BHUBANESWAR: Children of Malkangiri, Korkunda and Kalimela blocks, where Japanese Encephalitis (JE) has wreaked havoc, were destined to be doomed. With no basic health care service available, the victims, mostly between two and five years, never had a chance against the deadly virus.
The fact that the death toll continues unabated - four more died on Wednesday taking the toll to 34 in 27 days - has proved that by the time they reached any health care centre, they were beyond salvage. “The affected children do not just respond to any treatment, so critical is the condition,” said a doctor from the district.
Even if the children survive, there is no way their parents could find out what exactly is the damage. JE is known to cause extensive damage to the brain leading to permanent intellectual, behavioural or neurological problems such as paralysis, recurrent seizures or the inability to speak, as the WHO would put it. The district headquarters hospital at Malkangiri, their last hope, does not have a ventilator, nor does it possess a working CT scan machine.
Malkangiri has the dubious record of acute undernourishment, at least in 41 percent of its population in the age group of 5-18 years suffer from this. About 45 percent of its adult population has a body mass index below 18.5 percent.
The lesser said about the kids the better as they bore the brunt of under-nutrition and unhygienic condition which has led to the current spate of deaths.
In December last year, the Indian Journal of Medical Research (IJMR) published a research paper on JE calling for public health vigilance in areas which have environmental risk for acquiring the infection.
However, no active surveillance was kept in the vulnerable district since no death was reported last year although 2014 had recorded 14 deaths due to Acute Encephalitis Syndrome (AES). Had the Health Department worked in tandem with its Animal Resources Development counterpart well before monsoon, the isolation of pigs could have been worked out better.
The current exercise of isolation, sources said, is only half-hearted. The confinement of the pigs and piglets outside the villages is unlikely to work as fenced isolation has not been made and the vectors could still reach the host population.
Why was vaccination not explored as a preventive option? Health Department on Wednesday said the Centre did not approve Odisha as a JE affected State despite letters and representations at various meetings. The Centre did not count the outbreak in 2012, which had claimed 38 lives, as JE but the RMRC had got the deaths confirmed from National Institute of Virology.
The JE vaccination is unlikely to commence before November. It will be part of the routine immunisation (RI) scheme for four districts including Malkangiri, Keonjhar, Mayurbhanj and Jajpur.
The drug Japanese Encephalitis Vaccine Live (SA14-14-2), produced by Chengudu Institute of Biological Products in China, is the only WHO pre-qualified drug available for JE.