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Sunday, October 12, 2003

Meeting on epidemic prevention measures



By Our Staff Reporter

THIRUVANANTHAPURAM Oct. 6. The District Medical Officer, E. K. Madhavan, has convened a meeting of health supervisors from Primary Health Centres(PHCs) in the district on Tuesday to chalk out preventive strategies against a possible outbreak of water-borne epidemics.

Around 40 supervisors are expected to participate in the meeting which will draft an action-plan to tackle the threat of infectious diseases following incessant rain over the past four days.

Meanwhile, the Health Department has also urged the local bodies to actively participate in the efforts to check the spread of epidemics.

The local bodies have been asked to create awareness about preventive measures in the community and drive home the importance of hygiene.

The alert comes in the wake of a surge in epidemics reported across the State. Between January and September, there have been 3,119 cases and 82 deaths due to dengue, 1,222 cases and 83 deaths due to leptospirosis, 45 cases of cholera, 716 cases and one death of a typhoid case, 1,379 cases and six deaths due to malaria and 96 deaths of undiagnosed viral fever.

Sunday, September 14, 2003

Water samples from cholera-prone regions fail quality test



By M. Dinesh Varma

THIRUVANANTHAPURAM Sept. 13. The laboratory tests on water samples collected from the cholera-prone regions in the city have failed the quality test, raising concerns over a resurgence of the water-borne epidemic.

The outbreak of cholera this year has been largely confined to the Tiruvallam, Karumom and Nemom areas from where as many as 23 cases of confirmed cholera has been reported, so far. Last year, at least 38 cholera cases, including two deaths, had been reported from the coastal areas along the Poovar-Poonthura stretch along with sporadic cases from inland areas.

The cholera-affected areas in Tiruvallam spread across areas such as Punchakkari, Lankadweep, Kodithookkikkunnu, Thinavila colony and Karumam area in Nemom.

While five of eight water samples from Tiruvallam were termed `not satisfactory' in terms of bacteriological and chemical quality, the sample from the Nemom area had also failed the quality tests.

The tests conducted by the Public Health Laboratory had also recorded coliform content in water samples collected from the Kerala Water Authority (KWA) pump house as well as the main-line which supplies water to thickly-populated residential pockets in Tiruvallam, the stored water at a hotel in the area, and samples taken from the Vellayani Lake and the Karamana river.

Post-epidemic surveys found that there were only 2,020 latrines available for the population of 37,471 in the 8,620 households in Tiruvallam. The primary sources of water were the 20 public wells and around 1,306 private wells.

In the Nemom zone with a population of 36,968, out of the 7,364 houses, at least 5,534 houses lacked wells, 812 were without pipe connections and 362 houses lacked sanitary latrines.

Health officials point out that in spite of controlling the recent outbreak of cholera in these areas, the threat of transmission would continue to persist unless sanitary facilities and safe water were provided to these highly congested pockets.

The quality of well water is also highly suspect. At the pumphouse at Vellayani Lake, which serves as a source of tap water, there was no proper filtration. The chlorination at the treatment and distribution centre of the KWA at the Vandithadam was also found to be far from satisfactory.

Moreover, as people receive tap water only once or twice a week, they tend to store water. This, health officials say, increases the risk for water-borne diseases, as residents are not in the habit of boiling water before consuming it.

Health surveys have reported poor sanitary conditions and lack of access to potable water at places like Kodithookikkunnu and Thinavila settlement.

The situation is particularly alarming at the Lankadweep stretch where as many as 41 families had neither latrines nor wells. Streams coursing away from the lake nearby carry filthy water.

There is also lack of financial or manpower support for prevention and control of communicable diseases from local self-Governments in Tiruvallam and Nemom, which were earlier grama panchayats and subsequently upgraded as wards of the Thiruvananthapuram Corporation.

Health officials, who conducted a situational analysis of the cholera outbreak at Tiruvallam, point out that the pathogen might have been introduced during the `Vavubali', when thousands thronged the temple in the vicinity.

The district health administration has submitted a set of proposals to improve the scenario in these vulnerable areas. The measures mooted are provision of sanitary latrines, supply of safe drinking water, adequate fund release from the local self-Government and other sources, strengthening inter-sectoral coordination and increasing facilities in health centres. A proposal to increasingly involve health staff of the city Corporation in epidemic control and surveillance activities is also under consideration.

Chalking out an effective waste disposal system, construction of walls around the wells, regular chlorination of water sources and awareness campaigns feature in the action-plan drawn up by the district health administration.

Saturday, August 30, 2003

One more cholera case reported



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 29. A 53-year-old woman was on Friday diagnosed with cholera from the Tiruvallam area in the city. According to health officials, the patient was referred to the Medical College today from the General Hospital. Meanwhile, an eight-year-old child was confirmed with typhoid, while six new cases of confirmed dengue fever cases were also reported in the city and suburbs.

Malaria case reported in city



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 28. A case of malaria has been confirmed in a 21-year-old youth from Palkulangara in the city.

