THIRUVANANTHAPURAM: Over the past decade, close to 2,000 people have died in Kerala due to various communicable diseases. Deaths have resulted from epidemics like dengue, leptospirosis, malaria, H1N1, chickenpox, fever and Nipah, among others. That none of these diseases have foolproof vaccines makes the situation all the more grave.
As indicated by the low mortality rate for the more infectious COVID-19, the state’s health sector has risen up to meet the crisis. But statistics show that it has been a dismal failure in sustaining systematic surveillance programmes to contain epidemics.
From 2011 to 2019, 1,343 people died from various communicable diseases in the state's government hospitals alone. Deaths in private hospitals add a few hundred more every year, data for which is unavailable.
Year | Fever | Dengue | Leptospirosis | Malaria | H1N1 | Nipah | Chickenpox | Total deaths |
2011 | 0 | 10 | 70 | 2 | 10 | 0 | 0 | 92 |
2012 | 11 | 16 | 18 | 3 | 0 | 0 | 0 | 48 |
2013 | 23 | 29 | 34 | 0 | 0 | 0 | 0 | 86 |
2014 | 29 | 13 | 43 | 6 | 0 | 0 | 0 | 91 |
2015 | 26 | 29 | 43 | 4 | 0 | 0 | 0 | 102 |
2016 | 18 | 21 | 35 | 3 | 0 | 0 | 0 | 77 |
2017 | 76 | 165 | 80 | 2 | 76 | 0 | 0 | 399 |
2018 | 63 | 32 | 99 | 0 | 50 | 16 | 0 | 260 |
2019 | 51 | 14 | 57 | 1 | 45 | 0 | 20 | 188 |
Total number of deaths from 8 communicable diseases during 2011-19 is 1343 (govt hospitals) | ||||||||
(Source: Directorate of Health Services, Kerala)
The figure excludes epidemics like acute encephalitis syndrome, Japanese encephalitis, hepatitis A and B, cholera, diphtheria, typhoid, diarrhoea, scrub typhus, Kyasanur forest disease (monkey fever) and West Nile fever which have accounted for another few hundred deaths. During 2006-07, more than 100 lives were lost to chikungunya.
The then state government under V S Achuthanandan managed to contain the epidemic through vector-control methods. Unfortunately, dengue, H1N1, leptospirosis and fever-related illnesses continue to take a heavy toll. Dr V Meenakshy, additional director of health services (public health), told The New Indian Express that dengue remains a huge challenge.
“Dengue and leptospirosis have been a bane for us with repeated outbreaks. H1N1 has occurred almost every season. Despite bringing in vaccination for dengue, people still get affected," Dr Meenakshy said. Better waste management has helped contain H1N1 while effective treatment, personal protection and penicillin have enabled leptospirosis to be negated to an extent, she added.
Dr T Jacob John, emeritus professor at CMC Vellore and the brain behind the setting up of the Kerala Institute of Virology and Infectious Diseases in Alappuzha, said the lack of a public health surveillance system is hitting Kerala hard.
During 1997-98, Dr Jacob and his team had visited 128 towns across Kerala to study private and public sector hospitals, coming up with a surveillance system. Under his insistence, the Kerala Leptospirosis Elimination Programme (KLEP) was launched during P Sankaran’s tenure as health minister in 2002.
Dr Jacob laments that this report must be lying in some ministerial shelf in the Secretariat, or else, several lives could have been saved from this epidemic alone.
“You cannot get rid of leptospirosis (the disease-causing bacteria being a soil organism), but can eliminate it from humans. The state government had accepted the report, but failed to implement it. Kerala’s health sector is good at managing crises, but never sustains surveillance programmes,” the 84-year-old said.
Last year, 20 people died of chickenpox. Dr Jacob is furious about this statistic, terming death due to chickenpox as "unethical". “If I was the health minister, I would have brought out vaccines for chickenpox,” he said.
But he credits the Pinarayi Vijayan government for taking steps to combat the coronavirus even before the Centre arose from its slumber. The quarantine and infectious disease control was so “perfect” that other countries took notice of what K K Shailaja, the health minister, was doing.
“Kerala has received huge grades for combating COVID-19. Every other state imitated Kerala, which became the model and not the central government," Dr Jacob said.