Bihar: Rising Temperature in April Sends AES Alarm Bells Ringing in Vulnerable Areas
Patna: With severe heat wave conditions prevailing in Bihar in the third week of April this year, the fear of an outbreak of Acute Encephalitis Syndrome (AES) in Muzaffarpur and neighbouring districts is haunting the health department’s top brass yet again.
After reports of six minor children with the disease surfaced in April itself, health officials, including doctors, are worried because rising mercury above 42 to 43 degree Celsius is considered conducive for the spread of AES, locally known as chamki bukhar.
AES is considered a curse for children from the poorest of poor families who live without basic amenities. Various studies have pointed this out and suggested the need for creating awareness so that poor families ensure their children never go to sleep on an empty stomach and remain hydrated.
Local officials have also been repeatedly appealing to parents not to neglect any symptoms and rush to nearby primary health centres (PHCs) without delay.
Four years ago, a survey conducted by the state government showed that AES mostly affected children from families living below the poverty line (BPL) in Muzaffarpur and neighbouring districts in the past five years.
The survey was conducted in five blocks in Muzaffarpur in 2019, to gauge the socio-economic condition of the affected families after AES almost took the form of an epidemic.
Most of the victims of AES were children of landless farm labourers, daily wage workers, seasonal labourers and people earning livelihood by doing odd jobs. Besides, majority of the aftected children that year were living without toilets and were forced to go for open defecation.
Usually, AES cases see a surge in May and early June.
According to Muzaffarpur Civil Surgeon Dr U C Sharma, of the 12 AES affected children reported so far this year (January to April 19), six (6) were in the past two weeks. Out of the 12 cases ,10 were reported from Muzaffarpur and one each from East Champaran and Sitamarhi districts.
"Rising temperature has had some link with AES cases in recent years. Keeping this into consideration, all the hospitals, including PHCs, are on alert and government officials working at the village level have been directed to closely monitor any suspected and likely infected child and rush him or her for proper treatment without delay", Sharma told NewsClick.
He said only 2 AES cases were reported in January this year, followed by one case in February and three in March.
Sharma said the government-run Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur was fully ready to deal with the AES outbreak, if it happens.
SKMCH superintendent Dr BS Jha told NewsClick that no children were suffering from confirmed AES as of now. “Today (Wednesday), not a single child is admitted and under treatment. There is no death from AES till date this year. All fresh AES cases (six children) reported this month were treated and discharged after recovery", he added.
Jha, however, said a few children with suspected AES symptoms were under treatment. If their test report confirms AES, they would be treated as per proper medical guidelines, he said.
A health department official in Patna said due to climate change-induced hottest April, followed by early heat waves, the number of AES cases in coming days would expose the preparedness to deal with it.
"Last year, when number of AES cases were below 50 and only three deaths, it was claimed by government that prevention measures worked to combat the disease. But the real challenge of ongoing prevention measures will be this year, which will be known by the end of May or early June", he said.
Meanwhile, the government has issued fresh directives to hundreds of doctors, officers, block-level officers and lowly paid contractual health workers, including ANM, ASHA workers, Jeevika Didis, Anganwadi workers, Vikas Mitra, Tola Sevak, Cluster Resource Centre Coordinator (CRCC), elected members of panchayat including Mukhiya, Sarpanch, ward members engaged in prevention measures and awareness campaigns to contain the AES outbreak during the summer.
Dr Shakeel, head of the Bihar-based Centre for Health and Resource Management, a civil society organisation that works in the health sector, said the campaign for prevention is good but it has also limitations with regard to checking and controlling the spread of AES among the poor.
According to a district health official in Muzaffarpur, unlike in the recent past when focus was on providing treatment to children diagnosed with AES, since the past two years, the emphasis has been on prevention measures to control its spread.
Officials claimed that prevention strategies worked in 2022, as also in 2020 and 2021 during the COVID-19 pandemic period. In 2020, officially, 43 children were admitted to SKMCH with AES, and seven children died. In 2021, 39 children were admitted to SKMCH, of which seven died of the disease.
This was much less compared with 2019 data when the AES outbreak in Muzaffarpur and neighbouring districts hit the headlines. Officially, 111 children died, and more than 431 were reported to be suffering from AES and were admitted to the hospitals, including SKMCH.
In the last decade, over 500 children have died due to AES, mainly in Muzaffarpur and the neighbouring districts of Vaishali, Sitamarhi, Samastipur, Sheohar, and East and West Champaran.
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