Mentor’s Comment

1. Define AES
2. Mention reasons for it affecting young children in Muzaffarpur frequently.
3. List all measures so that it can be prevented.

Answer:

Acute encephalitis syndrome is a severe case of encephalitis transmitted by mosquitoes and is characterized by high fever and inflammation of the brain. The World Health Organisation (WHO) in 2006, coined the term AES to signify a group of diseases which seem similar to one another but are difficult to differentiate in the chaotic environment of an outbreak.

Several children have died in the Muzaffarpur district of north Bihar, due to Acute Encephalitis Syndrome (AES), which is locally known as Chamki bukhar (brain fever). Most cases of Encephalitis happen in children, the elderly and people with a weakened immune system from HIV/AIDS, cancer etc. Moreover, in India it is limited to children below 10 yrs, belonging to vulnerable sections of the society. The reasons for this mortality and morbidity is-
1. Malnourishment
2. Immunization
3. Lack of WASH strategy
4. Weakened Public Health Infrastructure.

There is seasonal and geographical variation is there in the causative organism. It is endemic zones along the Gangetic plain including states of eastern UP, Bihar, West Bengal, Assam etc. Unfortunately, these states have also high prevalence of poverty, open defication etc. Further, it also has seasonal variation i.e. it is limited to pre-monsoon period i.e. May-June.

Way forward-
In order to reduce morbidity, mortality, and disability in children due to JE/AES, Government of India under National Programme for Prevention and Control of Japanese Encephalitis(JE)/ Acute Encephalitis Syndrome (NPPCJA) has developed a multi-pronged strategy with the convergence of the concerned Ministries.

 Ministry of Health and Family Welfare:
o Strengthening and expanding JE vaccination
o Strengthening of public health activities
o Better clinical management of JE/AES Cases
o Physical medicine and rehabilitation (PMR)
o Establishing of the district counseling center
o Monitoring, supervision, and coordination

 Ministry of Drinking Water and Sanitation for the provision of safe water supply.
 Women and Child development for providing high-quality nutrition to vulnerable children
 Ministry of Social Justice and Empowerment for establishing District Disability Rehabilitation Centers for disability management and rehabilitation.
 Ministry of Housing and Urban Poverty Alleviation (HUPA) for ensuring the supply of safe water in slums and towns
 Ministry of Human Resource (Department of School Education) to provide special facilities for disabled children for their education.
 There is need of UP govt. “DASTAK” to increase awareness among poors.

It is imperative to enhance health budget as suggested by Niti Aayog Health Index 2019 to 2.5% and 8% by centre and state govt respectively. It will help India to achieve SDG-3 Good Health and well being.