Encephalitis deaths on the rise

A rise in the number of deaths from Japanese Encephalitis (JE) is causing concern among health workers in Nepal who say more needs to be done to combat the preventable disease. JE mostly affects impoverished families, with many children and elderly people among the victims. In the past two months alone at least 200 people have died of JE, according to the Nepalese health authorities. A spokesman for the health ministry said last week the mosquito-borne disease had affected more than 800 people in the same period. Annual outbreaks of the disease often occur near rice fields after rainwater is left standing during the monsoon season, which is about to end. A World Health Organization (WHO) report said that nearly 50,000 cases of JE were recorded every year, mostly in Asia. India and Nepal are particularly badly affected by the disease, which is preventable by vaccination. According to medical reports, the disease is particularly deadly because once infected, it is very difficult to cure those infected. Blinding headaches, seizures, nausea and high fever usually precede death. Those who manage to survive suffer from a series of disabilities, including paralysis and mental retardation. Most victims are from impoverished communities with poor housing, leaving them forced to sleep out in the open where they can become infected by mosquitoes carrying the disease. The Nepal Red Cross Society and other NGOs are providing bed nets to help prevention, but, according to health workers, the supply has not been enough. Nepalganj, a border city 500 km west of the capital, is one part of Nepal where the disease is at its worst. In less than three weeks, nearly 60 patients have died from JE. Already 45 patients have died at Nepalganj's government-run Bheri hospital. At least 15 others have died of the disease in other medical facilities in the city. Health workers say nearly 200 die every year from the disease in the area. "It's really a tragedy for most of these people who often arrive late [at hospital] as they are not aware of the disease until they become really sick," said health worker Nandalal Shrestha from Bheri hospital. "The government has to introduce strong measures to protect the vulnerable from this deadly disease but priority has not been given to it, unlike for malaria and HIV/AIDS," said health worker Anju Rai in Nepalganj. Awareness of JE is minimal in Nepal compared to other mosquito-borne diseases like malaria, say health workers. A survey by a local NGO, the Environmental Health Project (EHP), found that only a tiny percentage of the vulnerable population in the southern plains of west Nepal were aware of the disease and of measures to prevent it. The only effective way to prevent the disease is vaccination. Although the government does provide free vaccines in state-run hospitals, they are few and far between in a country where a nine-year-old Maoist rebellion has restricted government health care to a few large towns and cities.