Deaths of children due to encephalitis have been recently reported from Muzaffarpur, East Chaparan, Sitamarhi, Vaishali, Sheohar, Samastipur and West Champaran district of Bihar. Till 14.7.2014 a total of 156 deaths have been reported from Muzaffarpur and the adjoining districts. District wise details of children deaths due to encephalitis are given below:

 

 

To identify the Japanese Encephalitis, there are 7 sentinel surveillance sites established in the state of Bihar at the behest of NVBDCP which are supported by supply of JE kits from the Govt. of India to test the samples of Encephalitis cases for detection of Japanese Encephalitis cases. As per report, no JE case was detected till 14.7.2014.

 

Steps taken by the Centre:-

(i)        Government of India has launched a multipronged strategy for 5 high burden states including Bihar under which 60 districts in the country have been identified and Muzaffarpur is one of the identified districts among 15 districts of Bihar. Following ministries have been roped in :

•    Ministry of Health & Family Welfare

•    Ministry of Drinking Water Supply & Sanitation

•    Ministry of  Women & Child Development

•    Ministry of Social Justice & Empowerment

•    Ministry of Housing Urban Poverty & Alleviation

 

(ii)       Workshop/Meeting of SPOs of 9 JE endemic states including Bihar was held at Delhi on 7-8^th, 2011 Feb for formulating an Action Plan for prevention and control JE/AES.

(iii)    6 district in the state have been covered under JE vaccination from 2007 – 2010. During 2012 special vaccination campaign was carried out in Gaya. JE vaccination in campaign mode was also carried out in Aurangabad during 2012.

(iv)    Government is also taking help of experts from CDC Atlanta USA, NCDC, Delhi, NIV Pune RMRI, Patna to prevent the JE/AES.

(v)      Total 14 and 12 JE MAC- ELISA test kits have been supplied free of cost to the state during 2012 and 2013 respectively. In 2014, total 19 kits have been supplied till 30.6.2014.

(vi) To establish definite clinic-epidemiological linkage to identify source of infection for Acute Encephalitis Syndrome (AES) in district Muzaffarpur, a team from NCDC and NVDBCP visited Muzaffarpur w.e.f. 25.5.2014 respectively till date.

 

(vii) Hon’ble HFM visited Muzaffarpur w.e.f. 20^th – 22^nd June, 2014 along with         Director NVBDCP to review the control measures taken by the state.

 

(viii) The vaccination for JE was carried out in Nov-Dec, 2013. Special campaign for JE vaccination was carried out in Muzaffarpur, Vaishali, Nalanda, Samstipur, East Chaparan, Bhojpur, Nawada and Patna on 22^nd – 23^rd June 2014 to cover missed out children. 

 

During 2012-13 an amount of Rs. 6.84 crore has been released for strengthening District Hospitals and Medical College in Gaya and Muzaffarpur respectively. However during 2013-14 total Rs.16.88 core were released to Bihar for implementation of prevention and control strategy for JE/AES.

 

Steps taken by the Govt. of Bihar:-

1.   Printed IEC materials were given to ASHA and Anganwadi workers for Door to Door distribution under AES awareness activity

2.   ASHAs and Anganwadis worker were entrusted with the responsibility of identifying fever of recent onset and early referral to nearest health institution.

3.   MOs (MBBS) from other district APHCs were deployed at all block PHCs of Muzaffarpur under improved surveillance activities and at SKMCH to provide care to the admitted patients.

4.   Extra ambulances were deployed from other districts at block PHCs for early and timely referral to SKMCH/Kejriwal Hospital.

5.   State Health administration setup mobile medical units to pick up the patients from interiors of the village and onward transfer to the hospital.

6.   Specialist and Super Specialist Doctors from Patna Medical College were visiting SKMCH to treat admitted cases in Pediatric ICU.

7.   Patients of suspected encephalitis cases were tested using JE ELISA kit and treated at SKMCH Muzaffarpur. The kits were made available by Dte. NVBDCP.

8.   For treatment of Encephalitis cases, Pediatrics Deptt. of SKMCH & district Hospital Muzaffarpur were strengthened by establishing a separate  ICU & encephalitis ward to ensure immediate treatment and the line listing of the cases.

9.   All essential lifesaving medicine for treatment of the cases was made available at Medical College (SKMCH) Muzaffarpur.

10.  For intensive care of Encephalitis patients additional trained pediatrician and nurses (para-Medical staff) were posted.

11.  All the Medical Officers In-charge of Primary Health Centres were instructed for carrying out active surveillance in their areas & surrounding villages for detecting suspected encephalitis patients.

12.   All the ASHAs were appraised on necessary prevention & control measures to be taken in the villages such as use safe drinking water, sanitation toilet etc. 

13.  The ambulances for transportation of serious patients to the nearest Medical institution were made available.

14.  Wide publicity was made in the villages towards prevention and control of encephalitis through district information & publicity officers.

15.  All the affected villages where the cases were reported, fogging operations were carried by using technical Malathion vector control measures.

16.  Special campaign started by involving PRI (Panchayati Raj) members for prevention & control of encephalitis diseases, instructions issued to all in the matter.

17.  The district BDC (Block Development Committee) meeting was called for awareness campaign in the area.

18.  In Municipal corporation, Muzaffarpur, sanitation campaign started by spraying the bleaching powder.

19.  The special attention was given by the Village Sanitation Health Committee for maintaining cleanliness in the villages.

20.  The line listing of the patients of suspected JE cases was prepared from all the PHC, districts private Nursing Home etc.

21.  The monitoring and supervision was done by the Hon’ble Health Minister of Bihar, Principal Secretary (Health), Director in chief of state, Deputy CMO Malaria and Assistant Director of Kala-azar.

 

The Health Minister stated this in a written reply in the Lok Sabha here today.

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MV/BK