Epidemics in Kerala

2003-10-12T22:19:00.000-07:00

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.

2003-09-14T01:42:00.000-07:00

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.

2003-08-30T04:29:00.000-07:00

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.

2003-08-23T10:23:00.000-07:00

'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.

2003-08-17T06:11:00.000-07:00

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 Bhavanâ€™s Vidya Mandir have started special exercise programmes for their students.

The doctors had found that many students donâ€™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.

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

â€˜â€˜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,â€™â€™ 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. Bhavanâ€™s Vidya Mandir, Elamakkara, has banned junk food in its canteen and there is a compulsory weekly exercise programme for the children.

â€˜â€˜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,â€™â€™ says Meena Viswanathan, principal of the school.

â€˜â€˜Yes, we are also concerned about the health problems of students. And these exercise programmes are really good for them,â€™â€™ 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. â€˜â€˜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,â€™â€™ says Dr Harish.

2003-08-08T09:49:00.000-07:00

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.

2003-07-31T21:33:00.001-07:00

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.

2003-07-31T21:33:00.000-07:00

Seven more dengue cases

WHO kept in dark on epidemics outbreak

Dengue toll rises to 11 in city

16 new cases of dengue

2003-07-24T20:28:00.000-07:00

Fever: Govt urged to order probe

KOCHI: The Organisation of Government Homoeo Medical Officers Kerala (OGHMOK) has urged the State Government to undertake a comprehensive probe into the death of 170 people, reportedly due to Dengue fever.

Addressing a media conference here on Friday, Dr V A Nassirudheen, president of OGHMOK expressed doubts over the fact that all these people were affected by Dengue fever.

“The allegations that Homoeopathy medicines were not effective in curing people affected with viral and Dengue fever are completely baseless,” said Dr V A Nassirudheen. He asserted that only Homeo can offer medicines to prevent the fever which has been raging in the state for the last couple of months. “The Homoeopathy Department has been effectively implementing measures to check the spread of epidemics like viral fever, Dengue fever and Leptospirosis in the State. The department had distributed medicines to over 60 lakh people and had succeeded in curing around 75,000 people,” said Dr V A Nassirudheen.

There was also no report of any death due to Homoeopathic treatment, he said while adding that it had already proved that Homoeopthy medicines are effective in controling other diseases as well.

He said the Government had allotted Rs 14 lakh for treating diseases. On the Indian Medical Association’s recent remarks that Homoeo medicines were ineffective for curing viral and Dengue fever, he said that the people of Kerala understood very well the effectiveness of Homoeo medicines and any attempt to mislead them will not succeed.

Dengue fever claims one life

KOCHI: While the health authorities are busy with the routine fever control measures, a person died of Dengue fever at the Medical Trust Hospital on Thursday.

James Joseph, 40, of Padimattom house, Perumanoor, was admitted to the hospital on July 15.

A farmer by profession, James had a farm in Kavalakkad in Perumbavoor. He is survived father and brother.

It is the first confirmed Dengue fever death. The authorities still maintain that many cases of deaths by fever occurred in the district earlier were not caused by Dengue.

13 more dengue cases

By Our Staff Reporter

THIRUVANANTHAPURAM JULY 18. At least 13 fresh cases of confirmed dengue and three leptospirosis cases have been reported from the city and parts of the district.

According to Health Department officials, four suspected cases of dengue have also been reported in the district.

The fresh dengue cases have been reported from Valiathura, Pettah, Andoorkonam, Chowara, Vallakadavu, Vilappilsala, Tiruvallam, Peyyad, Tirumala, Neyyatinkara, Melancode and Mulluvila.

While three patients have been admitted to the SAT, two to the Medical College Hospital and two to a private hospital, the rest are under treatment at the General Hospital.

The leptospirosis cases reported from Vellarada, Attingal and Kunnathukal have been admitted to the Medical College.

Meanwhile, a meeting convened by the District Collector, E. Ayyappan, with health supervisors in 19 blocks, resolved to intensify the rapid action forces deployed in the dengue-affected areas.

Plans were finalised to implement a one-day cleanliness campaign in the district on July 25. The Collector has instructed offices, schools, hospitals and public sector undertakings to devise their own measures to ensure hygiene.

E. K. Madhavan, District Medical Officer, was present at the meeting.

Meanwhile, the Homoeo Medical Officers' Association and other organisations have taken exception to certain reports that cast doubts over the efficacy of homoeopathic medicines as preventive drugs against dengue.

The Association office-bearers said that no side-effects were associated with homoeopathy medicines if the right dosage was taken and the prescribed diet followed.

They pointed out that homoeopathic medicines had been effective in the past to limit the outbreak of infectious diseases such as cholera, encephalitis, viral conjunctivitis and chicken pox.