According to health officials, the malaria was an `imported' case and not indigenous as the youth had recently been to Bangalore, from where he is suspected to have got the infection.

Meanwhile, four cases of dengue fever have been confirmed in laboratory tests conducted on patients being treated for viral fever.

The cases were reported from Murinjapalam, Vizhinjam, Koliyakode and Vilappil.

Saturday, August 23, 2003

'Fever epidemic result of improper planning'



By Our Staff Reporter

KOLLAM Aug. 22. The Vice-Chancellor of the Kerala University, B. Ekbal, has said that improper planning would result in disaster. He was inaugurating the national-level seminar on "sustainable habitat'', organised by the Civil Engineering Department of the TKM College of Engineering, here today.

He said that the recent fever epidemic which had gripped the State was the disastrous outcome of the lack of proper garbage treatment coupled with society's irresponsible attitude towards maintenance of hygiene. SARS had claimed 700 lives the world over and the plague at Surat 50 lives. The authorities should seriously ponder over the fact that dengue fever had already claimed 150 lives in the State, he said.

Dr. Ekbal said uncontrolled economic growth and development would result in imbalances and that environmental pollution posed a threat to all living things. While evolving a plan, economists and environmentalists should sit together and find out avenues for cooperation.

The Principal Secretary for Higher Education, C.V. Ananadabose, delivered the keynote address and the president of the TKM College Trust, Shahal Hassan Musaliar, presided over the function..

State facing another epidemic outbreak



THIRUVANANTHAPURAM: Even as the State is limping back to normal after a series of epidemic attacks which claimed nearly 150 lives in just two months, the epidemiological report being prepared by the Health Directorate has predicted yet another outbreak, that too a more dangerous one by October.

The outbreak, according to the report, will be more severe as the second round will have more haemorrhagic cases which would result in increased casualties. It is expected to be spread over from October to December.
According to the epidemiological study, the vector density in the State is still at a dangerous level even after the much-hyped vector control activities. Most of the districts still remain the favourable breeding ground for vectors, especially for the ‘Aedis aegypti,’ the vector of dengue fever.

Experts had time and again pointed out the importance of the integration of various departments, mainly the Health and the Local Self-Government Departments, in the prevention and control of epidemic activities.
According to Kerala University Vice-Chancellor Dr B.Ekbal, the failure in checking the recent epidemic outbreak should be treated as a criminal offence considering the reach and strength of the State’s health institutions and LSGs.

Drawing parallels from Andhra Pradesh, which witnessed an epidemic outbreak recently, he said that Andhra Pradesh Chief Minister Chandra Babu Naidu had personally visited the area immediately along with his cabinet ministers and health experts and ordered a detailed report on each case.

‘‘It is only because of the absence of this kind of an integrated and coercive effort that the State is on the threshold of yet another epidemic outbreak,’’ he said.

This much needed conciliation is what is exactly lacking if one goes by the reactions of departments concerned.

Health Minister P.Sankaran claimed that his department had been doing everything it could. ‘‘We have alerted all departments concerned, especially the LSGs, on the impending danger. Now it is their responsibility to take up necessary measures. If they continue to sit on it, we must not be held responsible for the next round of epidemics,’’ he said.

Playing down the issue, Local Self-Government Minister Cherkalam Abdulla said, ‘‘The epidemics issue is a thing of the past. Why bother about it now.’’

When he was reminded about the epidemiology report and his department’s alleged failure in initiating measures to tackle it, he said, ‘‘We will take care of it at the time of the outbreak.’’
‘‘What has the media got to do with epidemics,’’ he did not forget to ask.

Not surprisingly, the LSGs are also following a wait and watch policy in vector management. Though the local bodies have been allowed to utilise Plan funds for various epidemic control activities, only 10 percent of LSGs have initiated steps in this regard.

The crisis management committee set up to tackle the epidemic threat had issued certain guidelines and accordingly, every panchayat was asked to buy three fogging machines each as a preliminary step of vector control activity.

Even after two months, 90 percent of the local bodies, especially panchayats, are at the preparatory stage of buying them. Similarly, spraying activities also have taken a back seat once the epidemic cases started showing a decreasing trend.

Solid waste management measures also have not reached anywhere as nearly half of the municipalities are still in the process of acquiring land for waste disposal.

According to the LSG officials, the delay in epidemic control activities is due to the various bottlenecks in procurement of required equipment and land.

Refuting this excuse, the health officials said that the local bodies had the right to seek exemption from tendering and other procedures citing grounds of emergency and added that the local bodies will be solely responsible for the next round of epidemics.

Epidemic: vector reduction steps mooted



By M. Dinesh Varma

THIRUVANANTHAPURAM Aug. 17. Vector reduction strategies to check the spread of infectious diseases transmitted by mosquitoes have to be specific to the behavioural peculiarities of the agents of transmission, A. Joseph, Technical Consultant to the Departments of Health and Local Administration on malaria and other parasitic diseases, has said.

