With the health ministry having announced a national emergency to tame the rising threat of encephalitis it is time to revisit the existing policy in regard to voluntary administration of the preventive vaccine against the disease.

The mortality rate of the disease is very high at around 26 per cent.

“This is a national emergency,” said Health Minister Dr Harsh Vardhan here on Tuesday on the latest deaths in Uttar Pradesh and Bihar due to Japanese Encephalitis (JE). The toll from encephalitis has risen to 25 and counting with 10 more children dying in Muzaffarpur (Bihar) in the last 12 hours, officials said.

Even though there is no cure for the disease, there is a preventive vaccine. Former Health minister Ghulam Nabi Azad had launched an indigenous vaccine for the disease.

In October 2013, Azad launched the indigenously produced Japanese Encephalitis vaccine JENVAC. The vaccine had been jointly developed by scientists of National Institute of Virology, the Indian Council of Medical Research (ICMR) and Bharat Biotech Ltd.

“Currently the JENVAC vaccine is not given to every child in the country. It is only given to those children born in districts where encephalitis is endemic,” said Dr Soumya (name changed), a senior Pediatrician (Child Specialist).

“With migration on the rise, this disease is spreading to other places,” she added. Officially there has been no confirmation on the vaccination either being voluntary or mandatory. “Indian Academy of Pediatrics (IAP) is the body which decides whether a vaccine should be given on a compulsory basis to every child or not. The body meets once a year and decides on vaccinations and other issues based on surveys done during the year,” she said.

“The public health need for this vaccine is immense since the birth rate in the affected 171 districts is about 40 lakh annually, which means that we would eventually need about 1 crore doses of the vaccine for comprehensive coverage,” she said.

Acute Encephalitis Syndrome (AES), so far limited to Muzaffarpur district, has now spread to neighbouring districts of Vaishali, Samastipur, Sitamarhi, Sheohar and East Champaran as 33 cases were reported from these districts recently.

Former Health Minister Ghulam Nabi Azad during his tenure had said that a national program for prevention and control of JE was started with a multi-pronged strategy in 60 high endemic districts of five states, including UP and Bihar.

Some of the aims of the program were strengthening and expansion of JE vaccination in affected districts, strengthening of surveillance, vector control, access to safe drinking water and proper sanitation facilities to the target population in affected areas, he said.

During the year 2013, an amount of Rs.346.9 million and Rs.603.83 million was allocated to the states of Uttar Pradesh and Bihar respectively for controlling the disease, Azad added. There was a mass vaccination program in 2006, but it was largely unsuccessful as only 35 per cent of the children could be immunized, according to ICMR data. For the next three years there was no mass vaccination program. The government records show that the number of deaths due to Japanese encephalitis is declining, but other strains of the virus are increasing and the yearly death toll has become a regular occurring.

A Press Information Bureau (PIB) tweet on Tuesday quoting Dr Harsh Vardhan read, “Mass awareness & universal immunization program to be taken up in selected districts of Bihar and UP on 22 & 23 June for JE/AES.”

Even though, it is a disease that affects people throughout the country, people living in Gorakhpur and adjoining areas near the Nepal border and in the western districts of Bihar are susceptible to floods. These floods then provide a good breeding ground for the mosquitoes to stay and spread the disease.

Every year, encephalitis hits Muzaffarpur, Gaya and other neighboring districts in May or June. Last year, 62 children died of encephalitis in Muzaffarpur, and 150 died in 2012 in the district. Most victims were from the poorest of the poor families and living in rural pockets of the state, according to Indian Academy of Pediatrics (IAP) data.

JE is a mosquito-borne disease, the symptoms of which include fever, headache and convulsions. It has a high mortality rate among children.

Encephalitis is a disease that results in inflammation of the brain. The patient’s central nervous system is affected. While the lesser symptoms include headaches and fevers, the more severe ones cause the onset of mental issues like seizures, confusion, disorientation, tremors and hallucinations. It can be caused due to bacterial or viral infections of the brain, injection of toxic substances or increased complications of an infectious disease.