The first cases of the illness appeared back in June. Since then, over 400 people have died, most of them children between the ages of six months and 15 years. So far, over 2,000 patients have been treated in the Gorakhpur area of the state.
Encephalitis is an inflammation of the brain caused by a virus. Children and the elderly are particularly at risk from the illness, which has symptoms such as fever, headache, vomiting and confusion. In severe cases, it can lead to seizures, paralysis and death. Even when children survive, some can be left permanently weakened. High levels of malnutrition in India also mean that children have low immunity and are more vulnerable to the effects of the disease. Many of the sufferers from 12 districts in the region come from poor families.
Most commonly, the viruses which cause encephalitis are transmitted through insect bites. For example, Japanese encephalitis is a mosquito-borne virus. Outbreaks therefore tend to occur during the rainy season, when standing water provides a breeding ground for the mosquitoes. The Gorakhpur region, which borders Nepal, lies in the foothills of the Himalayas and low-lying areas are prone to flooding, providing the right conditions for mosquitoes.
However, doctors in the region are wondering if this time the disease may be present in contaminated water. Two major vaccination drives against Japanese encephalitis were carried out in Gorakhpur in 2006 and 2010, causing a dramatic decline in cases. And locals have also been using mosquito nets and repellents to protect themselves. Scientists from the US-based Centres for Disease Control have been to the region in past years to collect samples, but money for a special programme of research and treatment in the Indian state’s BRD Medical College has all but run out. If the current outbreak does prove to be another form of encephalitis linked to poor sanitation and drinking water, health officials will find it exceedingly difficult to control its spread.
The BBC spoke to the head of paediatrics at the BRD Medical College, which is treating the affected. Dr KP Kushwaha said the current outbreak was now claiming the lives of “five to 10 children” each day. Spaces at the hospital are in such demand, that staff members are putting two patients into one bed. The senior doctor called what was happening to these children a “tragedy beyond imagination”.