2003-07-17T22:39:00.000-07:00

17 more patients test positive for dengue

By Our Staff Reporter

THIRUVANANTHAPURAM JULY 17. At least 17 patients, including seven from the Corporation area, tested positive for dengue, while five suspected dengue cases are kept under observation at various hospitals in the district.

No deaths have been reported, according to the Health Department officials.

The new cases were referred from Pallichal (two), Malayankeezh (three), Nemom (two), Anayara, Kunnukuzhy, Tiruvallam, Punnacode, Palancode, Pappanamcode (two cases), Palayam and Anayara.

While a majority of the cases have been admitted to the General Hospital, a patient with confirmed dengue hailing from Koovalasserry is being treated at the Malayankeezh Primary Health Centre (PHC).

Meanwhile, a nine-year-old boy from Pallichal, who had been under treatment for confirmed dengue infection at the Women and Children's Hospital, Thycaud, was today referred to the SAT Hospital.

According to the Health Department officials, an estimated 1,633 patients registered at out-patient clinics at various health institutions in the district with complaints of viral fever.

The number of dengue positive cases as well as viral fever cases is higher than the average recorded at the round-the-clock control room at the District Medical Office.

The average daily confirmation rate of dengue cases had been between five and ten over the past several days while out-patient registration of viral fever cases had been averaging a little over a thousand at various health care centres in the district. According to feedback from health centres in the district on Wednesday, there have been eight confirmed cases of dengue and an out-patient registration of 1,190 viral fever cases. However, this was much lesser than in some other districts such as Kannur (2,140), Kasaragod (1,636), Kollam (1,415) and Ernakulam (1,238).

WHO to despatch diagnostic kits

By Our Staff Reporter

THIRUVANANTHAPURAM JULY 17. The World Health Organisation (WHO) is despatching diagnostic kits for the detection of dengue and leptospirosis, which have emerged as major killer diseases with the advancement of the Southwest monsoon.

The WHO would be sending 100 diagnostic kits for dengue and 500 kits for the detection of leptospirosis. The initial consignment was expected to reach Kozhikode on July 20, the Health Secretary, K. Ramamoorthy, told The Hindu.

Since January this year, the State has recorded 46 dengue deaths (with one more fatality reported from the Thiruvananthapuram Medical College Hospital today) and 43 deaths due to leptospirosis. The cumulative total of patients who have tested positive for dengue during serological examination is 1,363, while that in the case of leptospirosis is 798.

Harshvardhan Batra, an expert on leptospirosis attached to the Defence Research and Development Organisation, which has manufactured the diagnostic kits, is expected to accompany the consignment and render his expertise to the medical fraternity in the State.

Confronted with the spiral of viral fever and the mounting dengue and rat fever deaths, the Health Department has been forced to outsource for more diagnostic kits for the vector-borne diseases from centres in New Delhi, Chennai and the Indian Council for Medical Research.

Mr. Ramamoorthy had placed a request for more diagnostic kits to S. J. Habayeb, WHO representative in India, as early as June 26 detailing the gravity of the situation in the State.

The WHO's official communication confirming the despatch of the first batch of kits has come almost three weeks after the request was made. In between, the Health Department imported 96 diagnostic kits from a German manufacturer to shore up the stock position.

According to the Health Secretary, the kitswould be distributed among district-level laboratories, microbiology units attached to the Medical Colleges and the Public Health Laboratory. It is estimated that at least 100 patients can be subjected to serological examination using a single kit.

``We are focussing on the importance of maintaining environmental cleanliness with multi-sectoral and community involvement'', Mr. Ramamoorthy said.

Suspected dengue death at MCH

By Our Staff Reporter

THIRUVANANTHAPURAM JULY 16. A 52-year-old woman died of suspected dengue-like complications at the Medical Intensive Care Unit on Wednesday.

According to the Medical College Hospital (MCH) officials, the involvement of dengue infection has not been serologically confirmed and the death was hastened due to multiple organ failure leading to septicemic shock. Meanwhile, at least eight cases of confirmed dengue cases and one leptospirosis case were reported from the district on Wednesday.

New project mooted to contain epidemic

KOCHI: District Collector Gyanesh Kumar has announced that a project worth Rs 2 crore will be implemented in the district to prevent the spread of epidemic like dengue fever.

He made this announcement while presiding over an awareness programme held for the presidents and representatives of local bodies at the Collectorate on Wednesday.

The administration sanctioned Rs 1 lakh each to 88 grama panchayats, Rs 3 lakh each to 15 block panchayats, Rs 4 lakh each to 8 municipalities and Rs 5 lakh each for Corporation, District Panchayat and District Collector.

As a first step towards the implementation of the project, panchayat and ward level committees on control of communicable disease will be constituted and these committees will hold review meet every day. Local Self Governments (LSGs) are directed to prepare a project plan for preventive measures and curative aspects which may include purchase of preventive medicine and purchase of fogging machines and chemical sprays to contain the rat menace.

