UNICEF India lauds Uttar Pradesh's efforts to end encephalitis: How state implemented initiative for immunisation, awareness

In the past few months, Uttar Pradesh’s fight against Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) has largely led to grim headlines, most notably the BRD Medical College tragedy in Gorakhpur in August 2017. However, the state recently earned the appreciation of UNICEF India for its initiative to immunise children against the disease.

A big shout out to #UttarPradesh for immunizing every child in the state against Japanese Encephalitis and Acute Encephalitis Syndrome under the #Dastak campaign! 👏#VaccinesWork for #DimagiBukharSeJung#EveryChildALIVE #WorldImmunizationWeek @CMOfficeUP @MoHFW_INDIA pic.twitter.com/4ww8aCdgOx

— UNICEF India (@UNICEFIndia) April 25, 2018

What the campaign entailed The Dastak campaign, for which the UNICEF has lauded the Uttar Pradesh government, was launched by Chief Minister Yogi Adityanath on 2 April. Government officials went door-to-door in 38 districts affected by the disease to spread awareness and ensure timely vaccination, according to a report in Financial Express.  The programme ended on 16 April. At an event to announce the beginning of the campaign, Adityanath also said that doctors would be provided training with respect to treating ailments found, particularly in children, a report in Patrika said. [caption id=“attachment_4450267” align=“alignleft” width=“380”]  An encephalitis ward in Gorakhpur. File image. Reuters[/caption] A report in The Times of India mentioned an example of an innovative way to spread awareness about encephalitis: A variant of a snakes and ladders game which helps children understand healthy behaviour which can help prevent the disease. For example, maintaining cleanliness in and around the house leads the player to a ’ladder,’ while ignoring fever leads her/him to a ‘snake.’ According to a video released by the state government, Accredited Social Health Activist (ASHA) workers were roped in to visit over 26,00,000 homes to spread awareness about the disease. As part of the campaign, 32,03,785 children were immunised. 

दिमागी बुखार पर सरकार का सीधा वार, सुरक्षित हो हर परिवार। pic.twitter.com/IH3L3nubRy

— CM Office, GoUP (@CMOfficeUP) April 25, 2018

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Rising cases in recent years The BRD Medical College tragedy in August 2017, in which 30 children died in 48 hours, brought the issue of the prevalence of encephalitis in eastern Uttar Pradesh into national focus. However, cases of AES in Uttar Pradesh have been rising for several years. According to this report , 12,578 people were affected by AES in India in 2017, which constitutes a rise of over 243 percent since 2010. Uttar Pradesh bears the highest burden , and 6,000 children have died in Gorakhpur region since the virus was first detected in 1978. Why eastern Uttar Pradesh is more prone to encephalitis JE is caused by rice field breeding mosquitoes (primarily the Culex tritaeniorhynchus group) that become infected with the virus. The mosquitoes, in turn, are infected by the virus by feeding on domestic pigs and wild birds which are infected. A report mentioned above quotes S Vijaya, who is in the Department of Microbiology and Cell Biology at the Indian Institute of Science in Bengaluru, as saying that such diseases are more prevalent in Uttar Pradesh due to “local socio-political conditions, civic facilities, overcrowding, poverty, corrupt government health systems etc”. The topography of eastern Uttar Pradesh may also be a major factor causing the spread of this disease. A BBC report pointed out that this region, which is at the foothills of the Himalayas, is prone to flooding, which leads to making it a breeding ground for mosquitoes. Nature of the disease AES is an umbrella term for a range of symptoms which cause inflammatory brain diseases. The bacteria, fungi or viruses which cause these diseases are difficult to individually identify, due to which the World Health Organisation has coined the term AES to refer to a range of ailments. The Japanese Encephalitis virus (JE) is the most common cause of encephalitis in India, accounting for about a quarter of all the cases. A informative page by the National Vector Borne Disease Control Programme lists the symptoms of severe JE as “quick onset, headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions (especially in infants) and spastic (but rarely flaccid) paralysis”.