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India struggles with disease epidemics

Medical experts have confirmed that a mystery disease which killed at least 30 children and 2 adults in north-eastern India over the past two weeks is a strain of encephalitis.

Hospitals across the state have been treating a number of cases where children particularly between the ages of two and eight have fallen ill and died. Health authorities are uncertain at this stage how many additional deaths may have occurred at home.

Tests have now shown the killer is a form of encephalitis, an inflammation of the brain caused by a number of viruses. Children and the elderly are particularly at risk from the severe illness, which gives symptoms such as fever, headache, vomiting and confusion and can lead to seizures, paralysis and death in severe cases. The most common viruses which cause the illness are transmitted through insect bites, but poor health and nutrition can also make children more vulnerable to the effects of the disease.

Health officials in Bihar have also been dealing this year with an epidemic of tuberculosis (TB). A virulent form of multi-drug resistant (MDR) TB has struck the region, which has inadequate facilities to test for the disease. India has to cope with nearly 2 million new cases of TB each year and it is the largest killer of those aged between 15 and 45. Though the country has made increasing efforts to reduce the number of deaths by ensuring patients complete a full course of treatment, the disease remains a huge challenge to public health and a serious drain on the economy.

The rise in drug-resistant cases is worrying, especially when diagnosis methods in states such as Bihar are labour-intensive and archaic. Officials in Bihar still use a 100-year-old test called Koch’s method to detect the disease in saliva, but this is only 50 per cent accurate even with an experienced person looking down the microscope. This means that Bihar detects less than half of TB sufferers, when average detection rates across India are 70 per cent.

Many poor migrants in Bihar contract the disease when they go to work in cities like Delhi. Most end up living in crowded slums and shantytowns which act like hotbeds for infectious diseases. Medical experts are worried that unless detection rates improve and patients receive proper treatment, the epidemic of MDR cases will spread. Some are placing their hopes on new rapid-testing technologies, such as a machine called GeneXpert, which looks at DNA amplification and can confirm a case of MDR-TB in less than two hours. In a country like India, where TB already kills two people every three minutes, such technological advances may be vital.

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