A resolution to this effect may be passed by the Local Self Government and the required amount that is to be taken from Plan fund has to be ratified by the District Planning Committee .

The Collector also directed that Village Panchayats and Municipalities should deem garbage disposal as their own responsibility.

Panchayats may identify a garbage disposal site, or two or three adjacent Panchayats or even a block may identify a common site for garbage disposal, he added.

Eminent Nephrologist Dr Georgy K Ninan made a presentation on various aspects of Leptospirosis and Dengue fever. Dr V K Krishanankutty, Deputy DMO (Homeo) explained the modalities of ‘Clear Kerala Campaign.’ The Deputy Director of Agriculture explained the strategies to be adopted to contain the rat menace. Dr Abraham Mathew, District Medical Officer (Homeo) spoke on the administration of preventive medicine against fever.

Others who attended the meet were K B Muhammadkutty master, President District Panchayat and Johnson K George, ADM.

Dengue fever claims one more life

By Our Staff Reporter

THIRUVANANTHAPURAM July 15. Dengue fever claimed one more life with the death of a 28-year-old youth at the Thiruvananthapuram Medical College.

According to health officials, Abhilash, hailing from Vattiyoorkavu, had been referred to the Medical College Hospital on July 7. Meanwhile, seven new cases of confirmed dengue were reported from various areas in the district.

Fever epidemic yet to be controlled

By M. Dinesh Varma

THIRUVANANTHAPURAM July 14. The sweep of dengue fever continues unabated due a combination of ineffective vector control measures and misplaced reliance on so-called preventive drugs, according to the findings of a recent survey undertaken by the Indian Medical Association(IMA) in the city.

The survey, which covered 1,040 high school students of a Government school and a `street sample' of 528 people, found that 46.9 per cent of children and 40.9 per cent of adults were affected by fever during the past two months. The results of the study were revealed by the IMA office-bearers today.

As many as 44.7 per cent of the surveyed population had been infected by fever in the past two months. The prevalence of fever in children (17.3 per cent) and adults (16.47 per cent) during the last one week was higher than the average of 5.58 per cent of the past two months and this indicated that the epidemic was far from being under control.

The infection control study was conducted by an expert committee comprising Sreejith Kumar, T. Suresh Kumar, V. C. Velayudhan Pillai, Alex Franklin, Anantha Narayanan and Joseph.

The IMA expressed doubts over the efficacy of the medicines being promoted as a preventive against dengue infection. According to the association, children and adults who were administered these medicines developed fever while those who did not take them, had not.

What was more serious was that 21.87 per cent of adults and 9.31 per cent of children who were administered these so-called preventive drugs also developed side-effects ranging from body ache and giddiness to diarrhoea and vomiting.

According to the IMA, while standard medical literature recommended controlling the aedes mosquito species, the survey established that the community at large was exposed to the dengue threat as vector control and environmental hygiene improvement measures covered barely 21 per cent of the area.

The IMA called for urgent vector control measures to prevent re-infection as well as to pre-empt fresh infections. Periodic vector surveys to limit the vector density, regular inter- epidemic surveillance and inter-departmental coordination were also recommended.

The IMA has appealed to the administration to evolve policies for mass health education.

New project mooted to contain epidemic

Prevention of epidemics: IMA blames Govt

KOCHI: Viral fever may be under control in the State now, but if the Government fails to take up adequate preventive measures the epidemic could still turn fatal, opined doctors who attended the emergency meeting of the state and district branches of Indian Medical Association (IMA) at IMA Hall on Sunday.

Hygiene is the only way to keep away Dengue fever, but the Government and local administration are trying to save their faces by recommending Homeo preventive medicines which are not yet proved effective. IMA officials alleged that most of the patients hospitalised with viral fever had taken these medicines.

The meeting evaluated the efforts of IMA in controlling viral fever, Dengue fever and Leptospirosis in the state. Meanwhile a meeting presided over by District Collector Gyanesh Kumar on Saturday has decided to conduct meets to evaluate preventive measures taken against viral fever at the district, taluk and block levels. These meetings will analyse the measures taken by health officials.

District Medical Officers of Allopathy, Ayurveda and Homeo, Mass Media Officer and District Information Officer will attend the meetings at the district level. Steps to eradicate mosquitoes and rats in the district will also be recommended. The authorities will seek the cooperation of the public in this venture and ask the officials of schools, colleges, Government agencies and hospitals to keep their surrounding clean.

As the mosquitoes that cause Dengue fever cannot fly beyond 300 meters, the authorities are planning to spray pesticides all over the district simultaneously. The public will be asked to destroy coconut shells and tyres lying abandoned near the house as they breed mosquitoes. The high level committee headed by the District Collector will monitor the control measures.

