The actions taken by KMC health authority at 12/1 Meher Ali Lane bustee, till 22.11.09, keeping in mind the public sentiment and rationality of investigating such fever deaths, are detailed below.
1. A vector team was immediately deployed in the area to carry out anti-larval spraying on 20.11.09, 21.11.09 and 22.11.09. Plenty of breeding spots were located in domestic containers and peri-domestic water collections. We involved the local population in our efforts to do anti-larval work in the locality and showed them the containers, receptacles and masonry tanks containing breeding. The local representatives agreed to take immediate remedial measures on their own initiative, but their point of contention remained the acute shortage of water, thereby forcing them to store water in containers that become future breeding places. We have also been successful in discussing with them the issue of resistance met by our field workers in trying to empty such containers, during the course of their regular work.
2. Deployment of a team of fourteen hon health workers for a house to house survey of fever cases for the consequetive two days of 20.11.09 and 21.11.09. A total of 723 households have been surveyed covering approximately 3000 population of the affected area. The number fever cases recorded till 21.11.09 being only 27 (twenty seven) and not in the range of hundreds as stated by the visual media, which is a very rational occurence and does not indicate any grave concern of epidemic proportions.
3. A fever slide collection center has also been opened at Pragati Sangha, a local club at 12/1 Meher Ali Lane, for the benefit of the local populace. The center that has started functioning on 21.11.09 will also function on 23.11.09 and 24.11.09. The fever blood slides collected at this center will be examined at the Ward Health Unit 57 and appropriate medications will be provided to the febrile cases as required.
4. A team of doctors from ID Hospital have visited the affected area on 21.11.09 around 3 pm and have collected 10 (ten) specimens of blood for serological testing from febrile patients of the bustee. The results of these tests will be made available to us by 24.11.09.
5. Though the area has already been visited by the vector control officer of KMC on 21.11.09, an entomologist will visit the area on 23.11.09 as a follow up action, to conduct his relevant investigations to rule out the incidence of japanese encephalitis as a probable cause of the deaths. The presence of the relevant vector culex vishui needs to be proved, to corroborate deaths due to the disease, japanese encephalitis.
6. Lastly the absence of serological test reports of the two death cases, questions the rationale of putting encephalitis/meningoencephalitis as the cause of deaths in the two cases under scrutiny.
LESSON OF THE DAY : Are we on the right track ? If we are talking of a fever with headache, convulsions and vomiting, then probably we are not talking of malaria even dengue or chikengunia.......thus we are more concerned about the occurence of a zoonotic disease, also viral in origin, japanese encephalitis. If that is so, we should concentrate our efforts exclusively in locating the carriers and amplifiers of this virus and the mosquitoes in its larval stages that are responsible for the spread of the disease. Anti-larval spraying as done above may only be a complimentary action and not the sole vector control activity. The real vector control activity lies elsewhere, in the breeding places of culex vishnui or culex tritaeniorhynchus. So we should search for larvae of the culex mosquito in the two canals that runs on either sides of this bustee and also the surface drains of the locality, even open septic tanks instead of the domestic and peri-domestic water collections. Thus we have not addressed the real cause even on the second day !
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