[Public Health] Japanese Encephalitis Menace in India: Reasons, Prevention and control

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  1. What is Japanese Encephalitis (JE)?
  2. What are the symptoms?
  3. Geographical Spread
  4. Solution for Japanese Encephalitis (JE)?
  5. What is Acute encephalitis syndrome  (AES)?
  6. Why is Japanese Encephalitis in News?
  7. JEEV (2 marker)
  8. National Vector Borne Disease Control Programme (5 marker)
  9. Mock Questions

What is Japanese Encephalitis (JE)?

  • The suffix -itis means “inflammation”.
  • Encephalitis means inflammation of the brain
  • Meningitis inflammation of the meninges (the tissues that surround the brain or spinal cord)

What are the symptoms?

  • headache and stiff neck
  • Convulsions
  • Weakness of the arms, legs
  • Pain behind the eyes
  • Raised body temperature between 38 and 41 degrees Celsius.
  • If untreated, it can result in to Coma, paralysis Mental retardation or death. fatality rate can be as high as 60%

Geographical Spread

  • Flavivirus reproduces in pigs but doesn’t infect them. So, Pigs are amplifying hosts. (also water birds)
  • Mosquitoes belonging to the Culex tritaeniorhynchus and Culex vishnui groups – they usually breed in flooded rice fields.
  • These Culex mosquitoes are normally zoophilic, i.e. they prefer to take blood meals from animals rather than from humans.
  • These Mosquitoes usually prefer to drink the blood of such pigs. But when the population of such mosquitoes increases exponentially (during rainy season, around August), human biting rate increases.
  • And thus Flavivirus gets transferred from pigs to humans and damages our brain= inflation of brain = Japanese Encephilitis.
  • Man is the dead end host, i.e. JE is not transmitted from one infected person to other.

In short, Japanese Encephalitis requires four things

Japanese Encephalitis

  1. Pigs with flavivirus (Amplifying host).
  2. Rice fields (Mosquito breeding ground)
  3. Culex mosquitos (carrier)
  4. Human (The innocent victim)

Therefore, JE is found throughout south east Asia, because Rice cultivation and pig rearing is common.
But because of the critical role of pigs, its presence in Muslim countries is negligible.

Solution for Japanese Encephalitis (JE)?

  1. Vaccination
  2. Chemical vector control (e.g. spraying chemicals to kill mosquitos)= not good solution, because the breeding sites (irrigated rice fields) are huge.
  3. Keep larvae eating fish, such as guppies, in ponds.
  4. Personal protection (using repellents and/or mosquito nets) = good idea.
  5. There is no transmission from person to person and therefore patients do not need to be isolated.
  6. If there is large scale outbreak of JE, Government would need to eliminate pig population = problem of livelihood.
  7. Rice growing farmers should never be encouraged to do pig rearing as a secondary source of income.
  8. Firstly, there is no curative treatment for J.E. (i.e. No magic pill, injection etc. that will cure it). J.E. is treated symptomatically by reducing the fever, analgesics for headache, sedatives for seizures and specialized intravenous therapy to reduce cerebral swelling.

Apart from Japanese, there is another type of Encephalitis, known as Acute encephalitis syndrome  (AES)

What is Acute encephalitis syndrome  (AES)?

  • This is also inflammation of brain.
  • But it is caused by entero virus.
  • The virus comes in the air or water through open defecation and circulates mainly through shallow hand pumps in the area.

Why is Japanese Encephalitis in News?

In India alone, the of Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES), which have claimed nearly 1,000 lives so far in 2012.
In Oct 2012, Government of India launched a Rs.4000 crore plan to tackle JE problem.
Main Target States : Uttar Pradesh, West Bengal, Tamil Nadu, Bihar and Assam. This plan will jointly implemented by following Ministries of

  1. Health and Family Welfare,
  2. Drinking Water and Sanitation,
  3. Social Justice and Empowerment,
  4. Housing and Urban Poverty Alleviation
  5. Women and Child Development.

