Patna: Acute encephalitis syndrome (or brain fever or Chamki fever) has claimed more than 200 lives in Muzaffarpur and adjoining areas of Bihar, even as the authority is reluctant to declare the outbreak of encephalitis as an epidemic, defying the World Health Organisation (WHO) definition.
The WHO defines an “epidemic” as “the occurrence in a community or region of cases of an illness, specific health-related behaviour, or other health-related events clearly in excess of normal expectancy. The community or region and the period in which the cases occur are specified precisely. The number of cases indicating the presence of an epidemic varies according to the agent, size, and type of population exposed, previous experience or lack of exposure to the disease, and time and place of occurrence”.
Advantage of declaring AES outbreak as an epidemic
The advantage of declaring an outbreak to have acquired the proportions of an epidemic is the heightened and coordinated fight against the disease it entails. This includes preparedness, emergency response capacities, disease surveillance and monitoring of early warning signals presently and in the future, involving experts from both the Centre and the affected State.
Notwithstanding the technicality, senior lawyer Amitabh Sinha told Sirf News when he classified AES in Bihar as an epidemic on Republic TV in the evening of 21 June, a hue and cry among the anchor and the panellists ensued. They were, Sinha said, more interested in debating the culpability of Chief Minister Nitish Kumar in the whole affair. Thereafter, he was hardly given a chance to elaborate on his rationale, he complained.
#NoMaryadaNitish | Chief Minister Nitish Kumar evades questions of journalists as they ask him about the deaths of children in the state due to Acute Encephalitis Syndrome (AES).
— Republic (@republic) June 21, 2019
Social media users have taken exception to the media’s approach to the disease, too.
But experts would agree with Sinha. Dr Vipin Vashishtha, a member of the team that studied the outbreak of AES in Muzaffarpur, in collaboration with NCDC and CDC from 2011 to 2013, called it an epidemic in an interview with a television news channel.
Dr Vashishtha described the Muzaffarpur investigation into the outbreak of AES as “five blind people describing an elephant”.
Dr TJ John, former president of the Indian Association of Pediatrics (IAP) and Emeritus Professor of Virology at the Christian Medical College in Vellore, was part of an expert team that identified AES as an epidemic. He said to Network 18 that malnourished children who ate litchis and went to sleep without a meal fell ill in the pre-Monsoon season between 4 AM to 7 AM.
“Earlier people thought that the outbreak is caused by a virus. But it is a case of heat stroke causing these deaths. In the years 2005, 2011, 2013, 2014 and 2019, when temperature and humidity were recorded over consecutive days at more 38°C and 50% respectively, the epidemic had been at its worse with over 700 dying in 2014 alone,” said Dr Gopal Shankar, the acting HoD of the SKMCH where most of the patients breathed their last.
Science magazine Down to Earth has described the outbreak of AES in Muzaffarpur of Bihar as an epidemic, too.
In the meantime, a heat wave has killed another 100 people or more in the State.