Since the mosquito is the vector of the disease, people must avoid being bitten by it by using mosquito nets and mosquito repellents

With the nation preoccupied with the prevention of the spread of the coronavirus since the past one year, there is every likelihood of other major diseases afflicting the people being brushed aside.

Therefore, together with COVID-19, it is necessary to create awareness about diseases like encephalitis, in particular Japanese encephalitis, which is endemic to Nepal. This is essential, especially with the start of the warm season and the prevalence of mosquitoes that carry the disease. The country sees the number of cases go up in April and October. Encephalitis is inflammation of the brain caused by a viral infection.

Death rates are high, about 20-60 per cent of all cases in Nepal, and survivors are left with permanent brain injury, resulting in memory problems, confused thinking, personality changes and emotional and behavioural difficulties. What is worrisome is that children in South Asia are most commonly affected by Japanese encephalitis, and it could leave them with learning and other physical difficulties for life even if they survive the disease.

Since the disease was first detected in Rupandehi in the Tarai in 1978, it has been reported in most of the districts of the country, including Kathmandu, and now in the mountainous district of Solukhumbu.

However, it has yet to be established if the prevalence of the disease in the Everest region is due to migration or climate change, which has resulted in a warmer climate in the mountains. Understanding how Japanese encephalitis is transmitted could help in its prevention and control. The bite of an infected Culex mosquito is responsible for its transmission to humans.

So destroying the transmission cycle between mosquitoes and vertebrate hosts, namely pigs and water birds, could prevent its spread in the community. The disease is mostly found in rural and peri-urban areas, where people are in close contact with these animals and birds.

Doctors at a programme held in the capital to mark World Encephalitis Day on Monday warned against delay in encephalitis treatment. There is little doctors can do when the patient is brought to the hospital when the health condition is already complicated.

According to them, half of the children with Japanese encephalitis recover completely if diagnosed early on. However, an ounce of prevention is worth a pound of cure. Since the mosquito is the vector of the disease, people must avoid being bitten by it. This can be done by using mosquito nets, where feasible Insecticide Mosquito Nets, and mosquito repellents.

It also requires pigsties to be built away from residential areas. Since mosquitoes breed in stagnant water, destroying containers and small pools of such water around the household will help contain the disease.

Above all, cleanliness must be maintained at all times in the home and in the surroundings, which is also necessary to keep other diseases at bay. Quite unlike the coronavirus, there is a tested and effective vaccine against Japanese encephalitis. Thus, the onus lies on the government to increase coverage of the vaccination to bring down the number of cases, preferably in the National Immunisation Programme, as suggested by the doctors.

Investment rules

The Insurance Board (IB) has directed both life and non-life insurance companies to make mandatory investments in the productive sectors, such as water resources, infrastructure development, agriculture and tourism that can help generate employment opportunities within the country. The board recently sent a letter to all the insurance companies to this effect.

Till date, the insurance companies have been investing their savings mainly in the commercial banks and stock market that are profitable businesses without involving any risks.

As per the IB's investment guidelines, the insurance companies need to invest at least 20 per cent of the amount deposited in the insurance fund in the eight productive sectors, including agriculture, hydropower, tourism and infrastructure development.

There are 19 life insurance and 20 non-life insurance companies currently operating in the country. But quite a few of them have made investments in the productive sectors identified by the board. Every sector must understand that no country can move forward without making investments in the productive sectors. It is equally important to ensure that they have injected money in these sectors as per the rules.

A version of this article appears in the print on February 24, 2021, of The Himalayan Times.