CHITWAN, SEPTEMBER 12

Following the outbreak of Japanese encephalitis in Chitwan, awareness campaigns have been launched in the district.

A rapid response team coordinated by chief of the district health office has been formed and special measures have been adopted to contain the risks of the disease, according to health office Chief Durgadatta Chapagain. So far, out of 22 tests, nine cases of Japanese encephalitis have been confirmed in the district.

'Representatives from Bharatpur Hospital, two medical colleges, a private hospital and Nepal Red Cross Society are members of the response team that has been on standby in all seven local levels,' he said. Following the decision, buffer stocks of medicines required during the pandemic at all the local levels and health office have been managed. 'The team will immediately reach out and respond to the crisis when there is a sudden outbreak of any disease,' said Chapagain.

Arrangements have been made for the main response team to prepare report on a daily basis when it finds suspects of any pandemic, including Japanese encephalitis. 'Doctors belonging to the World Health Organisation were consulted on what types of Japanese encephalitis patients should be under surveillance,' he said.

Reportedly, doctors have continuously taken stock of infected patients and their families.

The team also discussed with medical superintendents and directors of major hospitals in the district and chief of the medical department on matters related to preparedness. Chiefs of the health sections at all the local levels have been asked to adopt preparedness measures.

So far, four cases of Japanese encephalitis have been confirmed in Bharatpur metropolis, two in Madi Municipality, and one each in Rapti, Ratnanagar and Kalika municipalities. The infection was first detected in the first week of August and seven cases were diagnosed last week alone. This suggests that the district has been hit. Of the infected, five were females and four were males, aged 29-75.

According to the World Health Organisation, Japanese Encephalitis Virus (JEV) is a flavivirus related to dengue, yellow fever and West Nile viruses, and it is spread by mosquitoes. For every case detected, there may be 300 hidden cases. As per WHO, the infection is mostly asymptomatic and has mild short-lived symptoms.

Office Chief Durga Dutta Chapagain said, 'On the basis of the WHO assessment, it can be said that the district is probably gripped by Japanese Encephalitis as there may be 2,700 cases across the district. This is probably the first time the district is tackling the situation at this level. So far, no JE fatality has been reported in the district.

In 2018, 2020 and 2021, the district reported one case each year and the figure was nil in 2019.

As per the WHO, the virus is transmitted to humans through the bite of infected Culex mosquitoes, which lay eggs in irrigated rice fields and other pools of stagnant water. Pigs and birds serve as amplifying vertebrate hosts.

The first case of Japanese Encephalitis was detected in Nepal in Rupandehi in 1978 and the year 2004 observed a nationwide campaign against the infection.

In 2006, 2011 and 2016, Nepal observed a national campaign for containment of the infection. Likewise, vaccination against Japanese Encephalitis has been incorporated in the national immunisation schedule since 2009. The vaccine is given when a child completes 12 months.

The case fatality rate can be as high as 30 per cent while permanent neurologic or psychiatric sequelae can occur in 30 to 50 per cent of those with encephalitis, WHO says. The infection is primarily seen from April/May to September/October.

According to Bharatpur Hospital's physician Dr Govinda Kunwar, pigs and ducks are primary carriers of the virus that is transmitted to mosquitoes when they bite the infected animals. It is then passed to humans when the same mosquito bites humans. It is not transmitted from human to human. The rural areas in the district seem vulnerable to the infection. Its symptoms include high fever, headache, and vomiting, unconsciousness, stiff neck and body convulsions.

Information officer Ram KC has advised all and sundry to expedite proper management of the areas where pigs and ducks are reared. He has also sought prompt medical intervention in suspected case.

A version of this article appears in the print on September 13, 2022 of The Himalayan Times.