Viral fever could create havoc in Kerala, say doctors

KOCHI: Viral fever is now under control in the State, but if the Government fails to take up preventive measures the epidemic could still turn fatal, opined doctors who attended the emergency meeting of the state and district branches of Indian Medical Association (IMA) at IMA hall on Sunday.

Hygiene is the only way to keep away Dengue fever, but the Government and local administration are trying to save their faces by recommending Homeo preventive medicines, which are not yet proved effective.

IMA officials alleged that most of the patients hospitalised with viral fever had taken this medicines.

The meeting evaluated the efforts of IMA in controlling viral fever, dengue fever and leptospirosis in the State. IMA had started Control Cells in every districts and 24-hour Fever Clinics in all hospitals.

It had formulated a treatment policy, referring patients to speciality hospitals if necessary, conducting survey in Government and private hospitals to get the exact statistics, visiting places of epidemics and recommending hygienic measures and conducting awareness camps for the public have been some of the programmes of IMA.

Meanwhile, a meeting presided over by District Collector Gyanesh Kumar on Saturday decided to conduct evaluation meetings on the preventive measures against viral fever every day in district, taluk and block levels.

These meetings will analyse the measures taken by health officials and will recommend new each day's works.

District Medical Officers of Allopathy, Ayurveda and Homeo, Mass Media Officer and District Information Officer will attend the meetings in the district level.

Authorities will also take steps to eradicate mosquitoes and rats in the district. They will seek the co-operation of the public in this venture and ask the officials of schools, colleges, Government agencies and hospitals to keep their surrounding clean to destroy rats and mosquitoes.

Panchayat will buy the sprayers and medicines needed to eradicate mosquitoes.

As the mosquitoes that cause Dengue fever cannot fly beyond 300 meters, the authorities are planning to spray medicines simultaneously in the district.

Health officials also pointed out that Kothamangalam area need to be given more attention as the highest number of cases have been reported from there.

The public will be asked to destroy coconut shells and tyres lying abandoned near the house as they breed mosquitoes.

The high level committee headed by the Collector will monitor the control measures. District Panchayat President K B Muhammadkutty master, Additional District Magistrate Johnson K George, DMOs, RDOs and Tahsildars attended the meeting.

Fever claims one more life

By Our Staff Reporter

THIRUVANANTHAPURAM July 11. A 17-year-old girl died due to viral fever complications at the Medical College here on Friday, even as 13 more patients were confirmed to carry dengue infections in serological examination.

According to district health officials, the victim, Serena, who had been under treatment for undiagnosed fever for nearly a month, hailed from Kaniyapuram.

A new case of leptospirosis was also confirmed in a 48-year-old patient from the Nemom area while a new case of malaria was reported from Vanchiyoor in the city.

With the latest casualty, the number of viral fever deaths in the district has risen to 23. Apart from this, there have been nine deaths due to dengue fever and two due to leptospirosis.

Tests on serological samples of fever patients, which were received at the District Medical Office, were found to be positive in 13 more cases. At least 1,571 viral fever admissions were registered at health institutions across the district on Friday.

Meanwhile, the district administration is formulating an action plan to launch a one-day massive cleanliness drive throughout the district on July 25 as part of measures to combat infectious diseases.

The District Collector, E. Ayyappan, informed in an official release that the cleanliness campaign would be launched at the municipality/grama panchayat ward levels. An awareness drive would also be dovetailed into the cleanliness campaign.

Dengue: MCH blood bank under strain

By Our Staff Reporter

THIRUVANANTHAPURAM July 11. The Blood Bank at the Medical College Hospital here is hard put to provide adequate units of blood platelets to the scores of dengue fever patients being admitted over the past one month.

There has been a steady demand for platelet replacements from the SAT Hospital to prevent child patients from developing Dengue Shock Syndrome or Dengue Haemorrhagic Fever.

The Blood Bank had stepped up its collection rate from voluntary donors from the normal average of between 80 to 100 units a day to nearly 150 units. On a single day, the bank had been catering to platelet requests of 10 patients and more, sources said.

The blood bank has been using a refrigerated centrifuge to segregate platelets, red cells and plasma from whole blood. Acutely ill dengue patients require constant transfusion of platelets to offset potentially fatal haemorrhages.

It is estimated that on an average an episode of transfusion from a single donor can boost platelet counts in the recipients by between 5,000 to 10,000 units. Often, children with drastic platelet reduction would require segregated components from more than one donor, experts say.

It is also pointed out that of the major blood components, platelets have the least shelf-life (roughly three days), whereas red cells can be preserved for up to 42 days. Plasma, on the other hand, has a shelf life of several years.

According to sources, whole blood transfusions are now warranted only in cases of major loss of blood in road traffic accidents, obstetric complications or a major surgery.