Plan has following components:

  1. Vaccination of Children (1.5 to 15 years age group)
  2. provide safe drinking water to the affected persons by replacing shallow tubewells with deep tubewells  (To prevent Acute Encephalitis Syndrome (AES))
  3. Provide proper sanitation facilities. (Perhaps allotting more money under Total Sanitation Campaign)
  4. Provide alternative means of livelihood for pig-rearing farmers.
  5. Set up special schools for mentally challenged children.

JEEV (2 marker)

  • JEEV is the brandname of India’s first indigenously developed vaccine for Japanese Encephalitis (JE). There is no other vaccine available to private doctors in India currently. But the company has yet to obtain approval of WHO to export this vaccine to other countries. (important because this happened in Sept.2012)

National Vector Borne Disease Control Programme (5 marker)

  • It is a comprehensive programme for prevention and control of vector borne diseases namely Malaria,
  • Filaria, Kala-azar, Japanese Encephalitis (JE), Dengue and Chikungunya.
  • It is covered under the overall umbrella of National Rural Health Mission.

Mock Questions

Please note: you can find truckload of potential MCQs Statements and 2 markers from India Yearbook’s chapter on Health and Family Welfare.
Multi Choice Question (MCQ)
Which of the following statements are correct?

  1. Swine is the amplifying host of the virus responsible for Japanese Encephalitis.
  2. Aedes aegypti mosquito is the main carrier of Japanese Encephalitis.
  3. Poultry culling is essential during the outbreak of Japanese Encephalitis.
  4. Japanese Encephalitis is widely prevalent in Arid and Desert areas of Africa.
  5. Japanese Encephalitis can spread by talking or touching a patient.
  6. The vectors of Japanese Encephalitis breed in large water bodies such as paddy fields.

Mains

  1. To what extend the geography and climate of India are responsible for the menace of Malaria, Dengue, Chikungunya  and Jap.Encephalities. Suggest long term mitigation efforts required to uproot these diseases. (25 marks).
  2. Suggest measures for prevention and control of “Japanese Encephalitis” in India (12 marks)
  3. The JEEV vaccine has been making the headlines in the recent months. Who make the ideal candidates for receiving this vaccine and what are its benefits? (2 marks)

Interview: As a district collector what steps would you take in case of an outbreak of Japanese Encephalitis / Dengue / SARS?
Ref:

  1. http://www.indianexpress.com/news/govt-nod-for-rs-4000cr-plan-to-fight-japanese-encephalitis/1018801/
  2. http://www.who.int/water_sanitation_health/diseases/encephalitis/en/
  3. http://www.baliadvertiser.biz/articles/paradise/2012/japanese.html
  4. http://newindianexpress.com/business/news/article606368.ece

Mrunal recommends

  1. (free) NCERT, NIOS, TN-Books
  2. Environment by ShankarIAS
  3. Indian Polity M.Laxmikanth (Hindi | English)
  4. Art & Culture by Nitin Singhania (Hindi | English)
  5. Spectrum: Modern History (Hindi | English)
  6. Bipin Chandra: Post Independence
  7. Fast-track to Arithmetic Rajesh Verma
  8. MK Pandey’s Analytical Reasoning
  9. Disha’s Topicwise Paperset (Hindi | English)
  10. School Atlas
  11. Mains: Language papers
  1. (free) NCERT, NIOS, TN-Books 4 History,Geo,Sci
  2. Indian Polity M.Laxmikanth (Hindi | English)
  3. Spectrum: Modern History (Hindi | English)
  4. Maths: Quantam CAT Sarvesh Kumar
  5. Objective General English SP Bakshi
  6. Word Power made Easy -Norman Lowe
  7. Topic wise Solved Paperset by Disha


So far 40 Comments posted

  1. Reverie

    Thankyou for sharing 🙂

  2. krishna

    thanks a lo sir…

  3. Prakash Ravichandran

    Thanks for ur nice explanation and related mock questions….

  4. Aparna

    hi Mrunal ..I live at a remote place where I do not hav access to THE HINDU..so i wanted to know if its ok that read the online version of indian express…or it w’d b a disadvantage for me since hindu is considered as the “GITA” of cse. pls reply..

    1. Mrunal

      If you’re going to read the online version then better just read The Hindu online.

      1. Aparna

        thx for replying Mrunal…..now with yr ez reader it has become even easier..thx a ton..

