Epidemics in Kerala

More viral fever cases

By Our Staff Reporter

THIRUVANANTHAPURAM June 29. Even as more than a thousand persons sought treatment for viral fever in various hospitals, primary health centres and community health centres in the district today, no dengue-related deaths were reported.

In the SAT hospital alone, more than 200 cases of viral fever were treated, while more than 40 persons reported sick at the casualty wing of the Medical College Hospital. According to an official at the office of the DMO, 1,428 cases of viral fever were reported in the district today.

Children in all the schools in the district will participate in an anti-dengue pledge tomorrow morning as part of the school assembly. Meanwhile, a cleaning programme organised by the Lion's Club, was initiated at the SAT hospital this morning and was inaugurated by V.S. Sivakumar, MP.

Fever cases on the rise in district

KOCHI: A total of 371 persons were hospitalised with fever on Sunday across the district while 2139 sought treatment on Saturday, taking the number of people undergoing treatment to well above 10,000.

Though five cases of Dengue fever and two of leptospirosis were reported on Saturday, no patient was diagnosed of these complicated varieties of fever on Sunday.

Meanwhile, office of the District Medical Office has asked public institutions and social organisations to participate actively in mosquito eradication programmes. The entomology study which has been going on for the last four days reported a drastic increase in mosquitoes that cause diseases.

No plans to lease out Medical College campuses: Sankaran

KOZHIKODE: Health Minister P Sankaran has strongly denied reports, appeared in a section of newspapers recently, that the Government was planning to lease out campuses of Government Medical Colleges to private groups to start profitable ventures.

Talking to mediapersons here, Sankaran claimed that he never made such a statement, which would affect the smooth functioning of Medical Colleges.

He also informed that the Government was in the process of requesting World Health Organisation (WHO) to send an expert team to the State to conduct a study on various communicable diseases. The Government will soon constitute an expert committee of doctors to streamline measures initiated in the State against communicable diseases, he added.

Frequent outbreaks due to poor surveillance: Health dept

THIRUVANANTHAPURAM: Poor surveillance system of the Health Department is responsible for the frequent outbreak of epidemics in the State, says an internal project report of the Department.

This report was prepared by the Health Department in connection with the Integrated Disease Surveillance Programme (IDSP) to be launched by the Union Government.

``Lack of a comprehensive surveillance system is responsible for both the emerging and re-emerging of infectious diseases in the State. By the time the outbreak is recognised, it is always too late,'' says the report.

The data available with the Department regarding various epidemics is ``not reliable nor valid as no further analysis has been done,'' according to the report. Moreover, delays of several days are very common before the outbreak of communicable diseases is reported to the authorities concerned.

``Some health workers are wary of informing the authorities about the sudden increase in the number of unusual diseases which have the potential to develop into an epidemic outbreak owing to the fear that it would increase their workload,'' the report said.

According to the study, lack of adequate feedback mechanism after the submission of the data to the higher authorities concerned is one of the major loopholes in the epidemic surveillance mechanism of the State. ``Very often, the field staff do not get any feedback regarding the interpretation of the data submitted nor about the proposed actions needed to be taken,'' the report said.

The inefficient training given to field staff of the Health Department and the lack of enough personnel had also affected the quality of disease surveillance in the State, the report pointed out.

Moreover, the poor opinion of the public regarding the quality of the service provided by the Health Department had also affected the quality of the data collected. ``Due to poor credibility of health systems, many people consider the surveillance activity as something meant for the Department alone with no benefit to the common people,'' says the report.

Proper training of health workers, timely feedback mechanism, involvement of private sector and standard operating procedures are some of the major recommendations suggested in the report for improving the surveillance system.

As the Health Department did not have any reliable information on prevalence of different types of diseases in the community, the self-reported illness data of the National Sample Survey (NSS) of 1995 is used in the project report.

According to it, 110 persons per thousand of the population in the State suffer from some ailment or the other. This rate is high in rural areas with 118 persons per thousand population compared to urban areas which has only 88 cases. These rates were the highest in the country where the national averages are 55 and 54 for rural and urban areas respectively, the report pointed out.

Epidemics claim 3 more lives

THIRUVANANTHAPURAM: The onslaught of epidemics all over the State are continuing with 16,577 cases of viral fever and 36 cases of Dengue being reported on Saturday.

Three epidemic deaths were reported in the State on Saturday.

Geethakumari, 33, a native of Edava, and Manoharan, 13, of Muttathara, died of viral fever at the Medical College Hospital here. One person died of rat fever in Kollam.

Six more cases of dengue fever were admitted to the Medical College Hospital here on Saturday. With this, the total number of confirmed dengue cases in the district has gone up to 144.

The Health Directorate said in a statement that three more cases of Malaria had been reported. Various preventive measures and awareness programmes initiated by the directorate were going on full swing and had started showing results, it claimed.

The district committee of the Kerala Vyapari Vyavasai Ekopana Samithi has decided to co-operate with the Health Department in its epidemic prevention activities.

The committee has also proposed to set up temporary clinics in its district offices and has sought the assistance of the Health Department in this regard.

One more dies of rat fever

THIRUVANANTHAPURAM: The onslaught of epidemics all over the State are continuing with 16,577 cases of viral fever and 36 cases of dengue being reported on Saturday.

The Health Directorate in a statement said that only one epidemic death was reported on Saturday. The death, reported from Kollam, was due to leptospyrosis. Three more cases of Malaria have also been reported, the statement said.

Various preventive measures and awareness programmes initiated by the Directorate were going on full swing and had started showing results, the statement claimed.

Meanwhile, the district committee of the Kerala Vyapari Vyavasai Ekopana Samithi has decided to co-operate with the Health Department in its epidemic prevention activities. The committee has also proposed to set up temporary clinics in its district offices and has sought the assistance of the Health Department in this regard.

Row over medicines leaves public confused

By Our Staff Reporter

KOLLAM JUNE 28. Medical professionals expected to act with responsibility in the wake of the mysterious fever epidemic gripping the State are engaged in confusing the general public rather than rising to the occasion.

