Times of India
23 July 2010
By Malathy Iyer
Mumbai, India

This is possibly one of Mumbai’s highest score: over 8,600 cases of malaria in the first 17 days of July. Last year, the positive cases for entire July stood at 4,380. For a city that was once a malaria–free area, the transformation into an endemic zone now appears complete.

One of the reasons for the higher positivity could be the fact that the civic administration has stepped up its door–todoor surveillance and is collecting more blood samples than before this year, but health experts feel that the city is in the throes of an outbreak. On Thursday, the health department registered the 11th death due to malaria since July 1; a 28–yearold resident of Duncan Road near Lalbaug became the latest victim of the disease.

The findings of a leading private laboratory lend credence to the assumption that malaria has never been so big a problem before. Dr Nisha Ahmed of Metropolis Laboratory in Worli says, “The percentage of patients detected positive with malaria has increased from 4% in June 2008 to 12% in June 2010.” She adds that the number of patients with symptoms has increased by 70% in the same period.

This peak in malaria cases is more than just a public health disaster for Mumbai. “It’s a moment of shame,” says former scientist from the Indian Council for Medical Research (ICMR), Dr C J Babu, who has written a book tracing the transformation of Mumbai into a malaria hub in a span of little over two decades.

He says that till 1980, there was no indigenous transmission of malaria in Mumbai. Only people who travelled from other towns and cities brought along the parasite that led to sporadic incidence of the disease. A former professor from JJ Hospital, who doesn’t want to be named, recalled how as a student they would rarely see cases of malaria in hospitals. “It was an event to have a malaria patient in our wards,” he says.

Why was Mumbai then was an oasis of health even though the rest of India reeled under malaria? “We perhaps have to thank the British for keeping a stringent check on malaria for decades,” says Babu, who has worked as an entomologist with several multinational companies as well. The British used the municipal act in toto to ensure that no tanks were leaking and that no fountains had larvae breeding. “There was such stringency that the insecticide department fined senior BMC officials if fountains in their bungalows were found to have the larvae.”

Then in the ‘70s, work started for setting up the satellite town of Navi Mumbai. “Construction workers brought along the parasite that slowly over a decade became local,” says Babu. This led to the first indigenous transmission of malaria in Mumbai in the ‘80s.

The malarial parasite and the disease soon spilled over to Mumbai and, without adequate policing, has grown to the present–day menace, says Babu.

In fact, the epidemiological report of the National Vector Borne Diseases Control Programme for the period between April 2009 and April 2010 shows that there has been a 55% increase in positivity cases and another 15% hike in the incidence of falciparum malaria, which is considered the deadlier form of malaria.

REQUEST FOR OBSERVERS
Given the uncontrolled increase in cases of malaria, the state government has requested the Directorate of the National Vector Borne Diseases Control Programme to depute a team of observers to the city. “The central team may be able to provide a perspective that would help us control the disease,” said a senior health official. However, the centre has so far not responded.

HEALTH CARDS FOR LABOURERS
In a bid to check cases of malaria, workers at each of the 2,400 contruction sites will get a health card from August 1. “Construction sites are breeding ground for malarial parasites and mosquitoes. Hence, in a bid to check malaria, 100 health workers will try to cover each of these 2,400 sites in 12 working days,” said Dr G Ambe, executive health officer of the BMC.