Enterovirus suspicion in encephalitis zone - Hint in unclean water, inconclusive tests

TT, July 24: Experts from Pune’s National Institute of Virology who have toured parts of north Bengal have told district health authorities that they suspect enterovirus outbreak to be the reason for the high death count.

In the North Bengal Medical College and Hospital, where most patients with symptoms of Japanese Encephalitis are being treated, one more person died today. The tests done on 50-year-old Hasan Eman, who hailed from Chopra in North Dinajpur, had not confirmed Japanese Encephalitis, according to Amerendranath Sarkar, the NBMCH superintendent.

Eman’s death without confirmation of what virus took his life has been the dominant pattern to emerge from this outbreak. This is one of the reasons why the NIV experts suspect that the cases being classified as Acute Encephalitis Syndrome (AES) could be related to some enterovirus — any virus that could be contracted from water, food, saliva and sputum, among other agents.

The NIV experts who toured Mainaguri and Dhupguri in Jalpaiguri district also found that many people were drinking water from contaminated sources.

The Pune experts have decided to send the samples of over 190 patients, all from Jalpaiguri and Alipurduar districts, to their laboratory in Pune and also another lab in Mumbai to test for enteroviruses.

“During their visit (to Jalpaiguri), the experts have found that many residents are drinking contaminated water,” Jagannath Sarkar, the chief medical officer of health of Jalpaiguri, said.

“On the other hand, they have been provided with data which shows that in the past one month, 240 patients from both these districts have shown symptoms of AES. Their blood samples were collected and tested in NBMCH but it was found that only 46 have the Japanese Encephalitis virus in their blood. Of them, 17 died while the remaining 29 have been treated. The JE virus was not found in the blood of the remaining 194 people who showed similar symptoms.”

Sarkar said: “These two factors put together have raised the suspicion of the experts. They have spoken to us and it has been decided that blood samples of all these 194 patients would be sent to Pune and Mumbai to find out whether there is any enterovirus in the samples.”

According to state health officials, symptoms such as fever, convulsions, body ache and headache were common among a huge number of patients but they tested negative for Japanese Encephalitis.

Any enterovirus can spread from common sources such as water, food and soil and also be transmitted from person to person through saliva, nasal mucus or sputum, doctors in Siliguri said.

The symptoms of the disease would be similar to Japanese Encephalitis.

At a district level meeting called at the CMOH’s office in Jalpaiguri today, officials down to the block levels and from various departments were told about the suspicions articulated by experts.

“The officials will have to monitor that no contaminated water is consumed by people. Also, right from railway stations to villages to tea estates, the surroundings should be clean to prevent infection,” Sarkar said.

“An awareness drive to ensure that people drink clean water would be initiated. All government office premises should also be kept clean.”

The expert teams have left for Cooch Behar today, he said.

The senior health official, asked about the state of affairs in Jalpaiguri district hospital, said the number of suspected Japanese Encephalitis patients had not increased and many people had visited the fever clinic at the hospital.

“Last year, we had vaccinated around 3 lakh children, aged between six months and 15 years, in Jalpaiguri and Alipurduar districts. This is why the number of affected children is considerably less,” Sarkar said.

“Our senior officials are already in touch with the Centre to introduce vaccination of all residents dwelling in this part of the state.”

NBMCH authorities, when asked about entero-virus tests, said there was no such facility. “To detect any enterovirus, there is no facility in NBMCH,” Anup Kumar Roy, the NBMCH principal, said.

Docs protest

Members of the Trinamul-backed Progressive Junior Doctors’ Association (PJDA) on Thursday submitted a memorandum to Jalpaiguri CMOH Sarkar, complaining that a section of the Group D staff of NBMCH rear pigs in their quarters on NBMCH premises.

Pigs and wild birds are known to be reservoirs of the Japanese Encephalitis virus. Mosquitos that breed in piggeries become carriers of the virus, transmitting it to humans.

“This is the sole-referral hospital for north Bengal districts and patients come here to get treatment for Japanese Encephalitis. However, the patients, doctors, hospital staff and nurses are at the risk of catching the disease in the hospital itself because there are pigs being reared on the hospital premises by some Group D staff in their quarters,” said Sukhdeb Mondal, the state secretary of PJDA.

“We have submitted a memorandum to the superintendent to remove the pigs from the premises immediately,” Mondal said.

Sarkar said he had told the police at NBMCH outpost to remove the pigs from the hospital premises.

“I have told the police to remove all the pigs from the hospital surroundings and also asked the members of Thiknikata gram panchayat, under which NBMCH falls, to remove pigs from the areas surrounding the hospital,” he said.

The Darjeeling district Left Front leaders have announced a week-long programme to clean SMC wards and also impart awareness among people. The drive, they said, will commence from next Saturday.

“We will spray bleaching power and mosquito repellents in different wards of Siliguri Municipal Corporation from Saturday. We will also distribute leaflets and put up hoardings, containing dos and don’ts to prevent the vector-borne diseases from spreading in the city,” Asok Bhattacharjee, the convener of Darjeeling district Left Front, said today.