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Sanjeev Kumar Patro

Bhubaneswar: When lack of proper case management saw Bihar saddled with a whopping 125 fatalities of children due to AES in the month of June so far, the alarming fact for Odisha is, it had recorded the highest Acute Encephalitis Syndrome (AES) cases in the country during the first 4-months of 2019.

According to the data available with National Vector Borne Disease Control Programme (NVBDCP), Odisha had recorded a high of 462 cases of AES during the period of January to April 2019. However, the big respite is, the case fatality in Odisha is nil.

The import of the fact here is AES is very much a big disease in Odisha. If an improper case management is undertaken here, then Odisha is also vulnerable to record high case fatality rate as the State topped the country in AES cases till April 2019.

Why the proper case management is very important in AES is the disease is caused by 100 different pathogens ranging from virus, bacteria to fungi and parasites. Even toxins can also trigger AES in malnourished populace. And undernourishment is high in many tribal districts in Odisha like Malkangiri, Nabarangpur, Rayagada, Gajapati and parts of Jajpur.

It is pertinent to mention that the infamous children fatalities in Malkangiri in 2016 was attributed to AES by the State Health Department. A total of 90 children had succumbed to the disease then. The total AES fatalities in Odisha then was 115.

However, the central team that visited Malkangiri then had observed that the high fatality rate in Odisha is mostly due to secondary injury to brain owing to encephalitis.

A team member then had noted that “The secondary injury manifests in a patient because a patient has not been provided the timely supportive care to maintain the glucose and oxygen supplies to brain, which is number one exigency factor in such a scenario to prevent damage to brain or any organ, and that can be ensured in proper supportive care only.”

As per Union Health Ministry studies,  in 75 per cent AES cases, there has been no identifiable etiology (means causative organism). In the context of this grave fact, another alarming reality is in almost 90 per cent AES cases, there is no specific treatment (means non-responsive to anti-viral medicines).

Therefore, surveillance of areas reporting AES cases is considered the first preventive guard against the killer disease. Because, time factor is crucial in treatment of AES cases. Late stage identification will be of no help, revealed studies done by Central Institutes.

Odisha, at least statistically, had no AES cases till 2014, if State Health Department data is to be believed.

According to the figures available with the NVBDCP, Odisha had reported as many as 1,720 AES cases in 2018. The number of fatalities stood at mere 10. The ominous fact is AES cases posted a 40 per cent jump in 2018 vis-a-vis 2017. The fact of solace, however, is the case fatality rate had shown a dip in 2018.

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