Japanese Encephalitis - An Arboviral Disease
Dr Jairaj pukhrambam
Japanese Encephalitis (JE) popularly called “Brain fever” is an acute viral encephalopathic illness which has got public health importance because of its epidemic potential and high fatality rate. In patients who survive, complications lead to lifelong sequelae.
Japanese Encephalitis presents a significant risk to humans and animals particularly in South East Asia where around 50,000 cases and 10,000 deaths occur per year, particularly affecting children below 10 years (WHO report). The statistics reveal that 50 per cent of the patients who develop Japanese Encephalitis suffer from permanent neurological defects and 30 per cent of them die due to the disease. The disease was first recorded in Japan in 1924 (Gatus and Rose, 1983). Presently it is seen in epidemic proportion in most countries like Korea, Malaysia, Singapore, Bangladesh, Thailand, Vietnam, China, Nepal, Myanmar and India. In recent years, JE has spread to newer geographic locations like Australia and Pakistan. In India, the first major outbreak of Japanese Encephalitis of occurred in 1973 in Bankura and Burdwan districts of West Bengal. During the last decade, there has been a major upsurge of JE in Assam, Andhra Pradesh, Karnataka, Goa, Manipur, Maharashtra, Madhya Pradesh, Tamil Nadu, Uttar Pradesh, Pondicherry and West Bengal.
Aetiology : Japanese Encephalitis (JE) is caused by an arbo (arthropod borne) virus of type B (Flavi virus) sub-group, of Togaviradae. It is a RNA virus 40mm in diameter having marked neurotropism (Rhodes, 1968). It is a zoonotic disease having its natural cycle in wild or domestic animals and haematophagus arthropods. The disease is transmitted to man by the bite of infected Culicine mosquitoes. Man being the only incidental “dead end host”.
Man to Man transmission has not so far been recorded. Eating pork cannot transmit the disease. The JE virus multiplies in the pig’s body. When the female Culex mosquito sucks the blood of pig, she picks up the JE virus. After an incubation period of 14 days, the Culex mosquito is able to transmit the JE virus to a new host usually pig. It has high morbidity and mortaliity rates. Usually affected age group is 5-10 years though children from 3-14 years can be affected. Morbidity rate estimated at 0.3 to 1.5 per 100000 populations, whereas Fatality rates ranged from 10% to 60% and 50% of those who recover left are with neurological deficit. Incidence is higher in males but sub-clinical infection has occurred equally in both sexes. Nearly 10% of cases are among those over 60 years, perhaps reflecting waning protective immunity.
Susceptible Hosts : Animal Hosts : Among the animal hosts, pigs have been incriminated as the major vertebrate hosts for JE virus. In some places, up to 100 percent of pigs may be infected with JE virus. Infected pigs do not manifest any overt symptoms of illness but circulate the virus so that mosquitoes get infected and can transmit the virus to man. Serological surveys showed that 1.2 to 44% pigs tested in different parts of the country had antibody to Japanese Encephalitis. The pigs are thus considered as “amplifiers” of the virus. Cattle and buffaloes may also be infected with the JE virus; although they may not be natural hosts of JE virus, they act as “mosquito attractants”. Horses are the only domestic animals so far known which show signs of encephalitis due to JE virus infection.
Birds : Swamp dwelling birds are natural reservoir of virus. Some species of birds such as pond herons, egrets and perhaps poultry and ducks appear to be involved in the natural history of JE virus. The virus does not cause any disease among its natural hosts and the transmission continues through mosquitoes. It is carried by female mosquitoes from infected pigs or water birds, pond herons and ducks to susceptible children. Mosquito Vectors : The main vector, culex mosquito (Culex tritaeniorhynchus, C.vishnui, C.gelidus and others—totally 8 species) lives in rural rice growing and pig farming regions. [Ecological studies implicate that mosquito (Culex tritaeniorhynchus) act as primary vector in many South East Asian countries as well as other parts of India.