It's viral infection, say Govt. doctors

By Our Staff Reporter

KOZHIKODE JULY 10. The Kozhikode branch of the Kerala Government Medical Officers Association (KGMOA), at a meeting of Government doctors in the district here on July 9, has opined that the prevailing infectious fever in the district had been diagnosed as `influenza viral fever'.

The doctors, who evaluated the measures initiated to combat the infection, expressed the view that it was the sudden changes in climate which had brought about the malady.

The president, N.Haridas, and the secretary, Appunny, in a statement pointed out that preventive measures initiated had been highly effective in combating Weils's disease (rat fever) this year.

If adequate preventive measures were taken, it would be possible to check the spread of the prevailing fever too next year, it added.

17 more dengue cases

By Our Staff Reporter

THIRUVANANTHAPURAM July 10 . Seventeen new cases of confirmed dengue fever were reported at various hospitals in Thiruvananthapuram city and suburbs on Wednesday.

According to officials, the extraordinary feature was the confirmation of dengue infection in 10 adults at a private hospital in the city. This is the first time since the dengue outbreak that the admission of adults has outnumbered child patients, who are most vulnerable to the mosquito-transmitted disease.

Of the new cases, eight were reported from various Corporation wards and one each from Pangappara, Poonthura, Nedumangad, Vilappil, Manamboor, Peringadavila, Kallara and two from Nemom.

So far, at least 74 of the 215 confirmed dengue cases have been reported from the Corporation precincts.

2003-07-09T21:35:00.000-07:00

Neem oil effective against Weil's disease?

By Our Staff Reporter

KOTTAYAM July 9. Even as public health authorities and modern medicine practitioners are struggling hard to control the outbreak of Leptospirosis in many parts of the State, the Leptospirosis Institute of Kerala here has come up with a simple and low cost preventive - Neem Oil.

According to Dr. Punnen Kurian, principal investigator, and Manuel Thomas, research scholar, their research into the issue has found that those who work in waterlogged areas, the most prone to Weil's Disease, can effectively prevent the portal entry of leptospira by covering the entire body surface with one layer of neem oil just before starting work.

According to them, a total of 60 regular workers of canals, paddyfields and sand-mining on rivers were provided with locally available neem oil after assessing its quality using standard procedures. They had ensured that oiling was done every day just before they started the day's work. The entire body surface, including areas of cuts and bruises, was covered with one layer of oil. All other regular workers of the area were considered as `control' group and ensured that they were not taking any such preventive measures. The study was continued for a period of one month during May-June period.

No leptospirosis case was reported from the treated group. But two cases were reported from the same area to the Kottayam medical College hospital which were serologically confirmed and one of them died. Water samples taken from the area also proved that they contained leptospires at moderate level. Three species of rats were captured from the area and 35 per cent of their samples were found serologically positive.

According to Dr Kurian, neem oil may form an impermeable layer on skin that prevents the portal entry of the bacteria. The high viscosity, density and surface tension of the oil helps to keep the film on skin intact for a longer duration. The anti-bacterial property of neem oil is well established and it is effective against leptospira too. Anti-bacterial constituents like nimbidines and mahmoodin have been isolated from the oil. Moreover, the neem oil, while it mixes with water even in lower concentrations becomes acidic and it may turn leptospiricidal. Leptospira is very sensitive to pH changes and acidic pH below 6.0 is leptospiricidal.

They pointed out that the only effective way to control Weil's disease was through taking up vigorous campaigns to eliminate rats. This should have been done by the local bodies with popular participation. However, the local bodies and authorities have miserably failed in this endeavour and the poorer sections of the people, who are most prone to rat fever can take care of themselves through this cheap method. Neem oil is cheap, easily available and inspite of the unpleasant odour, acceptable to the local community as a traditional commodity used in ayurvedic treatments. As such it can be recommended for wider use, they said.

Epidemic-control drive on

By Our Staff Reporter

THIRUVANANTHAPURAM July 9. The Leader of the Opposition, V.S. Achuthanandan, said here today that the Treasury ban was hampering the epidemic control drive taken up by local bodies.

Inaugurating an intensified epidemic prevention programme launched by the City Corporation, he said the Treasury ban had emerged as a major impediment to local bodies and hospitals in utilising Rs.2.5 crores sanctioned by the Government to handle the epidemic threat.

Expressing concern over the epidemic outbreak, which had claimed over 300 lives, he stressed the need for people's participation in sanitation and vector-control activities.

He called upon local bodies to coordinate their efforts with the Government, elected representatives and the general public.

The long- term programme launched by the Corporation is aimed at total eradication of epidemics in the city by the year 2007. Ward-level committees headed by councillors will be constituted to coordinate health and sanitation activities. The committees will have their own funds.

Monitoring cells will also be set up in the hospitals under the Corporation to tackle epidemic outbreaks and take up awareness campaigns. The Corporation will supply medicines to the hospitals.