Two days ago, the Ayurveda DMO issued a statement here claiming that ayurveda has a couple of effective medicines to deal with the epidemic. However the allopathy fraternity has through a statement disputed the Ayurveda DMO's claim and called upon the victims to rely on allopathy treatment.

Even as this war continues, the fact is that nothing concrete is being done to either counter the menace or identify the disease which has claimed more than fourteen lives in the district during the past one week.

While sufficient monetary allocations have been made to counter the outbreak through proper measures, the fact is that except for mike announcements, distribution of notices, chlorination and spraying of insecticides, nothing much is being done fight the epidemic from a professional medical point of view.

Even a death reported today in Kollam has been formally described by the health authorities as "suspected rat fever''. The fact that the medical authorities cannot identify what precisely caused a person's death, especially in a tense situation in which an epidemic is raging, only exposes the total inefficiency on the part of the health authorities in dealing with the situation.

Meanwhile, the total number of persons who have contracted the epidemic and are under treatment today has crossed 20,000.

One more death at MCH

By Our Staff Reporter

THIRUVANANTHAPURAM June 28. A 58-year-old patient died due to fever at the Thiruvananthapuram Medical College Hospital (MCH) on Saturday.

According to MCH officials, Bhargavan who hails from Chadayamangalam, was admitted on Thursday in a critical state. Doctors said age as well as a previous history of jaundice could have hastened the death due to platelet loss typical of advanced dengue.

Meanwhile, there were four new suspected cases of dengue fever admitted to the SAT Hospital today. No deaths were reported.

The SAT administrators are launching a campaign to highlight the message that while dengue was an important haemmorhagic fever, which had no treatment or vaccine, the only way to ward off infection was to maintain environmental cleanliness and eliminate mosquitoes.

As part of the campaign, the Lion's Club has volunteered to launch a source reduction campaign by cleaning the SAT hospital premises at 8-30 a.m. on Sunday. V.S. Sivakumar, MP, will inaugurate the programme.

Meanwhile, a review meeting of health officials observed that dengue cases were dwindling in Thiruvananthapuram while clusters were still surfacing at places like Kottayam.

In an official statement, P. K. Sivaraman, Additional Director of Public Health, said hospitals in the State had recorded 16,577 viral fever admissions, of which 36 were confirmed as dengue, four rat fever and three malaria. One leptospirosis death has been reported.

Concerted preventive/awareness programmes are in full swing in all panchayats, he added.

Meanwhile, a team of volunteers from the Government Ayurveda Colleges in Thiruvananthapuram, Tripunithura and Kannur are gearing up to launch preventive measures.

The team in Thiruvananthapuram has completed house-to-house visits in the vicinity of Burma road, where a patient died due to dengue. It has also formulated an action plan for various Corporation wards with the support of the Corporation Health standing committee.

Meanwhile, the City Corporation has intensified its activities under the epidemic control programme. Doctors from the Medical College Hospital and public health centres and Corporation health officials participated in awareness camps organised at the ward-level. Hundreds of residents turned up for the camps.

The Mayor, J. Chandra, has convened a meeting on Monday to review the progress of the drive. Councillors, health inspectors and medical officers of hospitals and public health centres in all the 81 wards have been directed to participate in the meeting.

Homoeopathy more effective for dengue: homeopaths institute

PTI

KOZHIKODE: The Institution of Homoeopaths, Kerala, on Friday called for a probe into the causes leading to a number of deaths from viral and dengue fevers in the state and claimed homoeopathy can cure dengue in just three days.

"The government should order an enquiry to find out how and why the epidemics caused a severe onslaught and the failure of the health department to check the outbreak", institution's state vice-president Dr S Vidya Prakash told reporters here.

Alleging proper steps had not been taken to prevent the spread of the epidemics, he said, "while Rs 2.48 crore has been allotted for allopathy treatment, only Rs 20 lakh has been granted for treating the diseases through homoeopathy".

Prakash said "homoeopathy can cure even dengue fever in only three days".

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Dengue, viral fever takes over 100 lives in Kerala

PTI

THIRUVANANTHAPURAMN: Dengue and other forms of viral fever have taken a toll of over 100 lives in Kerala in the last six months, official sources said.

According to the health authorities, 9,556 persons were now undergoing treatment for viral diseases in different parts of the state. This included those suffering from dengue fever, rat fever (leptospirosis), malaria and other afflictions. Children accounted for 60 per cent of the fever cases.

"The situation is yet to be contained, though there is no slackening of efforts like sanitation-cum-garbage removal campaign, fogging and fumigation to control mosquitoes and hygiene awareness drive," P K Sivarajan, Additional Director, Health, told PTI.

According to sources, government hospitals, including five medical colleges, are overcrowded with patients seeking treatment for fever.

Alarmed at the situation, the state government had sanctioned Rs five crore for fever-control measures and replenish hospitals with essential medicines. An emergency central assistance of Rs five crore had been sought.

Homeopathy and Ayurveda experts lend a hand to combat outbreak

KOCHI: Medical experts from Homoeopathy and Ayurveda are coming forward to control the rising cases of fever in the district even as efforts by the authorities have failed to control the outbreak.

Even the die hard followers of Allopathy are now gradually picking up the remedies offered by Homoeopathy and Ayurveda doctors, which are devoid of any side-effects and are found to be more effective in the long run.

Homoeopaths and Ayurveda doctors are now conducting camps across the district to make the public aware of the various treatment modalities available to tackle the fever outbreak.

The Department of Homoeo Medicine has 54 centres in the district, which are now engaged in the free distribution of medicines to prevent fever. Unlike in Allopathy, preventive medicines are available in both Homoeopathy and Ayurveda, which immensely help the public in controlling the outbreak.“We cannot compare Homoeopathy to Allopathy and we treat the disease in our own way. The medicines we offer have no side-effects and it helps the patients to improve their immune system,” says Dr Abraham Mathew, District Medical Officer of Homeopathy.