The mosquito breeds in flooded rice fields, marshes, and standing water around planted fields. This is the reason; JE is mostly a rural disease. Culex mosquitoes can fly up to 5 kms. Venereal transmission of JE virus occurs in Culex bitaeniorhynchus mosquitoes. This may have epidemiological significance. The virus is transmitted occasionally by Anopheles (3 species) and rarely Mansonia (1 species).
JE is a seasonal disease. Epidemics coincide with the monsoon and post monsoon period (August to December), and Agricultural practices, due to high density of the mosquito vector (because of stagnant water), and presence of reservoir hosts (pigs). Northern India, including Northeastern India, receives summer monsoons and as such the transmission season begins from May, with the incidence reaching peak in August—October depending on the advancement of monsoon. With onset of winter JE outbreaks subside. However, in endemic areas, sporadic cases may occur throughout the year due to congenial climate conditions throughout the year (eg Southern India). Susceptible children are infected by infected mosquito bites. After mosquito bite disease appears in 5-16 days. The virus then invades the Central Nervous System and causes disease. Although infection in human is incidental, the virus can cause serious neurological disease with high morbidity and mortality.
JE does not spread from child to child or from cattle to humans because of the low and transient viremia. This is the reason increase in cattle to pig ratio may reduce the risk of JE (mosquito bites are shared by cattle and pigs). The incidence of JE disease is never an indication of the risk at which the population is living in JE endemic areas, because of inapparent infections, which tend to outnumber the apparent infections, and also due to the lifelong immunity, which develops despite inapparent infection. The ratio of overt diseases to inapparent infection varies from 1:250 to 1:1000. Thus cases of JE represent only the tip of the iceberg compared to the large number of inapparent infections. Usually the number of cases reported from each village is 1 or 2.
Clinical manifestation : Animals : With the lapse of incubation period of 2-4 days, animals show loss of appetite and fever ranging from 38°to 40.7°C. At the height of fever animals show signs of depression, photophobia, tremor, ataxia and hyperaesthesia. Animals are extremely exhausted and unable to stand. Respiration is laboured. Death occurs after 3-5 days of illness. Few animals may survive.
Man : JE has an incubation period of 5-15 days and the vast majority of infections are asymptomatic only, 1 in 250 infections develop into encephalitis. Severe rigors mark the onset of this disease in humans. Fever, headache and malaise are other non-specific symptoms of this disease which may last for a period of between 1 and 6 days. Signs which develop during the acute encephalitic stage include neck rigidity, cachexia, hemiparesis, convulsions and a raised body temperature between 38 to 41 degrees Celsius. Mental retardation developed from this disease usually leads to coma. Mortality of this disease varies but is generally much higher in children. Trans-placental spread has been noted. Life-long neurological defects such as deafness, emotional lability and hemiparesis may occur in those who have had Central Nervous System involvement. In known cases some effects also include nausea, headache, fever, vomiting. —to be contd
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RTI Act and its impact in Manipur
Sinthoinu Nameirakpam
(contd from previous issue)
In section 3 of the order dated 21.1.2010 of MANIPUR lNFORMATION COMMISSION the case was stated in brief as “The application for the information was filed on 9-5-2007 and till date the information is still remaining unfurnished, over a period of about three years, which is quite unsual and ridiculous. In the meantime because of the unfurnishing of the information the applicant is suffering both mentally and physically, by attending the office of the commission on each hearing day during such long period for which she deserves compensation.
And the operative parts of the order ie sec. 4 and 5 reads as—
4. In the circumstances stated above, the commission recommends the disciplinary action against the responsible officer/officers for termination from their services with immediate effect under the Service Rules applicable to each of them u/s 20(2) of RTI Act, 2005. The Government of Manipur, Department of School Education, and Government of Manipur Imphal should complete the fixing of responsibility for the missing documents within 15 days from the receipt of this order if not the SPIO will be the responsible for the same.
5. Further the applicant should be compensated by the public Authority, ie the Secretariat, Education Department School, Government of Manipur, by paying a sum of Rs. l00000 (Rupees one lakh) within one month from the receipt of this order under sec 19 (8)(b) of the RTI, Act 2005.
Thus in this case the objective of the applicant to obtain the information regarding the marks obtained by the last candidate in the select list ends in a fiasco providing the immunity of the RTI Act against the stuborn and intentional registance of unscrupulous men in the administration.