17 more dengue cases

By Our Staff Reporter

THIRUVANANTHAPURAM July 9 . At least 17 new cases of confirmed dengue fever were reported at various hospitals in the city and suburbs on Wednesday.

According to officials, the extraordinary feature was the confirmation of dengue infection in 10 adults at a private hospital in the city. This is the first time since the dengue outbreak that the admission of adults has outnumbered child patients, who are most vulnerable to the mosquito-transmitted disease.

Of the new cases, eight were reported from various Corporation wards and one each from Pangappara, Poonthura, Nedumangad, Vilappil, Manamboor, Peringadavila, Kallara and two from Nemom.

Meanwhile, the Chief Minister, A.K. Antony, has convened a review meeting on Friday with District Medical Officers, Medical College professors and a cross-section of Health officials to assess the dengue threat and effectiveness of preventive measures undertaken so far.

Viral fever deaths mount to 24

By Our Staff Reporter

THIRUVANANTHAPURAM July 8. The total number of viral fever-related deaths in the district mounted to 24 with six more patients, including two children, succumbing to acute fever complications at the Medical College and SAT Hospital in Thiruvananthapuram on Monday.

The child victims, Sharath (three-and-a-half years) and Selvian (two-and-a-half) were referred to the SAT from Amboori and Adimalattura respectively.

While three adult patients died during emergency care at the Medical College, another person with a fever spiral was brought dead to the hospital, officials said.

The pathological cause of the adult deaths is yet to be determined.

There have been nine dengue deaths and two death due to leptospirosis in the district so far.

Meanwhile, various health care institutions in the district reported an estimated 2,867 viral fever cases on Monday, sources said.

Dengue infection was confirmed in three new patients, including two women in the city and suburbs.

Besides a 22-year- old male patient from Attoor, a 39-year-old woman patient from Vattappara and a 30-year-old patient from Peroorkada, have been admitted to the Thiruvananthapuram Medical College.

State seeks Central aid to support HIV victims

By Our Special Correspondent

THIRUVANANTHAPURAM July 8. The Health Minister, P. Sankaran, has said that the State Government has approached the Centre and the National AIDS Control Society for funds to offer financial support to HIV victims. Addressing a function in connection with the release of the biennial report of the State Management Agency (SMA) here today, Mr. Sankaran said that it was not enough to tackle AIDS at a preventive level and emphasis should be given in generating awareness about the disease.

He said the Government had prepared a programme of action to tackle dengue fever. This included conducting awareness campaigns, fogging in each ward of all panchayats, launching of special squads to carry out door-to-door campaigns in sanitation in the panchayats. He said the Government proposed to convene a meeting of District Collectors to decide on the implementation of the programme.

The Health Secretary, K. Ramamurthy, said that AIDS control activities in the State had failed to address the issue in totality and that it was necessary to redraft the entire intervention strategy. He said the scope for Government intervention was limited to providing guidelines. However, non-governmental organisations had an important role in spreading the concept of partnership in sexual health because they could reach out to the targeted people.

Along with AIDS control and awareness activities, the State would soon have to address allied issues like discrimination of HIV victims. He said the Government proposed to distribute 20 lakh condoms free through petrol bunks. M.N. Gunavardhanan, Additional Secretary, Health and project director of the Kerala State AIDS Control Society, (KSACS), said that AIDS had become a vicious circle and a more comprehensive programmes were required to tackle the issue.

Mr. Babu Joseph, president of the Partners Forum, a group of NGOs working in the field of AIDS control, called for a mass movement against AIDS. He said that the magnitude of the disease was such that there should be a definite shift in strategies. At present, AIDS control activities were aimed at the target groups. Kerala had achieved its unique record in family welfare through a mass movement. A similar movement was required in AIDS control, he added.

DMO flays private hospitals over fever statistics

KOCHI: How many people in the district have been affected by Dengue fever and Leptospirosis heat that have gripped the district for the last two months? Health officials put the figure somewhere around 120 and 103 in both cases, adding that the statistics is not complete.

But the data available from the private laboratories around the city tell a different story. And the office of the District Medical Officer feels that the private hospitals are not co-operating with the campaign of the Government officials to control the outbreak of Dengue fever and Leptospirosis in the district.

‘‘What can we do? Majority of the private hospitals never bother to report all the cases of fever admitted there even though we keep reminding them,’’ says Dr Sumathy, District Medical Officer (DMO).

Dr Sumathy points out that not one of the private hospitals reported the cases on Sunday even when the DMO office has a 24-hour cell functioning exclusively to handle these cases and collect the number of patients.

But the private hospitals maintain that they keep informing the DMO’s office every day. ‘‘We report the cases before 2 p.m. every day with complete address of the patients,’’ say the officials of Medical Trust hospital, where 106 people came for treatment for viral fever. Most of the cases that are tested at the private labs in city are referred from private hospitals in and around the district. Out of the 216 cases tested at the Medivision Laboratory, 90 were tested positive for Dengue fever. And, of the 171 samples which came for testing, 22 were tested positive for Leptospirosis.