According to Homoeopathy, diseases occur as a loss of the vital force, which results in the reduction of immunity and medicines are used to rebuild this vital force. Any person can use these medicines provided they stick to a prescribed diet and avoid unhealthy habits like drinking alcohol.

The Homoeopathy department is planning to organise more than 20 camps in various parts of the district before June 29 to distribute medicines and prevent the outbreak. One such camp was held in Kalamassery today.

The rise in the number of fever cases this year was more because of the sudden changes in climate, feels Dr Abraham. “Sudden shift from hot to cool and reverse was one of the reason for the disease to spread wide this year. Last year it was Leptospirosis that reigned supreme and before that it was Meningitis.”

The District Medical Office of Indigenous Medicine is also actively involved in the treatment of fevers being reported from all parts of the district. Medicines including various kinds of ’kashayam’, tablets and powders are being distributed from its centres, highlighting the medicinal properties of plants like Tulsi.

“We have already conducted two camps and the demand from the public is increasing,” says Dr V R Bahuleyan, District Medical Officer of Indigenous Medicine.

Meanwhile, viral fever outbreak is bringing more patients to hospitals in the city. Many are afraid of developing complications like Dengue and Leptospirosis and eagerly seek medical help instead of opting self-treatment. According to the office of the DMO, the number of people affected with viral fever in the last five months is around 10,000. “It’s difficult to get the complete picture as even small clinics treat fever cases and the statistics will not reach us.

But viral fever does not result in death unless the patients develops a secondary infection,” said Dr Krishnankutty, deputy DMO. As the viral fever is air borne, it’s difficult to control, says the doctors. A total of 89 cases of Leptospirosis have been reported in the district this year while cases of Dengue are 77 and Typhoid cases are 179. The district health authorities have confirmed only one death of Leptospirosis so far. More cases are being reported from the eastern parts of the district like Kothamangalam while the city folks are comparatively less affected by the complicated varieties of fever.

Majority of dengue fever patients are children

THIRUVANANTHAPURAM: As various epidemics are continuing their onslaught all over the State, school children are increasingly becoming the victims of these epidemics. According to the Health Directorate, 60 per cent of the patients affected by dengue fever are children. The number of deaths reported are also high among children in the State.

In Thiruvananthapuram alone, 23 children died due to various epidemics. As many as 173 confirmed cases have been admitted to various hospitals. Moreover, 48 children are reported to be in the ICUs in critical conditions.

The Additional Director of Health Dr P.K.Sivaraman said that children were easily affected as they were more exposed to epidemic virus. Moreover, their lower immunity was also a major reason. ‘‘Parents and teachers must make sure that children are not exposed to any kind of unhygienic conditions.’’ He also suggested the use of mosquito nets as an effective precaution to the spread of epidemics. ‘‘Whenever a child complaints of any kind of illness, he or she must be rushed to the hospital. Extra care must be taken in the case of children as the survival rate among them are seen to be very low,’’ he said.

Taking the seriousness of the issue into consideration, the Health Directorate was planning to conduct awareness programmes in schools in association with the Parent Teachers Association, he said.

Today, two deaths and 26 cases of dengue fever were reported in the State. In all, 10 cases of Leptospyrosis, 5 cases of Typhoid and one case of Cholera were also reported.

Govt. caught napping as epidemic spreads

By Radhakrishnan Kuttoor

PATHANAMTHITTA June 25. It may look an irony that a `mysterious' fever, assuming the proportion of an epidemic, has claimed over 100 lives, besides infecting many others, in a `health-conscious' and highly literate State like Kerala during the past one week. The Additional Director of Health Services, P.K. Sivaraman, himself has confided that 616 persons have contracted leptospirosis (rat fever) in the State, besides 416 suspected cases of dengue fever, as on June 22.

Though the official figures of death toll in the past one week are 53, unofficial records show that not less than 115 persons have succumbed to the illness. Meanwhile, the Government has sanctioned Rs.2.3 crores for combating the epidemic.

But the crucial question is whether the existing system is enough to take up the task, especially when towns and villages have been turned into waste-dumping yards, posing serious health hazards. Many hospitals do not have any proper biomedical waste disposal facility as prescribed by the Bio-Medical Waste Management and Handling Rules, 1998 despite reports of liquid waste from hospitals reaching water bodies. And the infectious wastes being generated at various health-care institutions are mounting day by day, exposing the common man to potential health hazards.

Management of highly contaminated clinical and pathological wastes is a major problem being encountered in the drive for environment protection. Statistics show that Kerala has the highest number of doctors and medical establishments per 1,000 people in the whole country. Another unique aspect of the State's demography is that there are no huge metropolitan cities here while there are a number of small and medium towns with populations varying from 50,000 to five lakhs.

Ministry's failure: Notwithstanding the gloomy picture, the Health Minister appears least bothered about the scenario. The mounting casualty, the mystery behind the epidemic and the failure of the official machinery in diagnosing the cases amply testify to the failure of the Health Ministry in ensuring public health and hygiene. The flow of liquid waste from the District Hospital at Kozhencherry into the public road continues unchecked despite the Minister's visit to the area a week ago. The hospital waste reaches the very source of a drinking water supply scheme in River Pampa through the panchayat drainage.

A private hospital in Ranni reportedly drains out untreated liquid waste into a large pit on the banks of a small stream leading to the Pampa, disregarding the objections raised by the State Pollution Control Board (PCB) and the local people. The PCB inquiry, on the basis of a mass petition, in September last observed that the waste water is being ``discharged into the open pit without any treatment.'' Moreover, the PCB environment engineer, in a letter to the hospital authorities has maintained that ``the present location for dispersion arrangements provided is inadequate to contain the water in the land. Hence, it is inferred that the waste water is likely to contaminate the nearby water sources.''

Negligent local bodies: Local bodies are a party to the pollution of water bodies and environment by their criminal negligence in ensuring a safe and fool-proof waste disposal mechanism in their respective areas. The wastes from slums, lodges and markets in Ranni town reach the Pampa waters mainly because of the laxity on the part of the local body. The case is no different in Kozhencherry, Pandalam and Konni.

