An Epidemiological Study of AES (Acute Encephalitis Syndrome) Outbreak 2019 in Muzaffarpur District, Bihar, India
Roshan Kamal Topno *
Department of Epidemiology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Krishna Pandey
Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Niyamat Ali Siddiqui
Department of Biostatistics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Vidyanand Rabibas
Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Sanjay Kumar Sinha
Department of Biostatistics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Ashish Kumar
Department of Biochemistry, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Maneesh Kumar
Department of Virology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Manas Ranjan Dikhit
Department of Bio-informatics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Major Madhukar
Department of Biostatistics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Diwakar Singh Dinesh
Department of Vector Biology & Control, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Shreekant Kesari
Department of Vector Biology & Control, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Vijay Kumar
Department of Vector Biology & Control, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Subhash Kumar
Department of Central Pathology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Md. Zahid Ansari
Department of Biostatistics, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Rakesh Mandal
Department of Vector Biology & Control, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna-800007, India.
Pradeep Das
Department of Molecular Biology, ICMR-Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India.
*Author to whom correspondence should be addressed.
Abstract
Acute encephalitis syndrome (AES) is a major public health concern in India, especially in Muzaffarpur, Bihar, as outbreaks of this neurological disorder have brought on significant morbidity and mortality. It is usually characterized by sudden fever, seizures, confusion, and altered mental status in children along with infectious agents, environmental factors, and malnutrition. It is evident during litchi harvest (April-June), affecting malnourished children from poor families. Among 622 AES cases from May till July 2019; a significant majority were found to have higher mortality and morbidity indices among female Scheduled Caste children. Access barriers in the social and cultural context delayed health care in the event of morbidity. Earlier speculation about associating litchi intake was set aside as most of affected children stayed far from orchards. Clinically, it manifests with fever starting suddenly associated with seizures, altered sensorium, hypoglycemia, hyponatremia, and elevated biomarkers CPK, LDH, and ammonia. High humidity and inadequate mosquito net use are linked. However, these observational studies could not show laboratory evidence of vectors of Japanese encephalitis. Priorities in action include strengthening surveillance, nutrition, education, and better health care access.
Keywords: Acute encephalitis syndrome, Japanese encephalitis, Muzaffarpur, malnourished children, dyselectrolytemia