And the story is more or less the same in other labs, making clear that the district health officials are losing much information regarding the number of patients undergoing treatment for these complicated varieties of fever. ‘‘We get data from the primary health centres which give us statistics from their areas and that is our main source.

Apart from direct information from hospitals we rely on the reports from the health centres in primary and block levels,’’ says Dr Krishnankutty, Deputy DMO. But he adds that some information could be missed in their data.

Meanwhile two new cases of Dengue fever have been reported today from the district. ‘‘Private hospitals are laying emphasis on treatment and not prevention of these diseases. Even though we gave a class on preventive measures to the public relations officers of all the hospitals before the monsoon season, nothing has come up,’’ said the DMO.

Municipality to battle epidemics

TRIPUNITHURA: The Tripunithura municipality will start distributing preventive medicines and start implementing precautionary measures to curb the rising cases of epidemics.

Free medicines will be distributed from various centers like Eroor Homoeopathic Clinic and other Primary Health Centres from Monday onwards. Social organisations are also actively taking part in the campaign. The Tripunithuram Merchants' Union unit donated medicines worth Rs 10,000 to the Taluk Hospital on Saturday.

The medicines include costly life-saving drugs. "We will continue the supply of medicines till these epidemics are eradicated from the area," said A M Raju, unit president of Merchants Union.

The students and staff of the Government Ayurveda College had already started distributing medicine kits containing traditional remedies against viral fever and dengue fever. They had also conducted several health camps at the thirty-two wards in the municipality. Meanwhile five cases of dengue fever were confirmed in the municipal area and the affected people are presently undergoing treatment in various hospitals.

Dengue fever is caused by a unique variety of mosquitoes which are active during daytime especially in the evenings. The students and staff of the Ayurveda college are also engaged in an awareness campaign to help the locals contain these disease causing mosquitoes with a unique medicinal smoke.

"Clean surroundings and hygiene are very important to contain the spread of these disease causing mosquitoes," says Dr Murali, RMO, Government Ayurveda College.

Three new cases of dengue fever in city

By Our Staff Reporter

THIRUVANANTHAPURAM July 6. At least three new cases of dengue fever and two cases of confirmed Leptospirosis were reported in the city on Sunday.

According to officials, the dengue cases were reported from Goureesapattom, Thycaud and Kottapuram.

The Leptospirosis cases, referred from Pangappara and Arattukuzhi, were admitted to the Medical College Hospital.

Dengue has so far claimed nine lives in the district and Leptospirosis two while there have been 18 deaths due to viral fever complications.

2003-07-05T20:05:00.000-07:00

Central team hints at another epidemics outbreak

THIRUVANANTHAPURAM: A three-member team from the Central Health Ministry which was here to take stock of the epidemic outbreak in the State said that another outbreak could not be ruled out as the vector density was still very high.

"As far as the Dengue fever is concerned, death is almost a certainty in the case of those getting infected for the second time," said the team at a news conference.

Health Minister P Sankaran, who also attended the news conference, said that the Central team appreciated the Government's initiatives in tackling the threat posed by epidemics in the State.

He said that only 30 new posts had been created in the Health Services since 1961 and this had affected the quality of the service.

Considering the gravity of the issue, the Government had initiated several corrective steps in this regard, he said. The decision to appoint doctors on contract basis was one such step, he added.

More hospitalised with dengue fever

By Our Staff Reporter

THIRUVANANTHAPURAM July 5. Ten new cases of dengue fever have been confirmed in the district on Saturday, taking the total number of confirmed cases in the district so far to 185.

Except for one case at the SAT hospital, all other confirmed cases have been admitted to the Medical College hospital.

Also, nine persons were newly admitted to hospitals here on Saturday of suspected dengue fever. One new case of malaria has also been reported from Poovar.

The number of persons with fever and related complaints who reported at the outpatient clinics at the primary health centres in the district today stood at 1,825.

The confirmed cases of dengue fever have been reported from Kumarapuram, Peroorkada, Thozhuvancode, Mukkola, Vattiyoorkavu, Poonthura, Manacaud, all within the Corporation limits and from Murukkumpuzha, Ottasekharamangalam and Kottukal.

So far, 11 cases of leptospirosis, one case of cholera, two cases of typhoid and 90 cases of malaria have been reported in the district. Of the 185 cases of dengue fever, 144 cases are of children below 12 years and 41 of children above 12 years.

A review meeting of medical officers in the district was held on Saturday to assess the situation and the sanitation work being undertaken in various wards.

The District Medical Officer, E. K. Madhavan, said that as dengue cases were still being reported in the district, it could not be said that the epidemic was on the decline.

