Lack of social hygiene and an anti-science attitude among people is bringing back several infectious diseases that were eradicated decades ago in Kerala.

Lack of social hygiene and an anti-science attitude among people is bringing back several infectious diseases that were eradicated decades ago in Kerala, said public health activist Dr B Eqbal.

“While everybody is focusing on Nipah, there are cases of dengue, rat fever, chicken pox, and even malaria, which were eradicated from the state in the 1960s, being reported from every district,” said Dr Eqbal.

As monsoon prepares to make landfall in Kerala, the state health department is stepping up on its preventive measures. But activists feel that enough is not being done to contain diseases, particularly vector-borne infections.

Local media reports claim that 76 people have lost their lives to fever and other epidemics in the first five months of 2018 in Kerala. There were 615 cases of dengue, 15,579 cases of chicken pox, and 1,091 people were diagnosed with rat fever.

A public health official, requesting anonymity, said dengue cases are being reported from the northern districts in the state, with most cases coming from Kasaragod, Malappuram and Kannur. “In the coming days, vector density will explode. Dengue will affect thousands,” the official added.

Rajeev Sadanandan, additional chief secretary (Health), said that lack of social hygiene is the primary reason for the spread of vector-borne diseases.

“Waste management is in a bad state. Till that is not resolved, the disease cannot be contained,” he added.

Mini Mohan, a community health activist, feels that the state needs to focus on disease preventive centres. “In due course of time, they (disease prevention centres) have been converted into treatment centres. There is no focus on disease prevention. It is all about treatment now,” she said.

Last year, a total of 420 people died and over 22 lakh persons were affected by various kinds of diseases causing fever in the state.

Health Minister KK Shailaja had informed the state Assembly in 2017 that out of the total deaths due to fever, 74 people died of H1N1 and 24 succumbed to dengue.

Dr Eqbal said Kerala needs to do more in its attempt to control disease-carrying mosquitoes and added that several viral and bacterial diseases that were eradicated are making a comeback due to poor hygiene and lack of awareness.

“Diphtheria was eradicated in Kerala. But during the Nipah outbreak, one diphtheria case in Kerala were the victim succumbed went unnoticed,” he added.

Sixteen of 17 persons tested positive for Nipah died in Kerala. While all measures have been taken to contain the disease, state officials still remain clueless about how the Nipah spread in the state.

Vaccination drives have not been able to completely eradicate diphtheria in Kerala, Karnataka and Telangana. A WHO report states that in 2016, 1,530 cases were seen in Bihar, Uttar Pradesh, Kerala and Haryana and 177 deaths were reported the same year.

But Sadanandan denied claims of infectious diseases coming back to the state.

“Yes of course, some infectious diseases like rat fever are making a comeback or are being reported more. But that doesn’t mean that, we have failed, and infectious diseases are making a comeback,” he said.

There were 1,400 cases of rat fever reported in the state in the last three months. Rajeev said that in the last three months, 9,00,000 fever cases from various infections were reported in the state. “Among those, only around 4,000 cases are suspected to be caused by dengue. Last year, it was around 17,000,” he added.

Faith against science

According to Dr Eqbal, an anti-science attitude among people in the state is a major hurdle in containing the spread of viral and bacterial infections.

“There are several instances in the state where people are against vaccination; besides, some people have started to believe that cow urine can cure diseases. Such views are dangerous and must be eradicated. But sometimes, governments and politicians can be seen favouring such actions,” said Dr Eqbal.

Last year, in Kerala's Malappuram district, medical staff administering Measles-Rubella vaccine to children as part of a government-run campaign were attacked on two separate occasions. A junior public health centre nurse was attacked by an armed group and suffered fractures. Doctors who were monitoring the camp said their staff received death threats from angry locals who wanted to stop the vaccination drive.

In a separate incident, a group of parents manhandled health workers during a vaccination drive at a school in the same district. While this was the first instance of violence against health workers in Malappuram, doctors and other health workers say they frequently receive threats from locals for conducting vaccination camps.

The author is a member of The NewsCart, a Bengaluru-based media startup