Thus, the brilliant and unwavering efforts of RK Angousana to do justice to the Act itself in his capacity of being the State Chief Information Commissioner, Manipur also fails measurably.
In the 2nd case mentioned above two students L Malem Mangal and N Abhi Singh of LMS Law College, Imphal lodged a complaint for not providing information they sought.
As of a common trait among the top officials the SPIO in the office of the Directorate of Education (Higher Education) did not care to provide the relevant information for more than six months. Thus for infraction of the RTI Act and of the duty the SPIO was ordered to pay a fine of Rs.10, 500 (Rupees ten thousand five hundred) only through treasury officer Imphal.
In the second case there was compliance in furnishing the information sought and SPIO was fined direct for delay and negligence. However for the first case the commission expressly declared that all its efforts have been thwarted by the sinister design of a handful of unscrupulous officers and the information was not provided for more than three years. Thus the above mentioned penalties of giving compensation and termination of services were recommended. However the compliance of the recommendations are not reported upto the time of this write ups. The difference between the two cases is the implicit involvement of financial and pecuniary interest.
Thus one can honestly judge the effectiveness of the Right to Information Act in the milieu of the present day society on the top of which the bureaucratic Ministers and high officials set to rule with rampant corruption and ruthless bribery along with high scale favouritism and nepotism.
These orders are not surprising in our present misinformed and disinformed society. But how it comes? Let’s have a glance on RTI Act 2005. The Addendum—
1. What does Right to Information mean ?
Ans:- U/S 2(j) of the Act Right to Information includes the right to inspect works, documents, records takes notes, extracts or certified copies of documents or records, take certified samples of material obtain information in form of printouts, diskettes, floppies, tapes, video cassettes or in any other electronic mode or through printouts.
2. What is information ?
Information means any material in any form including records, documents, memos, e-mails, opinions; advices, press releases, circulars, orders, logbooks, contracts, reports, papers, samples, modes, data materials held in any electronic form and infonnation relating to any private body which can be accessed by a public authority under any other law for the time being in force.
—to be contd
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Genesis of the All Manipur Christian Organisation
Pro Kungsong Wanbe
(contd from previous issue)
The AMCO actively took part in restoring peace and normalcy in the hills and valley of Manipur. In the context of communal conflicts in the Manipur hill districts ie the Naga-Kuki feud, the AMCO was the first organisation to make a great effort to bring back peace and normalcy among these two hill communities.
The AMCO convened several meetings in the effort to bring an end to the communal conflict. On 30/9/92, the AMCO issued an appeal pamphlet for peace and also organised a mass prayer on 4/10/92 at MBC centre church for Imphal town area and on 11/10/92 at all the hill district headquarters. The AMCO formed a peace committee and visited communal clash affected people who were hospitalised at RMC, now RIMS and Chamber of Commerce.
The visiting committee members also extended Rs 200/- (Rupees two hundred) each to those who were being hospitalised and offered prayer for their soon recovery. The AMCO also visited communal clash affected villages and refugee camps and distributed cash relief. Another pamphlet was issued in both the plains and the hills : to the Nagas, Kukis, Meiteis and Meitei pangans to stop communal violence and love one another.
An AMCO silent peace rally was taken out on December 10, 2000 in Imphal in protest against the gunning down of Fr Jacob Chittinapilly, assistant parish priest of St. Joseph’s parish church, Sugunu on December 2, 2000 by unidentified gunmen.
Apart from protesting the killing of Fr Jacob Chittinapilly, the speakers at the rally meeting recalled the assassinations of Fr Matthew Manianchira, Principal of catholic School, Kanchipur, Fr NV Joseph, the Principal of Don Bosco Higher Secondary School, Maram and assault Fr VJ Sebastian, Headmaster of Don Bosco High School, Imphal.
