, where the monsoon session commenced Friday. On Monday, the treasury benches allowed a rare adjournment motion on the death of around 180 children in Muzaffarpur due to the Acute Encephalitis Syndrome (AES).

Adjournment motions are an opportunity for the opposition to censure the government on its lapses, but Tejashwi, the son of RJD chief Lalu Prasad Yadav, wasn’t present in the House despite his home in Patna being less than a kilometre from the assembly building.

That prompted Parliamentary Affairs Minister Srawan Kumar to gesture at Tejashwi’s empty chair even as Speaker Vijay Choudhary remarked, “Let’s focus on the members who are present”, leaving RJD MLAs red-faced.

“This must be the first time in parliamentary history that the leader of the opposition has been absent on such an important issue,” an angry RJD MLA later told ThePrint.

The onus was then on a few senior opposition leaders such as Abdul Bari Siddiqui of the RJD and Sadanand Singh of the Congress to grill the JD(U)-BJP government on the issue but they targeted Health Minister, the BJP’s Mangal Pandey, as opposed to Chief Minister Nitish Kumar.

The Nitish government has been pulled up by the Supreme Court and the media over the Encephalitis deaths but was virtually handed a walk-over in the assembly as the opposition allowed Pandey to read out the steps taken by his department without questioning him.

Family, party unsure of whereabouts
Tejashwi had gone off the radar after addressing a press meet in Patna on 28 May following the Grand Alliance’s defeat in the Lok Sabha elections. There was much speculation on his whereabouts with some RJD leaders even claiming that he may have gone to London to watch the Cricket World Cup as he is a former cricketer himself.

On 28 June, exactly a month later, Tejashwi tweeted accusing the media and his political opponents “of cooking up spicy stories” of his absence and stating that he was away as he had an anterior cruciate ligament (ACL) injury.

He then went on to reiterate his party’s “commitment to the poor” and added that he was “following up on” the death of children due to Encephalitis.

But there is little clarity on his whereabouts, with family members showing irritation when asked the question. Tejashwi’s brother Tej Pratap surfaced in the assembly Monday but shrugged off the question. “He must be at his home,” Tej Pratap said. Their mother, former chief minister Rabri Devi, Friday snapped back at a reporter over the same question. “He is at your home,” she said.

RJD MLAs, however, told ThePrint that Tejashwi was yet to interact with them. “When a few MLAs telephoned him they were told that he would call back. But that call never came,” a senior RJD MLA said, adding that the party was yet to hold its routine meeting of legislators to discuss its floor strategy for the monsoon session.

“The result is that in the assembly we are going soft on CM Nitish Kumar, but in the state legislative council, Rabri Devi is demanding his resignation,” he added.

Opponents mock RJD leader
NDA leaders have been taking jabs at Tejashwi ever since his tweet on 28 June.

“Arun Jaitley and Sushma Swaraj made their illness public while they were in office,” said deputy CM Sushil Kumar Modi. “Tejashwi Yadav made his absence mysterious and has disrespected his party and its legislators.”

The RJD leader is also facing flak from his own party colleagues. “The manner in which he runs the party raises questions on if the party will survive. He refuses to meet his supporters and leaders,” said another RJD leader. “All this is happening when the party has to gear up for the assembly polls next year.”

The leader further said that Tejashwi is living up to his reputation as a “non-serious political leader who did not even cast his vote in Patna during the Lok Sabha polls”.

Posters in Patna blame Nitish, Pandey for AES deaths

Source: nationalheraldindia.com

Hours ahead of the Monsoon session of the Bihar Assembly on Friday, posters appeared in Patna blaming the NDA government for the death of over 150 children in Muzaffarpur due to Acute Encephalitis Syndrome (AES) and the complete collapse of law and order in the state.

Dozens of posters in Hindi that were pasted on walls along the main roads in the state capital, also demanded resignations of Chief Minister Nitish Kumar and Bihar Health Minister Mangal Pandey on moral grounds for having failed to check the spread of AES.

The posters termed Bihar as “maut ka kuan” (death well) and mocked it leaders lack of concern for the suffering of the people of the state.

“Chief Minister Nitish Kumar found time to visit Muzaffarpur only after 100 children had died, while Mangal Pandey was more interested knowing the score of the India and Pakistan World Cup cricket match at his press conference with Union Health Minister Harsh Vardhan in Muzaffarpur,” it said.

The posters also expressed growing resentment among the people over the rising lawlessness in the state with daily reports of murder, kidnapping, extortion, loot, robbery and rape.

Ealier similar posters had come up in Muzaffarpur — the epicentre of AES epidemic — asking people to trace “missing” Opposition Rashtriya Janata Dal (RJD) leader Tejashwi Yadav.