It is noteworthy that of the 10 fever casualties reported in the district in the past one week, five are from Ranni. As per Health Department records, 750 cases of acute viral fever have been reported by various peripheral health care centres in the district during the past one week. Of the 52 suspected dengue fever cases reported from the district, only six have been diagnosed as dengue fever, official sources say.

More alarmingly, the hazardous filth finally reaches the backwaters of Kuttanad along with the flood waters during the monsoon, extending the epidemic threat to the coastal areas. The Vembanad lake is connected to the five major river systems of Pampa, Achenkoil, Manimala, Muvattupuzha and Meenachil. These rivers pass through a good number of towns which do not have any proper waste disposal facility, before draining out into the lake. It is of primary importance to take fool proof waste disposal mechanism in towns and villages if the Health Ministry and the Government are sincere in their initiatives to prevent the spread of epidemics.

There are also allegations that the local bodies which are supposed to ensure a safe waste disposal facility in their jurisdiction are often found to have been violating the Act and rules for reasons best known to them. Many people are of the opinion that it is high time criminal proceedings were initiated against these political executives in the State Government as well as the local self-governments for not implementing the waste disposal rules.

Nine-year-old dies of dengue fever

By Our Staff Reporter

THIRUVANANTHAPURAM JUNE 25. A nine-year-old boy hailing from Kumarapuram in the city died of Dengue fever in the Intensive Care Unit (ICU) of the SAT Hospital today, creating panic among the students and parents.

With this, the number of children who have died due to the epidemic in the SAT Hospital in the city alone has gone up to five.

As many as six children are in the ICU of the hospital at present and the condition of three of them was stated to be `serious'.

Arjun, a fourth standard student of the Sarvodya Vidyalaya, Nalanchira, had been admitted to the SAT Hospital on Monday following symptoms of Dengue fever.

He died of `bleeding and shock' this morning while under treatment in the ICU.

The hospital Superintendent, K. Rajamohan said Arjun, son of a staff nurse of the hospital and a resident of Burma Road, Kumarapuram, had ``clinical Dengue as there was bleeding''.

The boy, who had been attending school, developed fever on Friday evening and was taken to the hospital.

Following this, he was under treatment at home.

He was rushed to the hospital yesterday after he showed symptoms of Dengue fever.

According to Dr. Rajamohan, 63 positive cases of Dengue fever have been confirmed in the blood tests conducted among those patients admitted in the SAT Hospital.

Two children of the attenders of the hospital were also under treatment there for dengue.

As there is no specific treatment for those with Dengue fever, blood and blood products were needed in ample quantities.

Hospital sources said there was already a shortage of blood in the blood banks attached to the Medical College. Doctors have appealed to the public to donate blood voluntarily.

Clinic opened

The district health authorities have opened a special fever clinic at the Vithura Community Health centre, following the death of a four-year-old boy, Srihari, here due to Dengue fever.

The Health Secretary, Ramamoorthy, and the Director of Health Services, V. K. Rajan, visited Srihari's house at Vithura and the neighbouring areas on Tuesday to assess the situation.

The fever clinic will function on all days from 8 a.m. till 5 p.m. and the required medicines are available at the Vithura hospital.

It has also been directed to buy additional medicines if required, using the funds of the hospital development society.

A special medical camp was also conducted here on Tuesday under the leadership of Dr. Rajmohan of the SAT Hospital.

The service of nursing school and college students would also be utilised for the fever clinic.

A meeting of panchayat officials was convened by the Health Secretary to chart out programmes to check the spread of Dengue fever, according to sources.

Panchayats will initiate programmes for vector control and rodent control.

Special awareness classes would be held and publicity material released.

The Vithura community health centre has reported over 40,000 cases of fever this year so far.

Of this, 1,000-odd cases were referrals from other centres. Dengue fever was detected in only two persons.

Meanwhile special medical camps were conducted at Pozhiyoor and Vamanapuram where Dengue fever had been reported.

Medical camps to be organised at localities with cases of fever

KOZHIKODE: Medical camps will be organised at several places in the district from where more suspected cases of rat fever and dengue fever were reported.

This was decided at a meeting of office-bearers of local bodies in the district and various department heads held here on Monday.

The meeting was presided over by district collector T O Sooraj.

A district-level committee, with the collector as chairman, has been formed to unify and intensify awareness of precautionary measures among the people against the epidemics.

31 cases of Epidemics reported in State

THIRUVANANTHAPURAM: As many as 19 leptospirosis cases, eight dengue fever cases and four malaria cases were reported in the State on Tuesday.

According to Additional Director of Health Dr P.K.Sivaraman, a person died of dengue fever in Thiruvananthapuram on Tuesday.

He said that 50 persons had died in the State so far due to various epidemics.

He said that the fury of these epidemics was likely to come down in the wake of heavy rains and storms as it would wash away the larvae of the vector mosquitoes.

Dengue fever: Kerala seeks Central aid

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Thiruvananthapuram: Kerala has sought an assistance of Rs 5 crore from the Centre to deal with the situation arising out of the outbreak of Dengue and other epidemics which have so far claimed 55 lives in the state.

Health Minister P. Sankaran told the state assembly on Monday that a detailed report with regard to the outbreak of epidemics had been sent to the Centre.

On its part, the state government had sanctioned Rs 2.20 crore to tackle the situation.

The Minister said the district-level monitoring committees would review the situation and report to the three-member ministerial crisis management team headed by Rural Development Minister C.F. Thomas. In addition to the deaths by Dengue fever, rat fever and viral fever, five people died of jaundice, he said replying to questions.

Medical camps held

By Our Staff Reporter

PATHANAMTHITTA June 24. The district administration organised medical camps in Ranni, Ranni-Angadi and Ranni-Pazhavangadi panchayats today as part of its intensive drive to combat the epidemic fever in the district.

The Ranni grama panchayat president, P.R.Prasad, inaugurated the camp at Ranni and the Angadi panchayat president, Georly Mathew, the camp at Angadi. A total of 500 patients attended the camp at Ranni and 300 patients were administered medicines at the camp at Angadi, the Health department sources said.