``The strategy to tackle Anopheles stephensi, the primary agent of spreading malaria, should be different from combating the Aedes species behind the recent outbreak of dengue fever,'' Dr. Joseph, former Professor of the Community Medicine at the Thiruvananthapuram Medical College, told The Hindu.

The entomologist said the resurgence of eradicated diseases like malaria and relatively new threats like dengue was due to the unscientific mosquito-control methods adopted by various departments. Moreover, a combination of poor inter-departmental coordination and insufficient number of medical officers with technical knowledge about vector control in the Local Self-Government Department had hampered the efficiency of a concerted response to the dengue outbreak, he said.

Vector control of the Aedes aegypti and the Aedes albopictus, the main agents of dengue, required a strategy that took into account the peculiarities of the species, Dr. Joseph said. The Aedes species, also called `container breeders', are known to have their blood meal during day-time as opposed to the habit of the Anopheles species of entering households between 5 p.m. and 9-30 p.m. and preying on humans at night or during the wee hours.

``Therefore, a blanket vector reduction strategy for various species of mosquitoes is bound to fail,'' the malariologist said.

According to the expert, larvicidal operations as well as resorting to rotation of pesticides to offset adult vectors gaining resistance form an important part of vector reduction programmes.

Rapid urbanisation and densely populated habitats marked by poor environment hygiene had set up the perfect stage for an explosion in the density of the vector population responsible for diseases ranging from malaria, dengue and Japanese encephalitis, he said.

The entomologist, who played a key role in eradicating malaria from the State in 1965, also offered technical assistance to control malarial resurgence of the disease in Valiathura in 1994. He was also in charge of filaria control programme in Thiruvananthapuram, Kollam, Alappuzha and Ernakulam.

According to Dr. Joseph, the malarial epidemic in the coastal ward in the mid-90s was also significant in that the disease, historically and etymologically associated with the hill-tracts, had surfaced in a contrasting habitat.

Dr. Joseph, who is a guest lecturer at the Liverpool of Tropical Medicine, U.K., said that urbanisation in tropical countries had resulted in both the proliferation of the Aegypti species as well as increase in the number of susceptible human hosts. Moreover, in cities, the movement of virus carriers could be a more important means of transmissions of the dengue viruses, especially given the short flight range of about 1.5 km of the typical vector.

Places where people congregate during the daytime could be potential sites of dissemination of dengue viruses; schoolchildren bitten by infected mosquitoes may take the virus home and to other parts of the city. Most importantly, dengue viruses may also spread in hospitals, if other patients or staff were bitten by infective mosquitoes, he said.

Moreover, being a freshwater breeder, vector control strategies should involve source reduction measures through a denial of breeding sites. ``The community should realise that the villain is lurking right inside the household,'' he said.

The Aedes species could make breeding sites in flowerpots, discarded tyres, cups, coconut shells and concrete slabs of construction sites where water collects. ``Moreover, the `plastic culture' has been a major contributor to the explosion in the density of the vector population,'' he said.

The entomologist highlighted the importance of community participation alongside the formulation of a package of serological, epidemiological surveillance, contingency plans, control and prevention, he said.

In fact, the World Health Organisation (WHO) advisories for the community included active participation by undertaking the disposal of unused objects that may collect water and by routinely changing the water in flower vases. Water jars and large drums that cannot be disposed of should be adequately covered to prevent egg-laying by the species, or cleaned and scrubbed weekly, he said.

Seven more dengue cases



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 17. At least seven cases of confirmed dengue were reported from the city and suburbs on Sunday.

According to staff at the DMO's control room, there were three confirmed cases from the Corporation area- Peroorkada, Paruthikuzhy and Aramnada.

While two cases were reported from Karakulam, one case each were from Vilappilsala and Malayinkeezh. The results of laboratory tests of 10 suspected dengue cases is awaited.

The progressive total of confirmed dengue cases reported in the district between January and August aggregates 492, of which 96 cases were reported in August alone. The number of suspected dengue cases totals 111.

There have been 11 dengue-related deaths in the district so far.

According to officials, there were no reports of cholera or diarrhoeal disorders.

Sunday, August 17, 2003

Two more cholera cases



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 13. Two more cases of cholera were reported from the Tiruvallam area in the city.

So, far there have been 13 cases of confirmed cholera during the outbreak of diarrhoeal disorders. Meanwhile, 11 confirmed cases of dengue were reported from various parts of the city and suburbs.

Govt. probing foeticide incidents



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 11. The reported increase in incidents of foeticide in the State was being looked into by the Government and if it was found to assume a social dimension, appropriate action would be taken to prevent it, said P.K. Kunhalikutty, Minister for Industries and Social Welfare.

Replying to a series of questions and supplementaries in the State Assembly during Question Hour today, he said stringent action would be taken against private hospitals if it was found that there was a deliberate attempt on their part to encourage foeticide.

