Times of India
17 July 2010
Mumbai, India

The BMC may be tackling the outbreak of malaria on a war footing, but it’s losing the battle as hospitals across the city are swamped with people showing symptoms of the disease. More than 45% of beds in private and public hospitals as well as nursing homes are being occupied by patients suffering from fever and malaria. It’s little wonder then that Mumbai has earned the dubious distinction of being the country’s malaria capital, accounting for more than 40% of all cases in Maharashtra.

Officials from the BMC have admitted that there has been an alarming surge in the number of malaria cases–since the start of this year, close to 9,000 Mumbaikars have fallen victim to the mosquito’s deadly sting. "There has been a 20% increase in the number of malaria cases this year. The good news, though, is that the mortality rates are lower than last year.

Killer Stats
Deaths due to malaria in July: 8
Most malarial deaths in Mumbai are caused by the Falciparum strain The milder vivax strain is becoming more virulent Over 45% of hospital beds (nearly 17,000) across the city–including private and civic hospitals–are filled with patients suffering from fever and malaria

The figure for nursing homes is 75%–90% Hospitals admitting only serious patients
Mumbai: Wards at civic hospitals are packed to their capacity, so much so that every bit of floor space is taken up by patients. The already skewed patient–bed ratio of one is to 3,000 has become worse since the outbreak. BMC’s executive health officer Dr Girish Ambe said: "More than 25% of the civic beds are occupied by patients suffering from malaria and fever. Nearly 4,000 people have already been hospitalised this month.’’ A senior doctor at the civic–run KEM Hospital said that doctors are admitting only serious cases: "We treat the rest and send them home.’’

Private hospitals, nursing homes and general practitioners are also reporting a similar trend. "This year, the number of people coming down with malaria is overwhelming,’’ said a consultant physician at Breach Candy Hospital. He added that infrastructure and construction work, lack of hygiene and inadequate means of vector control are the main reasons for the rise in malaria cases.

The dearth of beds is underlined by the fact that several smaller hospitals and nursing homes are admitting only those people who are critical. A case in point is the 15–bed Dr Gandhi’s nursing home at Dadar, which is currently treating 13 malaria patients. "Over the past few weeks, 90% of my beds are being occupied by patients suffering from fever and malaria,’’ said the director of the hospital, Dr Manoj Gandhi. He said that the same scene was being played out in other nursing homes in the area as well. At Good Health nursing home in Jogeshwari, 15 of the 24 beds are occupied by patients showing symptoms of the disease. "We have been turning away four to five patients every day as we have no beds,’’ said the duty officer.

Many of the larger and more expensive private hospitals have also noted the sudden surge. "We are mostly trying to treat malaria and fever patients on an OPD basis but some patients, out of fear, insist on hospitalisation,’’ said Dr A V Hegde of the internal medicine department in P D Hinduja Hospital. In Jaslok Hospital, out of 64 patients treated for malaria around 29 had to be hospitalised.

Around 49 lab technicians at Kasturba Hospital are scanning more than 3,500 blood samples for malaria strains. "The staff ’s weekly holidays have been cancelled,’’ said Dr Kishore Harugoli, assistant health officer, malaria surveillance. The BMC is discouraging doctors from prescribing malaria drugs indiscriminately. Nearly 3,500 doctors have been warned. "The state is conducting a study to see if there is any resistance to the first line malaria drugs in the city,’’ said Ambe.

Different Strains
There are four types of human malaria
1 Plasmodium falciparum 2 Plasmodium vivax 3 Plasmodium malariae 4 Plasmodium ovale A mixed strain occurs when a mosquito is a carrier of both parasites, and when a patient is bitten by two mosquitoes carrying two different strains of parasite Vivax malaria | Is a benign strain, which results in fever and shivering that lasts for a few days.

Anti–malarial treatment works on most patients Falciparum malaria | Is more deadly with high rates of mortality. Often patients develop complications in the liver, kidneys and the brain making diagnosis and treatment difficult

Hot Spots
Worst affected areas in Mumbai Worli, Prabhadevi, Kalachowkie, Sewri, Cotton Green, Bandra, Mahalaxmi, Khar (W), Santa Cruz (W), Vile Parle (E), Andheri (E), Jogeshwari (E), Chandivali, Chunabhatti Number Crunching Blood Samples Collected Every Day By BMC 3,500 slides

Blood Samples Collected From July 1–15
60,843
Samples Tested Positive In July
6,899

Deaths Due To Malaria From January To June 24 Dearth Of Hospital Beds
Around 45% of hospital beds across the city–including private and civic hospitals and nursing homes–are filled with patients suffering from fever and malaria In civic hospital, close to 500–900 patients are admitted only for malaria and fever nearly every day OPDs are flooded with fever cases as civic hospitals treat around 5,000 patients daily