[op-ed snap] Gorakhpur’s Japanese encephalitis malady

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Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

Once you are done reading this op-ed, you will be able to attempt the below.

What are the reasons for increasing vector borne diseases in India? How should India address the rising challenge of vector-borne diseases? Discuss.

From UPSC perspective, the following things are important:

Prelims level: Vector borne diseases, Japanese encephalitis

 Mains level: Vector borne diseases and its control


News

Context

  1. Baba Raghav Das (BRD) Medical College in Gorakhpur was in controversy after more than 60 children there died earlier this month.
  2. Regarding the cause of death, the debate shifted back to—Japanese encephalitis (JE)

What is Japanese encephalitis (JE)?

  1. JE is a viral disease transmitted by the infective bite of the Culex species of mosquitoes.
  2. The infection can lead to high fever, headache, stiffness in muscles, seizures, coma, and in worst cases, death.
  3. It primarily affects children because of their weaker immune systems.
  4. In 2016, Uttar Pradesh (UP) contributed 5% of JE deaths in India. 

Factors that influence propagation of Japanese encephalitis (JE)?

1.Climate:

  • Gorakhpur has a climate that makes it vulnerable to JE.
  • 28 degrees Celsius temperature with 50-55% relative humidity is the most appropriate condition for increase in mosquito density.

2.Agricultural and husbandry:

  • JE vectors thrive in irrigated paddy fields. Large swathes of land in the district are cultivated for paddy.
  • Families that depend on agriculture supplement their income with cattle rearing.
  • Pigs and birds are considered to be primary carriers of the JE virus.

3.Urban development and management:

  • Culex tritaeniorhynchusand Culex gelidus are two important Culex vectors in India.
  • While Culex tritaeniorhynchus was more prevalent in rural areas, Culex geliduswas common in urban areas.
  • Gorakhpur has high groundwater tables and the gradient of the city is low to flat, which leads to problems of water logging and flooding.

4.Public health infrastructure:

  • There is a shortage of sub-centres and primary health centres in rural areas. More than 81% of Gorakhpur’s population is rural.

Way forward

1. Address agro-climatic concerns:

  • Irrigation technologies like alternate wetting and drying (AWD) methods can help with vector control.
  • AWD refers to intermittent drying and re-flooding the rice fields without stressing the plants.

2.Address husbandry practices

  • Also, 86% of Gorakhpur’s livestock comprises poultry
  • The state government should run campaigns to make citizens aware that pigs and poultry need to be segregated from humans.

3.Address urban development issues

  • In Gorakhpur, more than 80% of the rural population defecates in the open.
  • Climate change is likely to increase rain events.
  • Therefore, flood-resilient housing, solid waste management and sewage treatment should be pursued on priority.

5. Address public health issues

  • Immunization is a good strategy but coverage remains low due to low levels of awareness and low availability of vaccines.
  • Mosquito population counts should be done for all cities and local entomological knowledge repositories should be maintained to strategize vector control.

6. Intersectoral coordination

  • Vector-borne diseases are determined by interrelated social, economic, and environmental factors. This means that health cannot be left to the health sector alone
  • It requires intersectoral coordination, cooperation and action. Government departments should work with each other horizontally (inter-ministry cooperation) as well as vertically (at national, regional and local levels)
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