  5. monty

    mrunal shall i wait till jan 13 for iyb 2013,,,d one available now is of no use..2013 vl b updated..suggest plz

  6. Srinivas

    Thanx Mrunal
    MCQ 1 and 6 are correct
    2 3 4 5 are incorrect

  7. porshia

    pl provide iyb 2011 in hindi version

  8. santhu

    is it civils mains will be changed r not in from2014? plz respond mrunal sir….thanks ND REGARD SANTHU

  9. Abhimanyu

    Therefore, JE is found throughout south east Asia, because Rice cultivation and pig rearing is common.

    But because of the critical role of pigs, its presence in Muslim countries is negligible.

    I can’t get the 2nd line???

    1. Mrunal

      Pork is haraam (forbidden) in Islam, therefore very few people involved in pig rearing in those countries.

  10. nachiket

    Hi Mrunal, is it necessary to read old NCERTs for HISTORY and GEOGRAPHY? I have read new ones.

    1. Mrunal

      if you’ve the book and have the time, then it read. Otherwise no need.

      older NCERTs contain truckload of facts (this king and that temple, this mountain and that river etc.) so they were important few years ago. But nowadays UPSC doesn’t ask that type of questions much.

  11. harkirat

    thank u,,ur blog has been,,nd will always be of great help.

  12. prateek

    1. Austrian biotech group Intercell has launched its Japanese encephalitis vaccine in India.
    2. The vaccine, which will be called Jeev in India and is known as Ixario in other markets.
    4. In India, Jeev was launched by Intercell’s partner Biological E., which makes the vaccine at a plant in Hyderabad.
    3. Intercell said it expected the approval for other Asian territories through the World Health Organisation, and said Swiss drugmaker Novartis would be responsible for marketing and distribution in those countries. Novartis owns 14.9 percent of Intercell.

    reference: http://news.yahoo.com/intercell-launches-jeev-vaccine-india-070114129–finance.html

  13. rohit barthwal

    nice article….please also give article on israel/palestine conflict and what is india’s and UN role so for…thnks in advance…

  14. Goud

    Sir, now your website looks good.

  15. Abhishek

    Thanks dude. Your efforts are much appreciated.

  16. Abhishek

    Hi Mrunal,
    as we are slowly approaching the day of fate, which test series, in your opinion would be the best to evaluate our preparation, for Prelims as well as mains?

  17. Mohammad Arshad Raza

    Succinct

  18. varinder saini

    1,2,3,4,5 are false and 6 is true

    1. Apoorv

      1 is also true. Swine is the amplifying host of the flavivirus responsible for JE.

  19. NRM

    Hi Mrunalji
    I need some help regarding selection of my daily newspaper.
    For the last 1 year i have been reading TOI regularly and have bcome comfortable with its liberal and progressive ideology on all issues and its language.
    However in your previous articles you have stressed on importance of The Hindu and The Indian Express specially keeping in mind their weightage in mains 2012.
    I want to highlight 2 problems i face with The Hindu/Frontline
    – Not comfortable with the extreme leftist approach on all matters
    – In mumbai i get two days old hindu(eg Thu paper on Sat) and that also at double the printed price

    I plan to continue reading TOI/ET and only read select op-ed and editorials of The Hindu online
    Request you to advice me further on this so that if any changes are required to be made could be implemented immediately.
    Thanks&Regards
    NRM

    1. Mrunal

      Good enough but Atleast Change from TOI to Indian Express.

  20. Shiva Ram

    Hey Mrunal,

    The interview question that you posed. Is the methods to follow the same for dengue and JE diseases? I know that Dengue is a mosquito borne disease. So as far as making the culling of pigs does not hold relevant here. What else for SARS? How similar is it to the other diseases?

  21. Mohit Diwan

    Mrunal

    Can we include THR ( Take Home Ration ) in the components of the plan mentioned ?

    Ref: Periscope ( deadly disease, desperate measures)

  22. amit

    thanks that made my concept crystal clear

  23. Sunil M

    Hi Mrunal,
    Thanks for the article..
    Could you clarify..does JE spreads if one consume Pig or water bird ?

  24. Abhishek

    thanks a lot

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