More than 900 dead in India encephalitis outbreak

The death toll in India’s worst Encephalitis outbreak in nearly 30 years has reached 900 but the number of new infections has fallen in the past week, officials said on Sunday.

More than 4,200 people have fallen ill with the virus in the densely populated northern state of Uttar Pradesh since late July and close to 90 percent of fatalities have been children between 3-to-15 years.

“With 12 deaths over the past 24 hours, the overall toll has reached 914,” a spokesman for the Uttar Pradesh government said.

Encephalitis is caused by a virus found in pigs and wild birds and transferred to humans by a mosquito bite. The disease affects the brain and causes headaches, convulsions, high fever and respiratory distress. Many survivors are left mentally or physically handicapped.

Authorities in Uttar Pradesh said the number of patients coming to hospitals in the past week had fallen, indicating the outbreak was subsiding. But scores of children remain in hospitals, many of them in a semi-comatose state or in a coma.

“This week, there has been a definite fall in the number of new admissions… but we were still treating as many as 189 children with only about 130 beds,” Dr. K.P. Kushwaha, head of the paediatric unit at the state-run hospital in Gorakhpur town in eastern Uttar Pradesh, which is the epicentre of the outbreak.

Encephalitis is most often caused by a viral infection, and many types of viruses may cause it. Exposure to viruses can occur through insect bites, food or drink contamination, inhalation of respiratory droplets from an infected person, or skin contact. In rural areas, arboviruses - carried by mosquitoes or ticks, or accidentally ingested - are the most common cause.

In urban areas, enteroviruses are most common, including coxsackievirus, poliovirus, and echovirus. Other causes include herpes simplex infection, varicella (chickenpox or shingles), measles, mumps, rubella, adenovirus, rabies, West Nile virus, and extremely rarely, vaccinations.

Voluntary groups have slammed Uttar Pradesh and the federal government for not vaccinating enough children against Encephalitis despite smaller outbreaks in the past 27 years and of being slow to respond to this year’s deadly outbreak, fuelled by early monsoon rains.

Provided by ArmMed Media
Revision date: July 5, 2011
Last revised: by Andrew G. Epstein, M.D.