The Government was viewing with concern reports that around 39,000 incidents of foeticides had taken place over a one-year period. If need be, the Government would even bring about a legislation to prevent foeticide in the State, he added.

Insurance for girl child

The State Government was considering an insurance cover for the girl child, taking into account several Centrally-sponsored schemes. The Juvenile Justice Act would be implemented in toto in the State which would ensure that certain stringent guidelines were followed in the matter of arrest of children by police, Mr.Kunhalikutty said.

The Government was committed to providing better facilities in the `anganwadis'. It had come to the attention of the Government that anganwadi workers were being deputed for works of a miscellaneous nature like surveys and other related jobs, to the extent that the normal functioning of the anganwaids was being affected. This would be put an end to, the Minister said.

There was an allocation of Rs. 61.10 crores in the State budget for the current year, for various schemes under the Department of Social Welfare, Mr.Kunhalikutty said. Additional funds could be provided through supplementary grants, if required, he added.

The KINFRA has received Central assistance to the tune of Rs. 5.24 crores for the promotion of the food processing industry in the State. The State Government was committed to providing a fillip to the food processing industry. It had been decided to present more branded processed products from Kerala at the Trade Festival in Dubai, Mr.Kunhalikutty informed.

Tiruvallam emerges as hotspot for cholera



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 8. Tiruvallam has emerged as a new hotspot for an outbreak of diarrhoeal disorders, with most of patients with cholera-like symptoms being reported from the area.

Of the nine new admissions of patients with cholera-like symptoms on Friday, five were from Tiruvallam. The other patients were from Poonthura, Vellayani, Vattiyoorkavu and Koduvazhanoor. And 21 of the 41 suspected cases of cholera with symptoms of acute diarrhoea have also been reported from Tiruvallam as well.

On Thursday, a team of health official had visited Tiruvallam and adjoining areas to supervise preventive measures and coordinate door-to-door awareness campaigns.

The District Medical Officer, E.K. Madhavan, who visited the affected site, told The Hindu that sanitary conditions at the Tiruvallam area were conducive to an outbreak of epidemics. The residential colonies were highly congested and lacked basic sanitary facilities and access to safe drinking water.

As many as 8,620 families depended on only 20 community wells for drinking water. The deep wells were also on the verge of drying up shortly.

At the Lankadweep colony in the neighbourhood, where 110 families lived in poor hygienic conditions, there was a critical dearth of latrines and access to safe water supply.

Locals told visiting health officials that they could depend on well water for only two days a week. Their main source of potable water was sourced from the Vellayani Lake. The water from the lake was subjected to chlorination at a treatment plant in Vandithadom before it was made available to the residents in the area.

Staffers at the treatment plant told officials that at least 2 kg of bleaching powder was being used to treat the water pumped in from the lake at two-hour intervals. Following the outbreak of diarrhoeal disorders, they had been asked to increase the chlorination dosage.

Meanwhile, it could take at least a week to isolate and culture the micro-organism at the Public Health Laboratory. Water samples from the Vellayani Lake besides piped water and well water had been collected for testing for presence of the `Ogawa' strain of vibriocholera, which was detected in the seven confirmed cholera cases. The Corporation health squads had also seized food samples for testing.

Meanwhile, at least seven patients have been confirmed with infection with vibriocholera organism during tests conducted at the Microbiology Department of the Thiruvananthapuram Medical College. In all, there have been 41 diarrhoeal cases reported in the city and suburbs so far. At present, there are 33 patients under treatment at the General Hospital and four patients at the Medical College.

Cholera has become the newest concern for district health authorities who had been tackling an upsurge of dengue fevers, leptospirosis and malaria.

So far, there have been 11 dengue-related and two- leptospirosis-triggered deaths in the January-August period. The number of patients who tested positive for dengue has been 464, 100 for malaria and 31 for leptospirosis.

Meanwhile, four new case of confirmed dengue cases have been reported in the district. Feedback from health centres in the district indicate a slight reduction in the proportions of patients reporting with viral fever. On Friday, 480 patients sought treatment for viral fever at various health institutions in the district.

One more cholera case confirmed



By Our Staff Reporter

THIRUVANANTHAPURAM Aug. 7. One more case of cholera was confirmed in a 27-year-old patient who was under treatment at the Medical College on Wednesday.

According to health officials, it was not clear whether the infection was an indigenously acquired one as the patient had a travel history of visiting Bangalore recently.

So far, five patients had been infected with `Ogawa' strain of vibriocholera.

Meanwhile, 25 suspected cholera cases were under observation at the General Hospital. As many as 12 cases had been referred from Tiruvallam alone. The other cases were sourced from Vazhithadam (2), Vellayani (3), and one each from Vizhinjam, Karickakam, Kuttichal, Pangappara, Poonthura and Malayinkeezh.

The stool samples of the patients were being investigated at the Microbiological Department of the Medical College.

District health officials had also collected nine water samples, which included water from the Vellayani lake, a borewell, stored water and pipe water from affected areas.

