September 15, 2005

Indian state caught napping by deadly disease

By Kamil Zaheer

GORAKHPUR, India (Reuters) - India's most serious outbreak
of encephalitis in three decades, which has killed 750 people
and infected thousands in the past two months, could have been
prevented if authorities had stuck to an immunization program,
experts said.

While neighboring China has drastically cut its infection
rate of Japanese encephalitis through mass vaccination
programs, India, which has suffered smaller outbreaks for
decades, has consistently ignored it.

Last year, only 400,000 children out of 7.5 million were
vaccinated against encephalitis in the most populous Uttar
Pradesh state, which has taken the brunt of the disease.

"For many years, the public health situation in Uttar
Pradesh has been completely eroded," Alok Mukhopadhyay, head of
the Voluntary Health Association of India, said. "We always
have a firefighting response."

India which spends a paltry 0.9 percent of GDP on
healthcare has been more pre-occupied with AIDS, tuberculosis
and polio in recent years than encephalitis. The 750 or so
victims this year have been mostly children from poor families,
experts said.

Encephalitis is caused by a virus found in pigs and is
spread by mosquitoes. It affects the brain and symptoms include
high fever, severe headaches and convulsions and it can lead to
paralysis, coma and death.

This year, the problem was compounded after annual monsoon
rains broke early allowing mosquitoes to breed in large
numbers. The authorities in Uttar Pradesh were caught off-guard
as the first cases of the disease started arriving after the
rains in June, a month ahead of schedule, a state health
official said.

"Medical authorities were not prepared for such an early
rise in the number of cases," regional health services chief
O.P. Singh told Reuters.

With about 3,000 cases officially reported, the outbreak is
the most serious in India in nearly three decades.

The early onset of the disease also meant hospitals were
ill-equipped to deal with the crisis. In a government hospital
in the eastern city of Gorakhpur, about 250 children are packed
into paediatric wards meant for 52. Many comatose children,
gaunt after days of fever and convulsions, lie two to a metal

Housewife Dhaneswari is worn out nursing her nine-year-old
daughter Lalita, who is infected by the disease and lies
unconscious in her mother's lap.

"She has not spoken for 10 days. What will become of her?"
she asks.

Thousands of mosquito nets are being distributed across the
affected parts of Uttar Pradesh, officials said, calling it a
desperate bid to halt the spread of the disease.

But it seems like too little too late.

"The government has done nothing. People are afraid," said
Gorakhpur resident Feroz Khan.