Around 100 children have died of Japanese encephalitis in Muzaffarpur district of Bihar. These all are reported deaths. Locals claim the actual toll could be higher as many from remote villages fail to make it to hospitals in the district headquarters.

The Nitish Kumar government has looked clueless in checking the death toll and spread of Japanese encephalitis in this North Bihar district and its neighborhood.

Currently Muzaffarpur is at the epicentre of Japanese encephalitis but only a couple of years ago Gorakhpur in Uttar Pradesh was in the grip of Japanese encephalitis, which killed thousands of children over four decades. When Yogi Adityanath government took over from Akhilesh Yadav, Japanese encephalitis was the biggest health challenge in eastern Uttar Pradesh in 2017.

More than 500 children had died of Japanese encephalitis that year in Gorakhpur and its neighbourhood. Altogether 14 districts of the region were in the grip of Japanese encephalitis. In August 2017, many children admitted for treatment of Japanese encephalitis and acute encephalitis syndrome (AES), died at the BRD Hospital of Gorakhpur leading to huge political furore.

Pushed against the wall, Yogi Adityanath government opted for desperate measures and launched Action Plan 2018 in collaboration of the World Health Organisation (WHO) and Unicef for containing AES and Japanese encephalitis.

A massive vaccination drive was launched for Japanese encephalitis. A robust health and sanitation campaign was launched.

Early vaccination was pushed. Drive to segregate pigs from affected habitation was launched. Immediate response teams were put to work for fogging. Information campaign was launched to convince parents not to let their kids sleep on mud floors, to use India Mark-2 water pipes or hand pump for drinking water and to immediately reach out to ambulance helpline 108 in case of any early symptoms.

These measures seem to have worked for Uttar Pradesh. The cases of Japanese encephalitis and AES dropped by about two-thirds in 2018 compared to a year ago.

UP Health Minister Siddharth Nath Singh, in February this year, informed the assembly that 187 deaths occurred due to Japanese encephalitis and AES in 2018 against 557 in 2017.

The total number of cases of Japanese encephalitis and AES dropped from 3,817 in 2018 to 2,043 in 2017 in the affected 14 districts.

Fewer number of patients of Japanese encephalitis and AES reaching hospitals meant that the doctors could take better care of those admitted resulting in drop in mortality rate. While one in every seven patients of Japanese encephalitis and AES died in 2017, this came down to one in 11 last year.

Till February this year, no deaths due to Japanese encephalitis and AES were reported despite 35 cases in the region, the minister had told UP assembly.

A woman carrying a child showing symptoms of Acute Encephalitis Syndrome (AES) arrives at Shri Krishna Medical College and Hospital (SKMCH) for treatment in Muzaffarpur on Sunday. (Photo: PTI)

Since both eastern UP and north Bihar share almost same geographical hot and humid climate, a favourable ground for the spread of Japanese encephalitis and AES, the measures adopted by the Yogi Adityanath government might help the Nitish Kumar government not only in checking deaths due to the outbreak of this endemic but will also help defusing growing tension among aam aadmi against the ruling dispensation in Bihar.

However, the Nitish Kumar government of Bihar, too, has a standard operating procedure (SOP) in place which were laid in 2015 in the view of rising cases of Japanese encephalitis and AES. In 2012, 120 children had died of the disease while the death toll was 90 in 2014.

The 2015 SOP was laid by the health department of Bihar in consultation with Unicef to meet the encephalitis challenge. The SOP mandates that grass-root health workers including auxiliary nurse-midwife (ANM), accredited social health activists (ASHA) and anganwadi employees have to conduct household-level survey to check if any child has symptoms of Japanese encephalitis and AES.

The efforts brought down the encephalitis death toll to four in 2016 and 2017, and 11 last year. But it has seen a spike this year clearing showing that the SOP was not followed. Encephalitis situation is desperate in Bihar for the Nitish Kumar government.