Thursday, June 20, 2019

Muzaffurpur encephalopathy: A multi-ministry coordination and comprehensive action plan is the answer

Dr KK Aggarwal

The outbreak of acute encephalitis syndrome (AES) in Muzaffurpur has claimed 109 lives so far. AES has been occurring every year for the past so many years with no solution in sight.

A visit by the Chief Minister of the state, or the state or central health minister is alone not the answer.

Since this is a local outbreak in Muzaffarpur and adjoining districts, the state should declare a public health emergency and invoke the Essential Commodities Act. This would bring the entire state health services, both government and private sectors under the gambit of the Essential Commodities Act and Essential Services Maintenance Act as ‘essential medical services’.

A multi-ministry coordination and comprehensive action plan should be drawn up and acted upon.

·          Health Ministry: Should arrange for 24x7 ICU, ventilators, ambulances; Asha workers should be provided with glucometers and thermometers so that they can monitor the temperature and blood sugar levels. They should be taught how to prevent deaths due to hypoglycemia in children. They should be advised to give 1 teaspoon of sugar sublingually (not as a drink) every 20 min in children < 15 years of age. Make sure that the child does not clinch teeth or swallow the sugar. All healthcare providers to do home to home survey

·          ICMR/DST/ all medical colleges: Should spearhead research in the illness to understand its cause, to prevent future such outbreaks

·          Agriculture Ministry: To act on rotten litchis; advise farmers to destroy the rotten fruits, create awareness on harms of eating only litchis by malnourished children.

·          Ayush Ministry: Should deliberate if their pathy has some alternative treatment to offer

·          Women & Child Development Ministry: Should look after the nutrition of the children in the area; an Evening Day Meal Scheme for the children can be started in addition to the Midday Meal Scheme already in place.

·          Transport ministry and Civil Aviation ministry: to arrange for airlifting patients and shift them to other states for management, as and when required

·          Law Ministry: should ensure that no law and order problems arise in such situations and the action plan is implemented smoothly

·          Environment Ministry: should take all measures to prevent heat stroke in the area by providing makeshift shelter homes 

·          Military: can be called in for house to house visits to identify probable cases; when Zika threatened Brazil in 2015-16, when it was preparing to host the 2016 Olympic Games, the army was called into action and asked to join the efforts to control the virus, which was made into a public movement
Its time some concrete steps are taken to prevent recurrence of this illness.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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