A total of 962 patients have turned up to attend the camp at Pazhavangadi today, the sources said. The panchayat president, Thomas Philip, inaugurated the camp. Velayudhan, Additional Director of Health Services, delivered the keynote address at all the three camps.

Another camp was held in the tribal areas of Katathi-Kottampara in Aruvappulam grama panchayat today. The medical team has also collected blood samples from patients at the camp. The District Collector, P.S.Enos, who visited all the medical camps said monitoring cells would be opened at all the Government hospitals and primary health centres in the district soon as part of the ongoing programme to combat the epidemic fever.

He said the district administration has organised medical camps at Naranammoozhi panchayat hall, Vechoochira YMCA Hall and at the Vadasserikkara community hall tomorrow.

Fever claims 3 more lives in Kollam

By Our Staff Reporter

KOLLAM June 23. With three more deaths reported today, the mysterious fever epidemic gripping the district has claimed 11 lives during the past one week.

Health authorities are in the dark about the real nature or identity of the fever. The explanations range from rat fever to dengue fever, viral fever, typhoid and jaundice.

The authorities have, meanwhile, cautioned the general public to desist from self-medication in the event of a fever. The advise is to get themselves treated under a doctor or get admitted to a hospital.

Awareness programmes have been embarked upon at the rural levels through mike announcements. A special "fever clinic'' has been opened at the district hospital in the wake of the situation.

Official records show that more than 3,000 cases of fever had been reported at the various hospitals in the district during the past one week.

While high temperature is the general symptom, many of the other symptoms accompanying the fever vary and this is what confuses the medical authorities.

An emergency meeting with the panchayat authorities have been convened tomorrow by the district Health authorities.

Meanwhile, those who died today on account of the fever have been identified as Chandran Pillai (54) and Chandramathi (50), both from Paravur and Jumailathu Beevi (47) from Anchal. While Pillai and Chandramathi died while under treatment at a private hospital, Beevi died at the Thiruvananthapuram Medical College Hospital.

Medical camps to check spread of fever

By Our Staff Reporter

PATHANAMTHITTA June 23. The district administration has decided to open special cells at various Government hospitals as well as primary health centres in the district to check the spread of viral fever and other contagious diseases during the monsoon season.

In an official release here today, the Distrtict Collector, P.S. Enos, said that the district-level monitoring committee that met at the Collectorate Conference Hall here today had decided to organise medical camps in different parts of the district for the next three days.

He said that elaborate arrangements had been made to conduct medical camps at Ranni, Ranni-Pazhavangadi and Ranni-Angadi tomorrow. Those who need inpatient treatment will be shifted to the nearest Government hospital, he adds.

According to the Collector, the medical team will comprise experts from the Modern, Ayurveda and Homoeopathy branches of medicine and medicines will be supplied at the camps itself.

He said that free ambulance service would also be made available at all these camps.

He said that medical camps would be held at the Vadasserikkara Community Hall, Naranammoozhy and at Vechoochira YMCA Hall on June on 25. Similar camps will be held at Mezhuveli Primary Health Centre, Elanthoor PHC, and at the Thirumoolapuram community Hall, near Thiruvalla, on June 26.

The camps at Kattathi Kottampara in Aruvappulam panchayat and at Thannithode Manneera would be held on June 27 and 28 respectively.

Three children die of Dengue fever

THIRUVANANTHAPURAM: Three children died of Dengue fever here on Monday.

According to official sources, Unnikuttan, 4, of Vithura, Tushara, 12, of Koduvazhoor and Abhirami, 11, of Neyyattinkara died at the SAT Hospital here.

Fifteen other cases of Dengue fever and a case of rat fever were confirmed in the district on Monday.

The 24-hour epidemic control cell, opened at the Health Directorate here, can be contacted over phone numbers 2302160, fax-2519277, a release said.

Intensive drive to fight contagious diseases

By Our Special Correspondent

THIRUVANANTHAPURAM June 21. The State Government has set up district-level committees to tackle the increasing cases of contagious diseases reported in various parts of the State. Similarly, the State Government has issued orders raising the expenditure limit for panchayats, municipalities and city corporations to meet their commitments and take necessary steps to tackle the increasing cases of Dengue, Weil's disease, and other contagious diseases reported from various parts of the State.

An official statement here today said the district-level committees would be headed by the District Collector as chairperson. The District Medical Officer would be the convener.

The other members of the committee are the district medical officers of homoeopathy, Ayurveda, deputy directors of panchayat, agriculture, animal husbandry, fisheries and education departments, secretaries of municipalities and corporations, district coordinator of the total sanitation mission, and the district officer of the Kudumbashree programme.

The statement said that steps had been taken to set up special clinics in medical colleges, district, general and taluk hospitals offering free medical treatment. All expenditure for tackling the spread of contagious diseases has been exempted from treasury restrictions. A sum of Rs. 1 lakh would be spent in each district for carrying out awareness campaigns on sanitation in the 140 Assembly constituencies.

The statement said that the District Collectors have been asked to convene meetings of these committees by June 23 and prepare an action plan. The DMOs of Thiruvananthapuram, Alappuzha, Kottayam, Ernakulam, Thrissur, Malappuram, Kozhikode and Kannur have been given Rs. 9 lakhs each, while Idukki, Palakkad DMOs have been allotted Rs. 8 lakhs each, Kollam DMO Rs. 7 lakhs and the DMOs of Kasaragod and Wayanad Rs. 6 lakhs each to meet emergency expenditure on tackling contagious diseases.

The DMOs could utilise the amounts for purchase of medicines and diagnostic kits, the statement added.

The statement also said that the Government had directed private hospitals to inform the respective DMOs about patients arriving for treatment of the notified contagious diseases.

Another official statement said that the expenditure limit for panchayats would be Rs. 50,000, for municipalities Rs. 1 lakh and for corporations, Rs. 2 lakhs. The local bodies have also been permitted to appoint additional workers on daily wages basis or on contract for garbage removal work.