The samples had been handed over to the Public Health Laboratory for identifying the pathogen.

A team comprising K. Ramamoorthi, Health Secretary, V.K. Rajan, Director of Health Services, and E.K. Madhavan, District Medical Officer, is scheduled to visit Tiruvallam on Thursday as the bulk of the suspected cholera cases have been reported from there.

100 seats sanctioned in Jubilee Mission medical college



THIRUVANANTHAPURAM: The government has sanctioned 100 seats to the newly-sanctioned medical college of the Jubilee Mission Medical and Research Institute, Thrissur, for the academic year 2003-04.

An official statement said here on Tuesday that the admission to 50 percent seats in the college would be made from the list prepared by the Commissioner for Entrance Examinations.

Letter of permission issued to Amala Institute of Medical Sciences



THRISSUR: The Union Ministry of Health and Family Welfare has issued a letter of permission (LoP) to Amala Institute of Medical Sciences, set up under the management of Amala Cancer Hospital Society at Amalanagar, near here.

Sources said the LoP is for admitting 100 students for the first year MBBS course to be held during 2003 to 2004.

Diabetes among children makes schools proactive



KOCHI: A gradual rise in the number of children afflicted with diabetes in the city has forced medical experts and school authorities to revamp the curriculum, with more focus on healthy lifestyle with balanced diet and regular exercise.

The programme, organised by Amrita Institute of Medical Sciences (AIMS) in the city schools to educate the children on health habits, has found that a sedentary lifestyle is proving disastrous for the new generation who are addicted to junk food and long hours of TV watching.

And on the recommendations of the expert team, many schools like Chinmaya Vidyalaya and Bhavan’s Vidya Mandir have started special exercise programmes for their students.

The doctors had found that many students don’t watch their diet closely or live a healthy lifestyle. And it is a strict no-no to exercise. Even though there is a big trend to eat right and exercise, generally it does not catch on until people are in their 30s.

Considered once a true medical oddity in city, children with adult diabetes are becoming common now.

‘‘Obesity also plays a major role in these cases as children tend to over eat, especially sitting before the television,’’ says Dr Harish Kumar, Consultant Endocrinologist of AIMS, who is leading this project initiated by members of the Diabetics Welfare Association of the hospital.

‘‘So far, there have been no cases of Type I Diabetes, which require insulin therapy, in the city schools. But we found many students with the Type II variety,’’ says Dr Harish.

Type II has always been a disease of the people in their 50s, 60s and beyond, but now more cases of children with this variety are being reported from the city.

Students in the classes VI, VII and VIII are involved in this programme as experts feel that they are more receptive to such ideas than their juniors and seniors. Through a comprehensive programme, doctors make students aware of the challenges of being a teen with diabetes and the problems of living with this disease.

Earlier it was believed that diabetes cannot be prevented. But now, it is proven that with controlled diet and regular exercise it is possible not to let the disease affect you. And the doctors feel that parents have a much bigger role in making the children healthy instead of obese and avoiding many a health problem.

And keeping in mind the suggestions made by these doctors, schools have started healthy food-exercise packages. Bhavan’s Vidya Mandir, Elamakkara, has banned junk food in its canteen and there is a compulsory weekly exercise programme for the children.

‘‘We also focus on yoga and meditation apart from the mass PT and the students are now more aware of the problems caused by over-eating and inactivity,’’ says Meena Viswanathan, principal of the school.

‘‘Yes, we are also concerned about the health problems of students. And these exercise programmes are really good for them,’’ says Paulose, principal of Delta Study, Fort Kochi.

The project is being carried out on Fridays and the team has covered a good portion of the city schools, both Government and private. ‘‘The time to act is over for our generation, but we want to ensure that the new generation gets a chance to lead a healthy life, right from the beginning,’’ says Dr Harish.

Friday, August 08, 2003

Vector study identifies 19 'high-risk' areas



By M. Dinesh Varma

THIRUVANANTHAPURAM Aug. 1. A vector study undertaken by the district medical administration has identified 19 `high-risk' and three `moderate- risk' areas for dengue fever which is transmitted by the aedes species of mosquitoes.

The areas with high vector presence included proper city locations such as Thycaud, Vanchiyoor, Central Prison in Poojappura, Kunnukuzhy and Goureesapattom as well as contiguous urban-rural zones such as Thozhuvancode, Vattiyoorkavu, Vellanad, Nemom and Vizhinjam.

The other risk-areas in the district for dengue were Arasu Parambu (Nedumangad), Kanchira (Kanyakulangara), Cheeranikkara (Vembayam), Sisilipuram (Vizhinjam), Parasuvakkal, Kottukal, Anad, Manamboor, Russelpuram and Oorottumbalam.

The affected areas include Malayinkeezh, Pallichal, Vilavoorkal, Vamanapuram, Vellarada, Kallara, Athiyanoor, Parassala, Karumkulam, Venganoor and Chettivilakam.

