The union health minister, Dr Harsh Vardhan has ordered all stops be removed for 100 percent immunization of children in select districts of states affected by annual visitations of two deadly strains of Encephalitis. The reaction came after the death of 44 children in six districts of Bihar over the past fortnight, but the minister is concerned about the annual death toll in adjoining eastern Uttar Pradesh as well, which is in the 500-600 range.

Dr Harsh Vardhan said, "I am extremely distressed at the rapid spread of encephalitis and it is high time extraordinary steps are taken to stymie it. I have asked ministry officials to work in tandem with their counterparts in the states and identify the most vulnerable districts within a day. The actual immunization drive will take place over June 22 and 23."

The high level meeting was attended by Mr Upendra Kushwaha, union minister of State for Rural Development, former Health Minister of Bihar, Ms Ashwini Choubey, Mr Mahant Adityanath, member of Parliament from Gorakhpur, Mr Ram Kumar Sharma, member of Parliament from Sitamarhi, health officials from Bihar, Uttar Pradesh, the Center, and scientists.

Mission Mode

The minister asked officials to collect the views of all stakeholders. "I don't want this to be purely a government exercise. We must involve charities, Indian Medical Association, and religious organizations doing social work, even school children, to ensure that all children are brought to the immunization centres," Dr Harsh Vardhan said.

He stressed on the need for surveillance also. The ultimate objective is to prevent disease occurrence by early diagnosis, implementation of effective control measures, and high vaccine coverage with strong and active surveillance system, the Health Minister said.

He made it clear that the drive to eradicate encephalitis should replicate the Pulse Polio campaign which he pioneered as Delhi's health minister in 1994. Later it was spread on a national scale, eventually leading to India being declared "polio free" in January 2014.

Dr Harsh Vardhan said, "I am giving full authority to all concerned to go on a overdrive. We must have a complete immunization campaign for encephalitis in the affected districts." Aware that the drive against Encephalitis would involve diverse medical professionals like paediatricians, neurologists, paramedics, ambulance drivers as well as installing adequate infrastructure, he asked officials of the National Vector Borne Disease Control Program to implement the campaign efficiently.

While Japanese Encephalitis (JE) is responsible for about 10 percent of the fatalities, the more dreaded Acute Encephalitis Syndrome (AES) represents a far greater challenge as its causes are still debated.

The minister was apprised of numerous local bottlenecks and he reacted with firmness against bureaucratic delays. A Virology Centre in Muzzafarpur district of Bihar is unavoidable and the Ministry will assist in setting it up, the minister said. Dedicated beds for encephalitis victims must be set up in all hospitals in the districts having recurrent cases of encephalitis, he directed. The ministry has provided 100 ventilator machines in Gorakhpur for setting up a patients' Intensive Care Unit. He ordered that these should be made functional within three days of the signing of the Memorandum of Understanding with the state government.

Early Warning

Dr Harsh Vardhan said that since Encephalitis strikes mostly during the hot summer months, it is important to put in place an early warning system.

"I have asked the officials of UP and Bihar to approach the Natural Resources Defence Council and the Indian Institute of Public Health to replicate the early warning system installed in Ahmedabad. I think it is noteworthy that the Government of Gujarat gets support from local health and environmental groups to prepare local communities at the onset of summer so that they can take all the necessary steps to protect themselves. My Ministry will be happy to extend all possible assistance to put in place a preparedness plan", he informed.

The Minister also said he would confabulate with scientists of the Center for Disease Control and Prevention, Atlanta to discuss and exchange ideas on diagnosis, treatment and surveillance very soon.

"Apart from the immunization campaign, I will dedicate resources of the Ministry to research on Encephalitis. We have to get to the cause and then evolve into a world knowledge provider on encephalitis because many other countries are hit by this disease," Dr Harsh Vardhan added.