Problem Scenario

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Japanese Encephalitis (JE) is a killer disease. Japanese encephalitis (JE) remains the most important cause of Acute Viral Encephalitis (AES).

 It is prevalent throughout the world, especially in the Indian sub-continent and South East Asia, Japan, China, Korea, Taiwan. It continues to spread to hitherto unaffected regions like Indonesia, Pakistan and Australia. Approximately 60% of the world population inhabits JE endemic areas.

 

• Disease can be fatal in 25% of the cases.

• Magnitude of the problem is even more alarming since the survivors are left with serious long-term neuropsychiatric sequels.

• Almost every two to three years, epidemics of JE occur in Indian subcontinent with a higher mortality, and in about 10 years, it gives a peak of more than 2000 deaths.

• With adequate medical and other infrastructure, the rates of both death and morbidity can be substantially reduced, as was successfully done in Japan and other countries.

 

In India, it is widely spread in most major states like Uttar Pradesh (UP), Bihar, Andhra Pradesh, Tamil Nadu, Kerala. It came to Purvanchal, i.e., the eastern rice belt of UP, touching the Nepal and Bihar borders, in 1975. Looking closely at just this region, JE was noticed predominantly in the year 1978 (when 274 cases of JE were reported to BRD Medical College, Gorakhpur and 58 deaths occurred) and since then it has taken more than fifteen thousand lives and severely affected hundreds of thousands of people.

         

In BRD Medical College alone, from 1978 to 2016, the number of Encephalitis patients and death toll is reported as 39,735 and 9,604, respectively. For 2017, the corresponding figures until Aug 20 are 924 and 127, respectively. But all the patients did not go to BRD Medical college - some were lost at the initial stage at village level, some at Tahsil (Sub-division) level and hardly 20% could reach the district hospital or Medical College level.

 

From 1978 to 2017, in 40 years, the U.P. state has seen 21 Chief Ministers and 11 Governors, and almost all the political parties and their combinations have ruled the state, but so far, as far as JE/ AES victims are concerned, the crisis is still the same. In the affected area, even the basic infrastructure has not been built-up and the health services are not up to the marks. More and more cases of mortality and morbidity still reported years after years.

 

In the past decade, the Government of India has pumped a good sum of money. Specifically, it sanctioned about Rs.4000 crores (approx. USD 650 million at current rate) of which only 400 crores (10%) was actually spent. Still, the death toll never came down and 5954 deaths were reported in this period from the hospital alone, making the toll average about 600 deaths each year.

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