An Outbreak of JE/AES in North Bengal Districts of West Bengal during 2014

Japanese encephalitis (JE) is the most important cause of acute and epidemic viral encephalitis, as some districts of West Bengal are known to be endemic for Japanese encephalitis including Siliguri and Jalpaiguri. A study was made by a team of multi-disciplinary experts comprising of public health experts, neuro-physicians, clinicians, epidemiologists and entomologists, who visited North Bengal Districts from 20th to 26th July 2014 to aim at assessment and understanding of eco-clinico-epidemiological dynamics playing role in the sudden JE/AES outbreak situation in few districts of North Bengal. Secondary data for its analysis was collected from North Bengal Medical College, different tiers of health facilities i.e. BPHCs, PHC, Sub-centres under CMHOs of Darjeeling, Jalpaiguri and Cooch Behar districts including district hospitals. It was found that most of the cases have been referred to North Bengal Medical College from mainly three districts without case management at the Block PHC level or district Hospital level. This sudden spurt in the rise of such cases may be due to the absence of any surveillance system in these districts at the peripheral level. Entomological Monitoring of JE vectors has been lacking in these districts. Mapping of the areas vulnerable for AES cases and JE was not done for close monitoring. Line listing of the villages’ wise case would help to identify high risk population for taking all preventing measures. It was found that the treatment protocol was being followed up for the case management in the medical college. There was no shortage of IgM Elisa kits for the diagnosis of JE with the state. IEC campaigns have been intensified in the affected districts for taking preventive steps by the community. Vector control measures by fogging operations have been carried out in the affected areas. Availability of quick transport facilities or ambulances at the peripheral level needs strengthening to reduce mortality to high level.