There have been 11 dengue deaths and around 400 confirmed cases of dengue reported in the city so far this year. Vector biologists say that one-third of the confirmed cases of dengue have been sourced to Corporation areas, which has an abundance of aedes aegypti species of mosquitoes.

The vector study, undertaken during June-July by a team comprising a biologist, insect collector, field assistant and field workers, examined 1,388 potential vector breeder containers at 752 households in as many as 22 Corporation and district centres.

The classification as `high-risk' and `moderate risk' areas was done based on the classical House index and Bretaeu index as mandated by the National Anti-Malarial Programme. The immediate vicinity of a household with a House index above 20 and a Bretaeu index value of 50 or above is classified as `high-risk'.

The larvae samples collected from containers were later identified during laboratory investigations as belonging to the aedes aegypti (the primary vector for dengue) and aedes albopictus (a secondary vector). Significantly, 431 of the 1,388 containers tested positive for presence of aedes larvae.

``Public awareness is the best safeguard against dengue,'' said the District Medical Officer, E. K. Madhavan, speaking to The Hindu. House-to-house visits undertaken by a team of health promotion volunteers form an important component of the dengue-control measures.

However, even though the awareness campaigns have stressed the point that preventive measures against dengue should start at the household-level, the public tends to fall back on the false security of the more `visible' operations such as spraying of organo-phosphorous chemicals on polluted water bodies or fogging measures, a health worker said.

``Ideally, the fight against dengue should focus on larvicidal operations,'' said Unnikrishnan, district malaria officer. Targetting an aquatic breeding source ensures elimination of a large number of larvae which are confined to a limited area and are more vulnerable than their adult counterparts. It is futile to target the adult aedes species which has a life span of around three weeks and a flight range of 500 metres, he pointed out.

Sprucing up environmental hygiene would be more effective in mitigating the threat of diseases like malaria which are spread by a different mosquito species.

According to experts, the best source reduction method is deprive the vector of breeding sites. Fresh water should not be allowed to collect in discarded cups, coconut shells and other transient water receptacles such as stagnant pools of water near quarries. The biological measures include the introduction of the Guppie variety of fish into motor-fitted as well as abandoned wells.

Thursday, July 31, 2003

Seven more dengue cases



By Our Staff Reporter

THIRUVANANTHAPURAM July 30. At least seven cases of confirmed dengue and one case of leptospirosis were reported from the city and various parts of the district on Wednesday.

The confirmed cases have been sourced to the Medical College, Tagore Gardens and Vallakadavu areas in the city while the other patients are from Manamboor, Balaramapuram, Edava and Vattiyoorkavu.

The patients, included a 11-year-old boy from Balaramapuram, who has been admitted to the SAT Hospital. Meanwhile, 824 patients reported with complaints of viral fever at health institutions in the district.

WHO kept in dark on epidemics outbreak



KOZHIKODE: Though the outbreak of killer diseases like dengue, viral fever and leptospirosis has already claimed 181 lives in the State since January 2003, the grave issue is yet to draw the attention of the World Health Organisation (WHO).

In the case of dengue and leptospirosis, which have been included in the list of notified diseases last year, it is mandatory for the Government to inform the WHO about their outbreak.

‘‘It is the onus of the State Government to take up the outbreak of epidemics with the WHO. The international body cannot voluntarily step into a State for various reasons,’’ says Jayaram, information unit secretary with the WHO’s Regional Office for South East Asia, New Delhi.

‘‘The State should have viewed it as an emergency situation. Unless the State Government provides the data, the WHO cannot do anything. The WHO cannot act alone, it responds to the feed back from various agencies and governments,’’ the WHO official told The New Indian Express.

When contacted, State Health Director in-charge Dr Sivaraman told this paper that the Department had already taken up the issue with the National Institute of Communicable Diseases (NICD).

‘‘We are giving reports to the NICD on a daily basis about the latest position of the epidemic outbreak in the State. The NICD should have reported to WHO’s regional office. Dengue and leptospirosis are notified diseases. The outbreak of these diseases, apart from that of the non-notified ones, should have been conveyed to the WHO,’’ says Dr Sivaraman.

From January till last Sunday, a total of 808 leptospirosis cases have been reported from the State with 49 deaths. In the case of dengue, the total cases are 1,755 and deaths 51. More than four lakh people were afflicted with viral fever, which claimed 83 lives. Besides, 1,005 cases of malaria were also reported during the period.

The exact figures of confirmed cases and the death toll will be much higher as the State lacks a fool-proof documentation system encompassing both public and private hospitals in the State. Moreover, the reasons behind several epidemic deaths go unconfirmed as many patients reaching hospital in critical condition die, leaving no time for diagnosis.

The failure in detection may also play down the exact figures, medical sources said.

The magnitude of the infectious disease outbreak in Kerala so far this year could be gauged only by comparing the figures of similar outbreaks listed by the WHO in its weekly epidemological record based on the data received from across the world.

