One clue in Bihar mystery deaths: all kids BPL

All were from desperately poor families who live in suburban slum and rural areas of Muzaffarpur,mostly in the catchment area of the Gandak.

Priti,Nirjala,Sahil and Sonu,all three years old,Ajit (6),Anshu (4),Amarjit (8) and Shivani,just one and a half,were among the 15 children who have died of suspected encephalitis at Muzaffarpurs K D Kejriwal Maternity Hospital (KDKMH) this month.

All were from desperately poor families who live in suburban slum and rural areas of Muzaffarpur,mostly in the catchment area of the Gandak. All the children were brought to the hospital with fever and convulsions,drifting to unconsciousness,and died within hours.

Since June 1,36 children have succumbed to the mystery disease that has been stalking Bihars Tirhut Range,comprising the districts of Muzaffarpur,Sheohar,Sitamarhi and East Champaran. Two deaths have occurred over the past 24 hours.

Local people call the convulsions chimki,and say the disease has been striking the area every year since 1995. Around 50 children died last year,they say.

On Thursday,23 children between the ages of two and eight were admitted in KDKMH with symptoms of the disease including six who were brought to the hospital today. The hospital has admitted 58 patients with these symptoms since June 11,of which 15 have died.

Hospital doctors,advised by experts from Delhi and Punes National Institute of Virology (NIV) were treating the children. The 200-bed hospital,run by a charitable trust,has made the treatment free.

NIV and Rajendra Memorial Research Institute,Patna,have each so far collected 10 samples of blood. Four of the NIV samples showed negative for Japanese encephalitis; one sample at RMRI tested positive. The NIV team advised anti-viral antibiotics and anti-convulsion treatment. All KDKMH patients had cerebral oedema,suggesting viral encephalitis.

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All patients are from BPL families OBCs,SCs and STs living in Minapur,Kanti,Bochaha,Sakra,Ahiyapur,Musahari,Maripur,Kudni,Akharaghat,Saraiya,Karja,Sakra and Mehasi areas of rural Muzaffarpur. Their parents are rickshaw-pullers,carpenters,electricians or daily-wage labourers.

Ashok Kumar,who has a small shop in Minapur,said his two-year-old daughter Babli,who was the first patient to be admitted to the hospital on June 11,was better but her hands were still stiff. So many children have died before my eyes; I can only pray to God for her, Kumar said.

Kumar said he did not know that a Japanese encephalitis vaccine has been given to children between the ages of one and 15 for free at public health centres under a central government scheme since September 2010.

Satendra Prasad,who has come to KDKMH from Madhuban in East Champaran,said,I could not trust any hospital in Motihari for my daughter. I hope that I can take her back home alive.

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About 10 km from the hospital,at village in the Musahari block,nearly-naked,small children run around small,thatched-roof dwellings. Sukhdev Sahni,a daily-wager at the Musahari Farm village,said no one in the village has a mosquito net. Asked if government officials came to spray insecticide in the village,he said,No one has come in my 50-year life.

Encephalitis is spread by mosquitoes,and children with low immunity levels,living in close proximity to animals,are most at risk.

Muzaffarpur District Immunization Officer Dr Shiv Shankar told The Indian Express that only about 5,000 children could be immunized against Japanese encephalitis in April,against the target of 11,600 children. An immunisation camp was organised in December 2007,covering over 10 lakh children,but there has been no camp since, he said.