Title : Regarding situation arising out of spread of encephalitis in the country and steps taken by the Government in regard thereto.
(ii) Situation arising out of spread of encephalitis in the country and steps taken by the Government in regard thereto.
MR. DEPUTY-SPEAKER: Now, we will take up item no. 11. Yogi Aditya Nath.
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"देश में मस्तिष्क ज्वर के फैलने से उत्पन्न स्थिति तथा इस संबंध में सरकार द्वारा उठाए गए कदम। " MR. DEPUTY-SPEAKER: Mr. Minister, you can lay the statement on the Table of the House. THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. AMBUMANI RAMADAS) : Mr. Deputy Speaker, Sir, with your permission I would like to lay the statement on the Table of the House.
* Brain Fever due to Japanese Encephalitis (JE) is caused by a virus are pigs and water birds and in its natural cycle, virus is maintained in these animals. Man is an accidental host and does not play role in JE transmission. The outbreaks occur where there is close interaction between these animals and human beings. The vectors of JE breed in large water bodies such as paddy fields. The mosquitoes are outdoor rester and therefore vector control measures such as indoor residual spray are not very effective.
While there is no specific treatment for this disease, early symptomatic management is important. In case of JE and other viral encephalitis, the management of the critically ill children is directed at minimizing risk of death and complications. However, for prevention of the disease, various public health measures such as control of mosquitoes, protection from mosquito bites by using mosquito net, protective clothing and keeping the pig – animal reservoir of JE away from human dwelling are advocated. Killed mouse brain JE vaccine is being
* Laid on the Table and also placed in Library. See No. LT 2904/2005.
manufactured in limited quantities at the Central Research Institute, Kasauli and supplied directly to the states by using state funds. Government of India is strengthening CRI, Kasauli to augment the capacity for manufacturing of JE vaccines. Three doses of the vaccine provide immunity lasting a few years and repeated booster doses are required every 3 years. Vaccination is not recommended as an outbreak control measure.
Japanese Encephalitis (JE) is an outbreak prone viral infection having cyclic trend with seasonal phenomenon. Children below 15 years are mostly affected. As per reports received from state health authorities, during the year 2005 up to 17-11-2005, 6314 cases and 1539 deaths due to suspected Japanese Encephalitis (JE) have been reported from 9 states in the country. State-wise cases and deaths due to suspected JE as reported by the State health Authorities for the last five years are given at Annex-1, being laid on the Table of the House. During this year, outbreak of Japanese Encephalitis has been reported in eastern part of Uttar Pradesh. A total of 5842 cases with 1387 deaths (up to 17.11.2005) have been reported since 29th July, 2005. District-wise cases and deaths due to suspected JE in the State of U.P. are enclosed at Annex-2, being laid on the Table of the House.
For effective prevention and control of JE and implementation of advance action plan to prevent any outbreak, the Directorate of National Vector Borne Disease Control Programme (NVBDCP), Government of India has been regularly monitoring situation by maintaining constant touch with State Government as well as convening review meetings, organizing trainings for capacity building, awareness campaigns for community involvement and field visits for supervision and monitoring. Government of India provides need-based assistance to the states and technical support for outbreak investigations and control.
The state governments have been advised that in the endemic districts, anticipatory preparations should be made for timely availability of medicines, equipment and accessories as well as sufficient number of trained medical, nursing and paramedical personnel. The strategy for control includes strengthening the surveillance activities and integrated vector control, capacity building and Behaviour Change Communication.
The following actions have been undertaken by NVBDCP for the prevention and control of JE in U.P. :
During 2004, five training courses for Medical Officers to Uttar Pradesh were arranged to improve the skills of peripheral doctors in case management and prevention and control of JE.
Dte. of NVBDCP Team visited the western districts of Uttar Pradesh namely; Muzaffarpur and Saharanpur in April, 2005. high density of JE vectors was found and conveyed to the state to take the necessary control measures.
Dte. of NVBDCP Team visited Gorakhpur for review of JE prevention and control activities in June 2005.
A national review meeting on JE was conducted at NVBDCP, Delhi on 1 June 2005 to review the current strategy for prevention and control of JE.
Keeping in view of the forthcoming season for encephalitis outbreak, a review meeting on JE was conducted at Saharanpur to review the control strategy and to finalize the action plan for prevention and control of JE in Saharanpur and Muzaffar Nagar districts, Uttar Pradesh.
Guidelines for prevention and control of JE and advisories were also sent to states before transmission season.
The following actions have been undertaken by Government of India for control of the current outbreak of JE in U.P.
Central teams consisting of clinical and public health experts led by Director General of Health Services (D.G.H.S.), Government of India along with Director, National Vector Borne Disease Control Programme and Director, National Institute of Communicable Diseases visited Gorakhpur. They met and discussed with State health authorities, the Minister of State for Health. Chief Secretary, and other senior officers of Government of Uttar Pradesh regarding various remedial measures for containment of the JE outbreak.
Rapid Response Teams from DGHS, Ministry of Health & F.W., have visited worst affected districts of Gorakhpur Division and assisted the state in instituting containment measures.
The Central Teams of experts from Government of India also visited the affected districts of Gorakhpur Division and Saharanpur for providing guidance to the state Government and district health authorities in timely management of JE outbreak.
I alongwith Secretary (Health & FW) also visited Gorakhpur District on 1st September, 2005, to take stock of the JE situation and directed the authorities to gear up public health measures for the containment of epidemic outbreak. I assured the district administration that necessary support will be provided by the Government of India in tackling JE outbreak effectively.
Government of India has provided the following assistance to Government of Uttar Pradesh for the prevention and control of JE outbreak:
Essential medicines and consumables to manage JE cases.
Medical equipment i.e. Ventilators and ELISA reader
JE diagnostic kits
Mosquito bed nets for personal protection
Malathion (Technical) and hand-held fogging machines for insecticidal fogging in affected areas
Synthetic Pyrethroid insecticide liquid for impregnation of bed nets
Fenthion and Temephos larvicides for control of mosquito breeding
Details of supplies provided by Government of India to Uttar Pradesh are given at Annex-3 being laid on the Table of the House.
Community Health education is being undertaken to prevent spread of infection and rush the patients to nearest referral centres/hospitals for immediate case management.
A round-the-clock Control Room has been established at NICD, 22, Sham Nath Marg, Delhi-manned by Public Health specialist, Entomologist and Microbiologist. The control room at NICD is in liaison with state/Districts authorities for providing daily report to DGHS and any guidance and support needed by the state.
Surveillance unit has been established at Gorakhpur-Sub-office of Regional Director, RGO&FW established in LNM Railway Hospital Complex, Gorakhpur to provide logistic and technical support to the affected districts.
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