Typhoid in Hawaii claimed 40 deaths and 200 confirmed cases this year so far. Algeria reported 10 plague cases, Liberia had 15 cholera deaths, Mozambique had 87 cholera deaths and Sudan had 27 yellow fever deaths. The WHO is involved in combating the diseases in these countries.

Last year also the epidemic outbreaks in Kerala did not come to the notice of the WHO. However, the international body reported outbreaks of plague in Himachal Pradesh (4 deaths) and cholera in Orissa (33 deaths) in 2002 .

Dengue toll rises to 11 in city



By Our Staff Reporter

THIRUVANANTHAPURAM July 28. The incidence of dengue and leptospirosis in the capital city and district continues to cause concern in spite of the concerted attempts by the Health authorities to contain the spread of these vector-borne epidemics.

With one more dengue-related death in a city hospital being officially confirmed today, the toll in the district has risen to 11 so far this year.

Aji (28), the latest victim of dengue complications, had died at a private hospital where he had been under treatment since July 22. The youth had been referred from Moonnammoodu in Vattiyoorkavu.

The control room staff at the District Medical Office said 10 more confirmed cases of dengue, including one death, had been reported in the city and suburbs on Monday. This was besides the 14 suspected cases regarding which serological analysis was awaited.

The rising cases of dengue in the Corporation areas was of particular concern, with six of Monday's confirmed cases referred from the All Saint's College area, Kanjirampara, Barton Hill and Pattom. Two cases were from the Manacaud area. Barring a 40-year-old woman, the remaining cases were of children who were being treated at the General Hospital and the SAT Hospitals.

The other cases were reported from Balaramapuram and Kulatthoor and Tiruvallam. The number of patients complaining of viral fever at health care centres across the district on Monday aggregated 871.

A sharp increase in the incidence of dengue infections had been witnessed this month despite attempts to involve community participation in sprucing up household and environmental hygiene and vector control measures.

The district administration, with the collaboration of various departments and NGOs, had even launched a one-day intensive cleaning up operation throughout the district.

House-to-house visits also formed part of the awareness campaigns to convey the importance of reducing mosquito population as the only sure-fire method of tackling dengue. The awareness spiel sought to drive home the fact that there would be no dengue without aedes mosquitoes.

In fact, several vector surveys undertaken in the city in the past had indicated a rather high density of aedes aegypti and aedes albopictus mosquitoes which are the specific vectors of dengue.

However, data indicate that 235 out of the 383 confirmed dengue cases mapped out in the January-July phase were reported in July. The month also saw two dengue-related deaths.

Meanwhile, there have been 28 cases of leptospirosis and two deaths reported in till July. Nineteen confirmed cases of the rat-transmitted leptospirosis were reported in July alone.

Viral fever complications accounted for 24 lives in January-July. There were 10 viral fever deaths reported in July alone.

16 new cases of dengue



By Our Staff Reporter

THIRUVANANTHAPURAM July 27. At least 16 new cases of confirmed dengue fever and two cases of malaria were reported from different parts of the city and the district on Saturday.

According to the control room at the District Medical Office, the new dengue cases include three children.

While a 14-year-old boy from Vilappil had been admitted to the Medical College, a 12-year-old boy from Vamanapuram was under treatment at the Women and Children's Hospital, Thycaud and another 13-year-old girl from Malayinkeezh was admitted to the General Hospital.

The adult cases have been reported from Anayara, Karamana and Vallakadavu in the Corporation area.

The other cases have been reported from Nedumangad, Poovar, Perumbazhathoor, Kalliyoor, Vamanapuram, Kottukal, Pangappara and Vilappil.

Seven more dengue cases



By Our Staff Reporter

THIRUVANANTHAPURAM July 30. At least seven cases of confirmed dengue and one case of leptospirosis were reported from the city and various parts of the district on Wednesday.

The confirmed cases have been sourced to the Medical College, Tagore Gardens and Vallakadavu areas in the city while the other patients are from Manamboor, Balaramapuram, Edava and Vattiyoorkavu.

The patients, included a 11-year-old boy from Balaramapuram, who has been admitted to the SAT Hospital. Meanwhile, 824 patients reported with complaints of viral fever at health institutions in the district.

WHO kept in dark on epidemics outbreak



KOZHIKODE: Though the outbreak of killer diseases like dengue, viral fever and leptospirosis has already claimed 181 lives in the State since January 2003, the grave issue is yet to draw the attention of the World Health Organisation (WHO).

In the case of dengue and leptospirosis, which have been included in the list of notified diseases last year, it is mandatory for the Government to inform the WHO about their outbreak.

‘‘It is the onus of the State Government to take up the outbreak of epidemics with the WHO. The international body cannot voluntarily step into a State for various reasons,’’ says Jayaram, information unit secretary with the WHO’s Regional Office for South East Asia, New Delhi.

‘‘The State should have viewed it as an emergency situation. Unless the State Government provides the data, the WHO cannot do anything. The WHO cannot act alone, it responds to the feed back from various agencies and governments,’’ the WHO official told The New Indian Express.

