Japanese Encephalitis outbreak in Assam: Health officials take urgent measures to control spread

With the onset of Monsoon, the vector-borne disease Japanese Encephalitis (JE) has led to the loss of eleven lives in Assam this year so far, raising concerns among the state health officials.

In previous years, the mosquito-borne disease caused significant fatalities in the region, with 94 deaths in 2018 and 161 deaths in 2019. The number of fatalities decreased to 51 in 2020 and further dropped to 40 in 2021. However, in 2022, there was a surge in fatalities, reaching 96 deaths. The current year, though, has shown a decrease in the number of JE cases compared to previous years.

Speaking to India TodayNE, Dr Abhijit Sarma, Superintendent of Gauhati Medical College and Hospital (GMCH) said, “At Guwahati Medical College in Assam, we have observed a decrease in cases this time, with 28 compared to 103 cases previously. Unfortunately, out of the 28 cases, 6 patients have expired, and 1 left against medical advice. On the positive side, 4 cases were successfully treated and discharged, with seven cases in the pediatric age group and the rest being adults. Most of these cases are in the intensive care unit, so currently, we have 17 cases continuing treatment at GMC”. 

Japanese Encephalitis is a viral disease that poses a significant health risk to millions of people worldwide, especially in Asia. The Japanese encephalitis virus (JEV) is a type of flavivirus, similar to dengue, yellow fever, and West Nile viruses, and it is transmitted through mosquitoes. It belongs to the same genus as these other viruses and is primarily spread by mosquito bites.

Sarma said, “Japanese Encephalitis is transmitted through mosquito bites. It is a human pathogenic virus belonging to the flavivirus genus. Culex, Anopheles, and Mansonia are three types of mosquitoes that cause the surge of Japanese encephalitis.”

The impact of Japanese Encephalitis can be devastating. In affected areas, it leads to significant illness and death, particularly among children. The virus primarily affects the central nervous system, resulting in inflammation of the brain (encephalitis). Symptoms can range from mild flu-like signs to severe neurological complications such as high fever, headache, stiff neck, confusion, seizures, and paralysis.

“There is also another syndrome called acute encephalitis syndrome, which is the next phase of Japanese Encephalitis. Last year, there were 271 cases, and this year, there are 54 cases. Out of these 54 cases, 3 left against medical advice, 1 absconded, 5 recovered, and sadly, 19 cases expired. Acute encephalitis syndrome is a more dangerous complication. We conduct various tests, and the diagnosis is confirmed through IgM Elisa and kits, as well as serum tests. Treatment starts with antipyretics for fever and anticonvulsants for convulsions”, he explained”. 

He further added, “To prevent Japanese Encephalitis, vector control is essential, and measures include DDT spray, fogging, MLO spray, and using mosquito nets. In villages, people use smoke and eucalyptus oil as mosquito repellents. Stagnant water, like in ponds, should be treated with DDT and cleaned. In urban areas, water in coolers can lead to mosquito larvae, so these areas should be properly managed”.

Sarma also said, “We have specialized wards for encephalitis patients, comprising six beds in the High Dependency Unit (HDU) and six dedicated beds. If necessary, we can convert more general beds to accommodate additional encephalitis cases. The government has been immensely helpful, providing all the necessary support and resources we've requested."

Japanese encephalitis remains a significant health concern, where it poses a risk to millions of people. While there has been a decrease in JE cases in Assam this year , the disease still requires vigilant monitoring and prompt medical attention.