The statement said that local bodies that did not have funds of their own could mobilise them by preparing a project under the service sector in their respective Plan funds.

The Government has also issued directives to the three tiers of local bodies to form popular committees, under the respective panchayat presidents, to carry out sanitation work on a war footing. Similar popular committees should also be formed at the ward level, the statement said.

These local bodies have been asked to requisition the services of the Health, Animal Husbandry, Social Welfare, Education, Agriculture, Public Works and Water Resources departments to carry out preventive work.

These local bodies could also seek the assistance of the District Collector, district medical officer, or the panchayat deputy director if the need arose. The local bodies have been asked to utilise the services of the Kudumbashree units, besides strictly implementing the Clean Kerala project as per the laid out norms.

Lack of doctors hits control of epidemics

THIRUVANANTHAPURAM: While the State is reeling under the onslaught of various epidemics, the Health Directorate is finding it difficult to get enough doctors as 400 vacancies have been reported by District Medical Officers in the current month itself.

Meanwhile, the existing PSC list has been exhausted and it would take at least one year for the next round of postings.

To tackle the increasing number of vacancies, the department had given powers to DMOs to appoint doctors on contract basis. But even this has not worked out effectively as there were not many takers.

According to directorate sources, a good number of doctors have taken long leave to go to foreign countries and also to prepare for higher studies. To top it, many have taken VRS and joined private hospitals.

Admitting that there was a shortage of doctors, Health Minister P. Sankaran said that the government was thinking of taking stringent measures.

``We have decided not to give leave for doctors in the first two years of service. If the situation does not improve, we will have to fill the posts by appointing retired doctors,'' he said.

All sections of medical fraternity admit that the glory of government services, at least among doctors, is a thing of past.

``It is a fact that the attraction of Health Services is slowly vanishing and even those who enter the service refuses to work in remote areas,'' said director of Health Services Dr V.K.Rajan.

``There have been instances of newly recruited doctors resigning after a week of joining,'' he said.

Poor salary package, inadequate infrastructure facilities, frequent transfers and departmental politics are the major reasons cited for the prevailing situation in the Health services.

``Government service do not provide enough scope for making use of one's full potential and offers no scope for professional enhancement,'' said Dr K. Dinesh of the Kerala Government Medical Officers Association (KGMOA).

"Only those who are highly committed will opt for government services these days, where you are at a disadvantage when compared to the private sector," he said.

IMA secretary Jose Malana said: ``Unless there is a dramatic improvement in the pay package, working conditions, and interdepartmental relations, the situation is likely to go from bad to worse.''

According to director of Medical Education M. R. Chandran, the option of the government service did not figure anywhere in the professional aspirations of young doctors.

``The number of students opting for government service is decreasing in the recent years,'' he said.

House Surgeons' Association president S. M. Binyam said: ``Out of the 800 students who pass out every year, no one will think of joining government service unless there are some compulsions. All top rank holders will go for further studies and only those who do not get through PG courses will opt for Government services.''

Dr Joy Elamon of the Kerala Health Studies and Research Centre attributes the change in the attitude of young doctors to the change in the selection procedure of MBBS students.

``One of our surveys found out that only those with sound financial background have managed to get selected after the introduction of entrance examination. Naturally, they will not have any interest in going to remote areas to serve the deprived sections,'' he said.

``With the coming up of new private medical colleges, the situation is likely to worsen,'' he added.

Dengue fever dominates discussion at Corpn council meet

THIRUVANANTHAPURAM: Dengue fever dominated the discussion at Corporation council meeting here on Friday.

Poonthura Siraj presented an adjournment motion asking the Government to take urgent measures to curb dengue fever and spread of rabies in the State.

He said in the motion that the Government was adopting a lackadaisical attitude towards the proper management of the disease situations.

The State is in the grip of diseases like malaria, dengue fever, leptospirosis (rat fever), diarrhoea and rabies.

He said that the local self governments were unable to take proper action because of the Government directive that stray dogs should not be caught and killed.

Instead of taking proper action, the authorities were either passing the buck or resorting to political gimmicks, he alleged.

D.Sudarshanan of the UDF who replied to the allegation said that the Government had already taken adequate action to keep the situation under control.

He said that lack of cleanliness was the reason for the outbreak of the disease. An amount of Rs 2.5 crore had been sanctioned by the Government for the purpose, he said.

B.Sreekumar of the LDF said that the Corporation was unable to take proper measures owing to lack of workers in the Corporation.

He asked the Mayor to hire more workers for mosquito eradication.

Opposition leader Maheswaran Nair said that action should be taken in a time-bound manner and the pamphlet brought out by the Corporation to curb dengue fever should be distributed through Government departments to spread awareness about the disease.

The Mayor told the council that anti-rabies injection for stray dogs was all set to begin.

The Tourism Department had agreed to provide a machine worth Rs 30 lakh to remove mud and water from open drains.

Epidemics claimed 51 in State

THIRUVANANTHAPURAM: The Government on Thursday admitted that 51 people died in the recent outbreak of epidemics in the the form of dengue fever, rat fever, viral fever and malaria in the State.

Health Minister P.Sankaran told the Assembly while replying to an adjournment motion by M.V.Jayarajan of the CPM that dengue fever had claimed the life of 15 people, rat fever 21, viral fever 14, and malaria one in different parts of the State.

Intervening in the discussion, the Chief Minister assured the House that the Government would do all possible to contain the spread of the disease besides providing relief to those affected. He attributed the unprecedented outbreak of diseases to climatic changes.

He said the Government had sanctioned Rs 1.15 crore for controlling epidemics. Sanction was also given to all panchayats, municipalities and city corporations to spend Rs 25,000, Rs 50,000 and Rs 1 lakh respectively from their funds for taking emergency steps to contain diseases.

Jayarajan alleged that the measures taken so far had been inadequate~ENS

Epidemics spread to coastal belt in Kannur

KANNUR: Viral, dengue and rat fevers, which have already claimed more than a dozen lives in the district here, are now spreading to the coastal belt.

