Reports state that AES has fastened its grip on 12 districts of Bihar state, inclusive of Muzaffarpur, Vaishali and East Champaran.
This post will answer all your questions regarding AES.
What is AES?
Acute Encephalitis Syndrome (AES) is a viral infection that is generally characterized as a group of diseases like hypoglycemia, chicken pox, dyselectrolytemia, Japanese encephalitis +ve and AES unknown.
It is an acute-onset fever and its target is usually children and young adults. AES can lead to noteworthy mortality and desolation.
It occurs in two types:
- Primary: It involves virus, fungus or bacteria which straight away infect the brain. The infection might also be the revitalization of the virus after any sickness.
- Secondary: It happens because of the immune system responding to any past infection/sickness and attacking the brain by mistake. It can happen 2-3 weeks after the elementary infection.
As per a report in 2015, researchers in the US stated that brain disease could be in connection with the toxic element found in lychees.
Causes of encephalitis:
Indian doctors are blaming the scorching heat in the northern areas and delayed monsoon as the prominent reason for this outbreak. The reason behind the deaths is ‘acclimatization failure in children’ due to the environmental factors like heat wave and scanty to no rainfall.
NHPI (National Health Portal of India) states that encephalitis is caused by JE (Japanese Encephalitis) virus, which was first diagnosed in India in the year 1955 in the southern part of the country- Tamil Nadu and also later in Bihar.
India came up with a JE vaccination program in 2006, which eventually became a part of the National Immunization Program, in 2014.
Japanese Encephalitis (JE) transmits into the human body via infected mosquitoes (Culex Species), primarily during the summers.
Other viruses that cause encephalitis:
- HSV (Herpes Simplex Virus)
- EBV (Epstein-Barr Virus)
- Measles & Mumps
- Arboviruses
- West Nile Encephalitis
- Tick-borne Encephalitis
As for the Bihar condition, the exact reason for the deaths is still unknown and the blame is being shifted to the heat and litchi consumption. The deaths that have been reported are majorly from the lower income households. Many of them work in litchi farms and it is very easy for their children to eat the fallen litchis and sleep hungry and eventually falling sick if the litchis are toxic. Though, no fixed reason is yet claimed behind this eruption.
Signs and symptoms:
- High fever
- Headache
- Vomiting
- Sensitivity towards light
- Stiffness in neck and back
- Changes in personality and behavior
- Confusion
- Issues with speech or hearing
- Hallucinations
- Loss of memory
- Dizziness
- Seizures, paralysis, and coma (in severe cases)
- Bulges in the tender spots on the skull
- Vomiting/nausea
- Stiffness in body
- Poor feeding or not conscious for feeding
- Constant irritation
There are certain factors that put one on the risk of developing encephalitis. These are mentioned below:
- Age factor: Young children and older adults are at a higher risk of developing viral encephalitis.
- Weak immune system: HIV positive people tend to have a weaker immune system and they take immune-suppressing drugs and many other conditions also account for their frail immune system. People with frail immune system are also at risk.
- Geographical area: Some areas have a high prevalence of mosquitoes and tick-borne viruses. These are at risk of encephalitis.
- Season: Encephalitis is more common in summers.
- Brain imaging: MRI or CT scan can expose any swelling of brain or other conditions.
- Lumbar puncture: Under this method, a needle is penetrated in lower back that removes cerebrospinal fluid (CSF)- a fluid that enclose the brain and spinal column. The shift in this fluid reflects infection or tenderness in the brain.
- Brain biopsy: A little sample of brain tissue is removed for testing purposes. This method is adopted usually when patient’s state is worsening, and the treatments aren’t working.
- Other tests: Other general tests like blood samples, urine sample or discharge from the back of throat are usually tested for viruses.
- Children with encephalitis should be kept in ICU (Intensive Care Unit) under constant surveillance to avoid further complications.
- Anti-demagogic drugs like Ibuprofen, Acetaminophen and Naproxen Sodium can be used for providing relief in headaches and temperatures.
- Some anti-viral drugs like Acyclovir (Zovirax), Ganciclovir (Cytovene) and Foscarnet (Foscavir) are also used for treating certain symptoms of the disease.
Challenges in treatment of encephalitis in Bihar:
The state of Bihar is in crisis right now due to the rising deaths of children because of encephalitis. The situation is not getting any better in the state and it is struggling to provide proper healthcare facilities to the patients. Here are a few reasons why the state is still struggling to overcome this issue:
- The poor quality of living in the state is playing the negative role. Most of the children are malnourished in the state and this is a reason for the rising number of deaths due to immense drop in the blood sugar level.
- The poor healthcare facilities in the state is another reason for so many deaths. Many patients do not get timely treatment, and this results in the worsening of their condition and even death. The hospitals are finding it hard to cater to all the patients and the medical facilities provided are not up-to-the-mark.
- There is a lack of trained physicians and the problem of drinking water is contributing to the escalation of the condition.
- Bihar is one of the poorest states of India. The literacy and awareness level among masses is low and thus they are not aware of the disease, its symptoms, causes and treatments and precautions. The maximum number of deaths reported are from the lower income households.
Here are some precautionary steps that can be made part of the routine to prevent encephalitis.
- Adopt good and healthy sanitation habits. Wash your hands with soap and water before and after the meals and after using toilets.
- Don’t share your utensils. Eat in washed and separate utensils.
- Teach your kids healthy habits and try not to let them out in peak hours of the day to avoid heat wave.
- Go for proper vaccinations. If travelling to other places, consult your physician regarding the recommended vaccines for different areas/region.
- Wear long-sleeved tops/shirts and pants while going out between sunset and wee hours.
- Use mosquito repellents
- Put insecticides into action. Use products with permethrin- a component that repels and kills mosquitoes and ticks. It can be sprayed on clothes, tents and other outdoor stuff. Be careful not to apply it on skin.
- Don't go to places where there are a lot of mosquitoes.
- Get rid of stagnant water nearby your home to avoid mosquitoes. Don't let water stagnate in your house as this is where mosquitoes lay eggs.
- Stay alert and observe outdoor signals and signs of viral disease.
- Avoid using insect repellents on infants less than 2 months of age. Cover them with either infant carrier or stroller that has mosquito netting on it.
- For infants older than 2 months, repellents with 10-30% DEET can be used.
- Apply mosquito repellents on the kids yourself and also spray it on their clothing and revealing skin.
- Avoid using repellents on the hands of young children, as they have the tendency to put their hands in mouth.
- Wash treated skin with soap and water once you are back indoors. Keep children tidy and clean.
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