The team was led by director, NIMHANS, Dr P Satishchandra besides Dr James Sejvar and Dr S Oberste from CDC's head office in Atlanta. It was divided into three to examine clinical, laboratory and epidemiological aspects of the problem. They summed up the findings into a report which will be released and elaborately discussed at a health department programme on Friday.
The team noted that the number of AES cases had increased significantly since 2005 and suspected over reporting of the patients. The reason behind this was unsatisfactory diagnosis of the patients. The team said that evaluation was not reliable while all the cases were being listed under the broad head of acute encephalitis syndrome when some of cases have a specific diagnosis. It also pointed out that BRD medical college was consistently understaffed even during the peak season which remained over-burdened with continuous flow of new patients.
At the level of the lab, a systematic approach was missing both at the level of testing, declaration of reports and evaluation of the results. Standard operating procedures was also not up to the mark. Encephalitis was not being monitored correctly. Though the available data showed that AES cases had increased significantly since 2005,its flow was quite complicated and originated from multiple sources. It also said that Japanese encephalitis coverage was less than 50% and it was not being evaluated periodically.
When contacted, principal secretary, health and family welfare Arvind Kumar informed that the team had come on the request of the state government which speaks of state's commitment to solve the issue. "The team has given us recommendations which are being integrated in the strategy for subsequent years," he claimed. The team also included experts from Sanjay Gandhi Post Graduate Institute of Medical Sciences and King George's Medical University.
Key points
- CDC team evaluated government's strategy for encephalitis control in clinical, lab and epidemiological heads.
- It found that encephalitis cases were being over-reported.
- It said that diagnosis of patients was incomplete.
- Local doctors just labelled cases AES and not went to root of the problem even when it was possible.
- Coverage of JE vaccination was low and not monitored periodically.
- Standard operating procedures missing in lab testing and result not coordinated well.
- In 2014, encephalitis affected 3,329 cases including 627 deaths while 191 cases and 34 deaths of Japanese encephalitis were reported as per health ministry data.
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