When contacted, State Health Director in-charge Dr Sivaraman told this paper that the Department had already taken up the issue with the National Institute of Communicable Diseases (NICD).

‘‘We are giving reports to the NICD on a daily basis about the latest position of the epidemic outbreak in the State. The NICD should have reported to WHO’s regional office. Dengue and leptospirosis are notified diseases. The outbreak of these diseases, apart from that of the non-notified ones, should have been conveyed to the WHO,’’ says Dr Sivaraman.

From January till last Sunday, a total of 808 leptospirosis cases have been reported from the State with 49 deaths. In the case of dengue, the total cases are 1,755 and deaths 51. More than four lakh people were afflicted with viral fever, which claimed 83 lives. Besides, 1,005 cases of malaria were also reported during the period.

The exact figures of confirmed cases and the death toll will be much higher as the State lacks a fool-proof documentation system encompassing both public and private hospitals in the State. Moreover, the reasons behind several epidemic deaths go unconfirmed as many patients reaching hospital in critical condition die, leaving no time for diagnosis.

The failure in detection may also play down the exact figures, medical sources said.

The magnitude of the infectious disease outbreak in Kerala so far this year could be gauged only by comparing the figures of similar outbreaks listed by the WHO in its weekly epidemological record based on the data received from across the world.

Typhoid in Hawaii claimed 40 deaths and 200 confirmed cases this year so far. Algeria reported 10 plague cases, Liberia had 15 cholera deaths, Mozambique had 87 cholera deaths and Sudan had 27 yellow fever deaths. The WHO is involved in combating the diseases in these countries.

Last year also the epidemic outbreaks in Kerala did not come to the notice of the WHO. However, the international body reported outbreaks of plague in Himachal Pradesh (4 deaths) and cholera in Orissa (33 deaths) in 2002 .

Dengue toll rises to 11 in city



By Our Staff Reporter

THIRUVANANTHAPURAM July 28. The incidence of dengue and leptospirosis in the capital city and district continues to cause concern in spite of the concerted attempts by the Health authorities to contain the spread of these vector-borne epidemics.

With one more dengue-related death in a city hospital being officially confirmed today, the toll in the district has risen to 11 so far this year.

Aji (28), the latest victim of dengue complications, had died at a private hospital where he had been under treatment since July 22. The youth had been referred from Moonnammoodu in Vattiyoorkavu.

The control room staff at the District Medical Office said 10 more confirmed cases of dengue, including one death, had been reported in the city and suburbs on Monday. This was besides the 14 suspected cases regarding which serological analysis was awaited.

The rising cases of dengue in the Corporation areas was of particular concern, with six of Monday's confirmed cases referred from the All Saint's College area, Kanjirampara, Barton Hill and Pattom. Two cases were from the Manacaud area. Barring a 40-year-old woman, the remaining cases were of children who were being treated at the General Hospital and the SAT Hospitals.

The other cases were reported from Balaramapuram and Kulatthoor and Tiruvallam. The number of patients complaining of viral fever at health care centres across the district on Monday aggregated 871.

A sharp increase in the incidence of dengue infections had been witnessed this month despite attempts to involve community participation in sprucing up household and environmental hygiene and vector control measures.

The district administration, with the collaboration of various departments and NGOs, had even launched a one-day intensive cleaning up operation throughout the district.

House-to-house visits also formed part of the awareness campaigns to convey the importance of reducing mosquito population as the only sure-fire method of tackling dengue. The awareness spiel sought to drive home the fact that there would be no dengue without aedes mosquitoes.

In fact, several vector surveys undertaken in the city in the past had indicated a rather high density of aedes aegypti and aedes albopictus mosquitoes which are the specific vectors of dengue.

However, data indicate that 235 out of the 383 confirmed dengue cases mapped out in the January-July phase were reported in July. The month also saw two dengue-related deaths.

Meanwhile, there have been 28 cases of leptospirosis and two deaths reported in till July. Nineteen confirmed cases of the rat-transmitted leptospirosis were reported in July alone.

Viral fever complications accounted for 24 lives in January-July. There were 10 viral fever deaths reported in July alone.

16 new cases of dengue



By Our Staff Reporter

THIRUVANANTHAPURAM July 27. At least 16 new cases of confirmed dengue fever and two cases of malaria were reported from different parts of the city and the district on Saturday.

According to the control room at the District Medical Office, the new dengue cases include three children.

While a 14-year-old boy from Vilappil had been admitted to the Medical College, a 12-year-old boy from Vamanapuram was under treatment at the Women and Children's Hospital, Thycaud and another 13-year-old girl from Malayinkeezh was admitted to the General Hospital.

The adult cases have been reported from Anayara, Karamana and Vallakadavu in the Corporation area.

The other cases have been reported from Nedumangad, Poovar, Perumbazhathoor, Kalliyoor, Vamanapuram, Kottukal, Pangappara and Vilappil.

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