Scores of people from the coastal villages hit by viral fever reached various Government and private hospitals seeking medical treatment on Thursday.

Meanwhile, more than 30 persons affected by the disease belonging to Malur, Peravoor, Kanichar, Kelakam and Kottiyoor were taken to the Medical College Hospitals at Pariyaram and Kozhikode.

Former Union Minister Mullappally Ramachandran called upon the State Health Minister P Sankaran to send a State-level team of medical experts to the disease-hit regions in the district.

In a statement issued here, Mullappally said that the measures to check the spread of the disease taken by the Department of Health Services were ineffective.

Sanitation measures to be stepped up

By Our Staff Reporter

THIRUVANANTHAPURAM June 20. The City Corporation has decided to step up ward-level sanitation activities during the monsoon season to check the spread of epidemic diseases.

The Mayor, J. Chandra, told the Corporation Council today that the programme would primarily focus on vector control. Replying to a debate on the issue, she said spraying of larvicide would be intensified in all the wards.

Casual labourers would be engaged to clean up gutters and drains and excavators would be pressed into service to desilt canals. Power sprayers will be used to control mosquitoes in the highly infested wards.

Responding to the concern raised by several councillors over the failure to control the stray dog menace, Ms. Chandra informed the council that the Corporation was gearing up for an anti-rabies programme scheduled to take off on July 6.

The debate on the issue was sparked off by an adjournment motion moved by the Ambalathara ward councillor, Poonthura Siraj, urging the Government for immediate action to check the spread of epidemics. Mr. Siraj said malaria, dengue fever, leptospirosis, diarrhoea and rabies were rearing their ugly head in several parts of the city, posing a public health danger. Terming the Government response to the threat as inadequate, he said the Local Administration Department and the Health Department were blaming each other for the situation.

LDF councillors alleged that the Government decision to appoint a Cabinet sub-committee to handle the threat was dictated more by political compulsions than the need to address the issue. UDF councillors hit back by alleging that the Corporation was blaming the Government in a bid to evade the issue.

The UDF council party leader, K. Maheswaran Nair, said the Corporation should focus on utilising the funds and equipment at its disposal instead of condemning the Government initiative. He called for a grassroots campaign for vector control. The Sasthamangalam councillor, Sreekumar, (LDF) said the civic body was hamstrung by the lack of adequate manpower for larvicide spraying and fogging operations.

The Deputy Mayor, Sujanapriyan, said the District Medical Officer who had highlighted the epidemic threat was over reacting to the issue. He said the Corporation was most vigilant against public health hazards. Terming the UDF agitation as a politically motivated action, he sought the Chief Minister's intervention.

Earlier, the Mayor moved an official resolution seeking the Council's approval for a Rs.48 lakh project to construct a foot overbridge connecting the Central railway station with the Thampanoor bus stand.

The Thampanoor councillor, Satheesh, questioned the Corporation's decision to go it alone when the Thiruvananthapuram MP, V. S. Sivakumar had committed Rs.25 lakhs for the project. He said the proposal to widen the Thampanoor- Overbridge road had necessitated a revised estimate of Rs. 48 lakhs, forcing the MP to seek the Corporation's support.

Pointing out that TRIDA had a long- term proposal to widen the road for six- lane traffic, he said this should also be considered while preparing the overbridge project.

The Mayor said the revised project had been prepared to accommodate the maximum road width possible. She said the Corporation had decided to take up the project after the MP had backed out.

Earlier, the UDF benches opposed an official resolution seeking the sanction of 25 cents of land at Jagathy for the construction of a Mayor's Council building. Protesting the motion, the Jagathy councillor, S. Lekha, said the proposed site had been earmarked for the construction of a shopping complex. She warned that the new project would affect the rehabilitation of traders to be displaced for road widening.

The Mayor said the proposed facility was intended to provide conference facilities and accommodation for visiting Mayors and councillors. She said the Jagathy site was identified to avoid delay in land acquisition.

The council also adopted a resolution approving the Memorandum of Understanding for a BOT project to set up public comfort stations at various locations in the city.

Three die of viral fever

By Our Staff Reporter

THIRUVANANTHAPURAM JUNE 20. Viral fevers claimed three lives, including that of a girl, at the Medical College Hospital here on Friday.

An MCH official said that two youth from Nedumangad had been hospitalised in a critical state with high fever.

One, who was 22 years old, died within hardly 10 minutes of being admitted to the hospital, while the other, who was 18 years old, succumbed after battling for life for three hours in the ICU.

The third patient, a 19-year-old girl from Sreevarahom area in the city, died while under emergency care in the Medical Intensive Care Unit (MICU).

She had arrived with tell-tale signs of an end-stage Dengue attack.

Clinicians, however, were reluctant to classify the infective cause of the deaths as serological confirmation could not be obtained in any of the cases.

Doctors said the two youth from Nedumangad appeared to have suffered from severe broncho-pneumonia and had difficulty in breathing.

Meanwhile, according to official data, there have been 390 sero-positive cases of Dengue in the State so far.

The newest 11 cases have been reported from Kozhikode (4), Palakkad (2), Alappuzha (2), Thrissur (1) and Malappuram (2).

The patients had tested positive in the IGM Elisa diagnosis for Dengue virus.

According to an official count, there have been three Dengue-related deaths in the latest wave of viral infection.

Meanwhile, the Health Department and civic bodies are focusing on measures to check vector-borne diseases from assuming epidemic proportions in the community.

Viral fevers running riot

By Our Staff Reporter

THIRUVANANTHAPURAM June 19. Even as a rash of common fevers has surfaced in the city, afflicting children and adults alike, clinicians are taking no chances in ensuring that the infections are not of a life- threatening type.

Doctors say that the recent change in weather has led to a spate of viral infections. Though such infections are common during change of weather every year, this time the problem had acquired serious proportions.

Along with common viral fever, Dengue fever is also being seen and this often poses a diagnostic dilemma for clinicians. The treatment for Dengue is similar to the treatment given for common viral fevers.

