The disease had claimed more than 154 lives in Bihar

The tension on Sunita’s face is palpable as she looks at her eight-year-old daughter who is asleep on a bed at the Paediatric Intensive Care Unit at the Baba Raghav Das Medical College in Gorakhpur.

While the official diagnosis is yet to be ascertained, doctors say the child has shown symptoms of Acute Encephalitis Syndrome, a group of diseases that wreaks havoc in this part of east Uttar Pradesh in the monsoon season.

Suffering from high-grade fever, convulsions and altered sensorium or mental apathy, the child was first admitted to the hospital on May 29 and was discharged after 14 days but had to return for treatment after she developed sudden seizures.

“When we stopped the medicine, her fever would return. She would face jhatkas (convulsions),” said Sunita who hails from a village in Gorakhpur. A Dalit, Sunita and her family still defecate in the open as they are yet to get a toilet built. Her husband is a wage labourer, providing a glimpse of the socio-economic conditions of those affected by AES.

The disease hits the peak during monsoons, from July to October. Though the outbreak season is yet to commence this year, the BRD hospital has recorded 87 cases of AES and Japanese Encephalitis, of which 19 patients died. Authorities, however, say this is part of a declining trend since 2017 when the hospital was hit by the oxygen-supply tragedy.

That year, BRD Hospital dean Ganesh Kumar told The Hindu, 2,240 patients of AES and JE were admitted while 512 deaths were recorded. In 2018, the figures drastically fell to 1,047 patients and 166 deaths.

In the Gorakhpur Division, which comprises Gorakhpur, Kushinagar, Deoria and Maharajganj districts, the Case Fatality Rate (CFR) dropped from 12.64 in 2017 to 9.70 in 2018.

In 2017, the division witnessed 2,998 cases of AES of which 379 patients died, show official figures. In 2018, the cases fell to 1,279 while deaths recorded were 125. In comparison, the CFR in 2015 and 2016 was 17.32 and 15.12, with 338 and 426 deaths.

The figures for Japanese Encephalitis have also fallen drastically since 2017, when the CFR was 18.62 with 274 cases and 46 deaths as against 2018 when the CFR fell to 9.10, cases to 120 and 11 deaths.

The Yogi Adityanath government has tasked authorities to cut the figure down further this year. Authorities say the drop in cases and deaths is due to the State government’s investments in infrastructure, medicines, training of human resources, vaccination and awareness campaigns. They say the bed capacity at BRD has been increased to 428 from 272, the annual medicine budget raised from ₹2.5 crore to ₹13 crore, while 16 lakh persons are being vaccinated each year and 3.5 lakh paramedics trained to assist in treatment.

Dr. Ganesh Kumar said the awareness campaign and treatment at the peripheral level, primary health centres, district hospitals and Encephalitis Treatment Centres, has decreased the load at BRD from 80% to 45% in just one season. Additional Director, Health, Gorakhpur Division Pushkar Anand said eight mini-PICUs were established since 2018 in Gorakhpur division, with round-the-clock paediatricians and equipment like ventilators, monitors, pulse oscillators and a central oxygen supply. “Our aim is to control the disease within a day or two. So it doesn’t affect the brain,” said Mr. Anand.