Japanese encephalitis outbreak in Chitwan

NL Today

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Chitwan: Following the Japanese encephalitis outbreak in the Chitwan district, awareness campaigns have been launched in the district. 

A rapid response team coordinated by chief of the district health office has been formed and special cautions adopted to contain the risks, said the health office chief Durgadatta Chapagain. 

So far, out of 22 tests, nine Japanese encephalitis cases have been confirmed in the district. Representatives from Bharatpur Hospital, two medical colleges, a private hospital, and Nepal Red Cross Society are members of the response team that has been on standby each at all seven local levels, he said. Buffer stocks of medicines required during pandemic diseases at all local levels and the health officials have been managed after taking a decision. 

The team will immediately reach out and respond when there is a sudden outbreak of any disease, said Chapagain. Arrangements have been made for the main response team to report on a daily basis when it finds the suspects of any pandemic diseases including Japanese encephalitis. 

Doctors belonging to the World Health Organisation were consulted about what types of Japanese encephalitis patients should be under surveillance, he said. The doctors have continuously taken stock of the infection patients and their families, it has been said. 

The team also discussed with medical superintendents and directors of major hospitals in the district and the chief of the medical department the matter relating to preparedness. Chiefs of the health sections at all local levels have been asked to adopt the preparedness. 

The cases have so far confirmed in the Bharatpur metropolis (four), Madi municipality (two), and each at Rapti, Ratnanagar and Kalika municipalities.  The infection first was detected in the first week of August and the diagnosis of seven cases alone last week suggests the district is hit by JE epidemic.  The infected: five females and four males aged 29-75. 

According to the World Health Organisation (WHO), the Japanese Encephalitis Virus (JEV) is a flavivirus related to dengue, yellow fever and West Nile viruses, and it spreads by mosquitoes. When one case of JE is detected, there may be hidden cases of 300 because as the WHO says the infection is mostly asymptomatic and has mild short-lived symptoms. 

Office Chief Durga Dutta Chapagain said being based on the WHO assessment, it can be said the district is probably gripped by the JE epidemic as there may be 2,700 cases across the district. 

This is probably the first time the district is tacking with the situation to this level. So far no fatality from the disease has been reported in the district. In 2018, 2020 and 2021, the district reported one case each year and the figure was nil in 2019. 

The WHO says the virus is transmitted to humans through the bite of infected Culex mosquitoes, which lay their eggs in irrigated rice paddies and other pools of stagnant water. Pigs and birds serve as amplifying vertebrate hosts. 

The first case of JE was detected in Nepal in Rupandehi in 1978 and the year 2004 observed a nationwide campaign against it. In 2006, 2011 and 2016, Nepal observed a national campaign for the containment of the infection and vaccination against JE has been incorporated in the national immunization schedule since 2009. It is given when a child completes 12 months. 

The fatality rate can be as high as 30 per cent while permanent neurologic or psychiatric sequelae can occur in 30%–50% of those with encephalitis, WHO says. The infection is primarily seen from April/May to September/October. Bharatpur Hospital’s physician Dr Govinda Kunwar said pigs and ducks are primary carriers of the virus and it is transmitted to mosquitoes when they bite the infected animals, then it is passed to humans when the same mosquito bites humans. It is not transmitted from human to human. 

The rural areas in the district seem vulnerable to infection. Its symptoms include high fever, headache, and vomiting, unconscious, stiff neck and body tremor. Office information officer Ram KC advises on proper management of areas where pigs and ducks are reared and seeks a prompt medical intervention in the suspected case. Staying away from the mosquito bite is the best way to prevent the infection and for this, the control of the mosquito population was needed. Likewise, it is preventable through vaccination, proper management and handling of animal farming. RSS