The paediatrician, Noel Narayan, told The Hindu that while a Dengue infection may be benign the first time, a person who contracts it a second time due to another type of Dengue virus is likely to develop life-threatening infections such as Dengue Haemorrhagic Fever or Dengue Shock Syndrome.

A primary Dengue attack is also easily mistaken for an infection with the common self-limiting influenza virus.

Though children are most vulnerable to new infections, experts say that the proportion of adults going down with fever these days indicates that a relatively new virus is currently in circulation.

Healthy children are, in fact, more vulnerable to Dengue- triggered complications due to a phenomenon termed as "immune enhancement," wherein the antibody production exceeds required levels and works to the detriment of the host.

However, fewer than five per cent of children lapse into serious stages of Dengue infection. Dr. Noel says it is imperative to sort out the specific serotype of the virus that is in circulation.

Tracking down the specific serotype and establishing sero-positivity forms the basis for preventive measures.

The message to physicians treating common fevers is to go by clinical evaluation and suspect Dengue only when a patient, child or adult, develops tell-tale signs ranging from extreme fatigue to red spots on the skin.

The Indian Medical Association, meanwhile, has brought out advisories on the management of fevers.

According to the IMA, fever patients should be taken to hospital. Ample rest and intake of fluids is recommended. Vector (mosquito) control measures such as maintaining domestic hygiene and prudent waste management are also advised.

Dist lacks action plan to check epidemics

KOZHIKODE: The Crisis Management Cell in the district on Tuesday decided to go for fogging in areas from where suspected cases of dreaded dengue fever have been reported.

District Collector T O Sooraj said fogging has already begun in Vadakara municipality region. The exercise would be intensified in Thamarassery and Puthuppadi, the other vulnerable areas in the district.

He said the Medical College Hospital and Government hospitals in the district would be provided with enough diagnosis kits.

However, the district administration is yet to come out with a concrete action plan to contain epidemics which are fast spreading with the onset of the monsoon.

Stray cases of dengue fever have been reported from various parts of the district for the past several months. Besides, the Kozhikode field office of the National Institute of Communicable Diseases (NICD) has alerted the Health Department about the gravity of the situation.

Dr Koya, who is in charge of the field office of the NICD, said the number of dengue fever cases being reported from the region is going up, indicating that an outbreak of epidemic would happen in future. He said the aedes mosquitoes carrying the dengue virus do not breed in contaminated water in drains and canals. They breed only in small quantity of water gathered in air coolers, small bottles etc. Besides, they are active during day time.

He said fogging can contain only the spread of virus-carrying adult mosquitoes. The sources of breeding should be eliminated by drying up water gathered in discarded bottles and small puddles. A virus-carrying mosquito can spread the disease in a larger area, he said, adding that incessant rain would minimise the spread of the larve of the aedes mosquitoes.

The delay in confirming the disease is also affecting the treatment. Under the present diagnosis, the anti-body detection is possible only two weeks after the patient develops symptoms of the suspected disease.

Dr Bharghavan, of the Medicine Department of the Malabar Institute of Medical Sciences, said a trial run of a new technique for early confirmation of the disease, rapid antigen detection, is on. Dr Bhadra, a scientist with the National Defence Research Institute, had developed this technique for speedy diagnosis of the dengue fever and rat fever. A few months back, a demonstration of the new technique was conducted in Kozhikode.

Though the dengue fever may subside soon, as the health authorities expect, rat fever is waiting to wreak havoc in the city when the rain intensifies in the coming days.

Last year, officials of the NICD had collected serum from several rat fever patients for further studies on the disease. Sources said the NICD had so far not given any advice on containing the disease.

Besides, no effective steps have been taken to contain the rat population. Several drains in the city are blocked with garbage, providing a perfect place for rats to multiply.

The district agricultural department has an allocation of Rs 4.5 lakh for rat eradication. Department sources said they would go for an intensive rat eradication drive in the coming weeks.

Steps initiated against spread of epidemics

PATHANAMTHITTA: The district administration has initiated measures to contain and avert the spread of epidemics like dengue fever and cholera in the district, especially in the tribal belts of Attathode and Naranamoozhi.

As part of the programme, a 20-member medical team, headed by deputy district medical officer Dr Purushothaman and which includes six doctors, organised a medical camp at Attathode colony on Monday.

District Collector P.S.Enos inaugurated the camp. Speaking at the function, Enos said that measures had already been initiated to make available medical facilities for the needy. He said that a round-the-clock special cell attached to the district medical office had been opened at the Collectorate.

Enos said that awareness campaigns would be launched across the district, especially in the fringe areas of the forests where the tribals were settled.

As part of the second phase, another medical camp would be organised at Attathode colony on June 26. Enos said that the district administration would distribute 10 kg of rice and pulse to each tribal family a week for the next two months.

The Kudambasree and the Mahila Swastha Sangham had launched awareness programmes among the public regarding the precautionary measures to be taken to control the spread of cholera and dengue fever.

For mosquito eradication, the Kudumbasree had undertaken the task of fogging at Pandalam, Vadasserikara and Vechoochira.

16 died of dengue fever: Sankaran

THIRUVANANTHAPURAM: Health Minister P. Sankaran said that 16 persons had died of dengue fever in the State during the past few weeks.

Replying to a submission raised by Opposition leader V.S.Achuthanandan in the Assembly, the Health Minister said that several cases of dengue fever were reported from the districts of Thiruvananthapuram, Malappuram, Kottayam, Kannur, Thrissur and Alappuzha during the past few weeks.

A total of 279 suspected dengue fever patients were admitted to different hospitals in the State.

The higher death toll was due to the fact that several victims had taken their sickness lightly due to the wide prevalence of viral fever. The lives of those who were admitted to hospitals on time could be saved.

He said that `rapid response teams' were pressed into service in districts which reported prevalence of dengue fever.

Achuthanandan in his submission alleged that more than 1,000 people were hospitalised in the State with symptoms of dengue fever.