Encephalitis: The disease behind the Gorakhpur tragedy

The tragedy in Gorakhpur, in which more than 60 children aged 12 and below died over the course of 5 days has received international media attention. There are calls for the resignation of many of those deemed responsible.

Oxygen supplies dwindled because the supplier company was not paid, according to reports.  This led to the sudden spike in child mortality at the hospital. This has sparked huge criticism in the media and by opposition party politicians. The hospital has since claimed they had made prior arrangements for the supply of oxygen and that the deaths were caused by unrelated factors.

Encephalitis, swelling of the brain, is the cause of the majority of the deaths, according to the authorities. This is not an unreasonable claim:  in the last 30 years more than 50,000 people are reported to have died due to Japanese encephalitis and acute encephalitis syndrome in eastern Uttar Pradesh alone. Many of these deaths occurred in the Gorakhpur district.

One of the most common causes of the condition in India is Japanese encephalitis. This is a mosquito borne virus of the same genus as dengue fever. Children are far more prone to displaying symptoms than adults upon infection. An early start to the mosquito season may mean that Japanese encephalitis is a cause of  the sudden rise in deaths in Gorakhpur amongst children.

Though severe symptoms are rare (roughly one in 250), they are life threatening. A rapid onset of fever, headaches, stiffness and disorientation can quickly escalate to seizures or a coma. . The acute inflammation of the brain  can severely inhibit brain function and, even with treatment, can leave the patient with lifelong mental disability.

Since initial reports of the 60 deaths, around six more have occurred at the BRD medical college. The National Human Rights Commission (NHRC) requested the state Chief Secretary to submit a detailed report within a month detailing the steps taken for relief and rehabilitation of the affected families. , They have also requested information on the action taken against the guilty officers. “The reported deaths, in such a large number at a government-run hospital, amount to serious violation of right to life and health of the innocent victims, ” the Commission said.

Uttar Pradesh Chief Minister Yogi Adityanath on Tuesday stressed the importance of the Swachh Bharat Mission in reducing the prevalence of Japanese encephalitis. The Swachh Bharat Mission does present an opportunity to cut down on mosquito borne disease through limitation of breeding habitats for mosquitoes, particularly within cities. This would reduce numbers not just for Japanese encephalitis, but for other deadly diseases such as malaria, chikungunya and dengue fever.

The investigation, at the time of writing is still ongoing. Until the causes of such a spike in deaths is uncovered, the Chief Minister’s advice to focus on prevention of future outbreaks of mosquito borne disease is a reasonable strategy in any case.