For the readers and general information AMCO is an issue-based organisation. In fact, AMCO raises its voice whenever any issue arises in the Christian community or in the society at large. The AMCO does not keep silence but always tries to bring back peace and normalcy. It may not be possible to mention all the issues with which AMCO had involved itself. The following are some of the issues in the resolution of which AMCO had played a major role. Mention may be made here that at the request of the Chief Minister of Manipur and his Cabinet Ministers, the AMCO rescued the former Deputy Commissioner of Chandel district Shri Thamkishwar Singh from Chandel area who was detained by a Naga underground organisation; and another NGO leader from Germany who was detained by a Kuki underground organisation was also rescued from Nongdam Kuki area. The AMCO expressed their thankfulness to the underground organisations for heeding to AMCO’s request for release of the hostages.
The AMCO also visited the families of children who had been kidnapped and killed, women who had been raped and killed etc.
The AMCO also submitted a memorandum to Mr Shivraj Patil, then Honourable Union Home Minister in connection with the excesses of security forces committed against innocent civilians. Among those (i) 9 (nine) villagers of Tabanglong village in Tamenglong district including two Meitei chili traders were killed by the army posted at Tamenglong on the 28th of December, 2000, (ii) Pro Jamkholet Khongsai of Saichang village was killed allegedly by the 21 st Assam Rifles personnel and his bullet riddled body was found buried in the jungle near Bongyang village under Yairipok police station on the 8th of July 2004, (iii) The gruesome custodial killing of the alleged lady insurgent, Thangjam Manorama Devi by the 17th Assam Rifles personnel in the intervening night of the 11 and 12 July, 2004 and (iv) The cold blooded killing of ailing youth Jangkholien Chongloi aged 28 of Saikul Purum Likli in front of his family members without trial on 31st August 2004 at Khongsai veng by the Imphal West poice commandos.
Lastly but not the least, the All Manipur Christian Organisation (AMCO) appealed to both the militant groups and the security forces not to ambush and retaliate in crowded places where the possibility of civilian casualties is high. The appeal was published in The Sangai Express on the 23th of August, 2006. —concluded
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Human Rights Versus AFSPA, 1958
Khangembam Chonjohn Singh
(contd from previous issue)
Q. So, you agreee the AFSPA is an impediment indelivering justice?
A. AFSPA has huge problems of perception on both sides—the perception of the average resident of J&K that it is abused, and the sense that it is indispensable for the security forces. The need is to address both views. I don’t think we should constantly look at the AFSPA only from the prism of J&K. Long before this law was seen as a problem in J&K, it was a big problem in the Northeast. The move to amend it started there.
Presently, the army has already taken up an important point of law before the Courts as to the competency and jurisdiction of State Governments to constitute Judicial Inquiry under the Commission of Inquiry on Act, 1952 to inquire into and find out by it on the question of fact “Whether there was fake encounter extra judicial killing by the army/armed forces...” ? Pending the cases before the Courts, Judicial Inquiry Commissions constituted by the State Governments have been suspended. The question is by whom or by which authority the said point of law has to be determined, am at the same time, when, how and by whom the concerned army personal has to be booked and handed over to the State authorities for his alleged involvement in fake encounter or commission of extra judicial killing. In the absence of specific provisions in that regard under a special statute or the AFSPA itself, mere addition of a provision by amendnment of APSPA to hand over the army or armed forces officer involved in “fake encounter” or “extra judicial murder” to the State authorities, would not serve the purpose. AFSPA, if not repealed or amended thoroughly would ever remain as a “licence to kill” ie to eliminate anyone at any time and place, whenever and wherever it is allowed to be in operation or in force as against the rule of law. It is a must and an obligation long overdue for the Central Government to amend AFSPA, if not to be repealed, at least to delete or otherwise obliterate the words “. . . fire upon or otherwise use force, even to the causing of death, against any person...” appearing in Section 4(a) thereof. Life of citizens deserve protection ensuring them not to be deprived of their life except according to the Code of Criminal procedure, 1973. Further, it would be expedient to remove Section 6 of AFSPA and to make complaints against the army or armed or forces officers cognizable and to be investigated by police officer of some higher rank upon re gistration of FIR case at the Police Station within whose local area the occurrence complained of takes place.
Let AFSPA be no longer a “Licence to kill”.
—concluded