Meanwhile, the Indian Medical Association has warned of serious consequences unless preventive measures are initiated on a war footing against the string of epidemics that has gripped the State.

When dengue fever can be contained to a large extent through mosquito-control programmes, the fact that the disease has spread shows the ineffectiveness of the vector control programmes, the IMA said in a statement here.

The Health department and the local governing bodies were to be equally blamed for the spread of dengue epidemic, for though it has been six weeks since dengue began to be reported, vector-control programmes have not been launched comprehensively, it said.

Faster, cheaper rat fever test to be put on trial

KOZHIKODE: The Gwalior-based Defence Research and Development Establishment (DRDE) will soon conduct a large-scale clinical trial of a new antigen detection system for the early diagnosis of Leptospirosis (rat fever) at the Medical College Hospital here.

A demonstration of the new system was held in a private hospital here a few months back. If successful, the system would be a major breakthrough in tackling the killer disease, which has become a major threat in Kerala. Laboratory tests and evaluations of the new technique have been successful, sources said.

World Health Organisation’s consultant for Leptospirosis Dr Harshavardhan Batra, who developed the antigen detection method, will lead a team of scientists for the clinical experiment. Batra is also the Joint Director of the DRDE, a research institute under the Defence Ministry.

The new antigen detection kit would do away with all the shortcomings of the methods used at present, sources said. It is claimed that under the new method Leptospirosis could be diagnosed on the same day a person gets infected with the disease and the result would be available within two hours. The test would cost less than Rs 50.

A major obstacle in the treatment of Leptospirosis at present is the delay in confirming the disease. The diagnostic methods followed now, have several drawbacks, including the chances for false reports, according to experts.

Dark-field Microscopic Test, an antigen detection method, requires high-level of skills for the laboratory technicians. Besides, the yield would be very low.

Another detection method, the Polymerace Chain Reaction Test is costly, as a single test will cost Rs 1,200 to Rs 1,500.

Culturing the serum is another method. It would take one to six weeks to get the results due to the slow growth of the leptospira in the culture media. This test is also costly.

Hence, hospitals depend on IgM Elisa Test, an anti-body diagnosis method. However, this test is possible only after the patient develops the anti-body, which normally takes one to two weeks after the patient shows symptoms of the disease.

Fever incidence under control, claims Sankaran

By Our Special Correspondent

THIRUVANANTHAPURAM JULY 4. The Health Minister, P. Sankaran, and Secretary (Health), K. Ramamoorthy, claimed on Friday that the upsurge in fever cases in the State had plateaued out. The situation was under control and the incidence was expected to come down in the coming days.

Addressing a press conference here, they said that as many as 34 persons had died of dengue fever and 32 of leptospirosis this year. Besides, two died of typhoid and one of malaria. Of those died of dengue fever, 28 persons had died in June. They admitted that some deaths might not have been reported. (The unofficial count is about 200).

The Minister said that the larger number of cases had been reported from Thiruvananthapuram, Thrissur, Kottayam, Alappuzha, Ernakulam, Malappuram, Kozhikode and Kannur districts. The experts from the National Institute of Communicable Diseases, R. C. Sharma, V. K. Raina and U. V. S. Rana, had toured three districts and their report was awaited.

The experts, who were present at the press conference, said that the dengue fever would be most harmful if a person caught it the second time. Hence, a second outbreak in Kerala could be very dangerous. Rubber plantations were found to be the biggest breeding ground of Aedes Aegypti mosquitoes, which spread the disease, with mosquitoes breeding in the coconut shells used for collecting latex.

Tests conducted last time, they said, had shown that about 50 per cent of the cattle in affected areas carried viruses causing leptospirosis, besides rodents. Steps should be taken to collect urine of cattle in pits to prevent viruses from reaching water sources and surface soil. Early diagnosis and treatment could save many patients.

The Minister denied that patients were not getting proper treatment at the Medical Colleges and other Government hospitals. There had not been any shortage of blood at the Medical College here. Anticipating the need for more bloods, requests had been made to the Regional Cancer Centre and the Sree Chitra Medical Centre here.

Steps had been taken to appoint doctors on contract basis and fill up vacant posts. Promotions and posting had also been speeded up. Noting that there was shortage of doctors, the Minister said that the period for which Government doctors could go on leave had been reduced from 20 years to 10 years. Government service by doctors passing out from Medical Colleges would be made mandatory.

He said that the Government proposed several long-term measures to improve sanitation in the State. Waste management facilities would be taken up in each panchayat. Proper maintenance of drainages, roads and market places and supply of adequate drinking water would be ensured. As short-term measures, source reduction, fogging, spraying and other vector control activities had been started. Local Self-Government (LSG) leaders were to supervise vector control and public awareness campaigns. About ten per cent of the budgets of LSGs were to be earned for public health activities.

He said that several clinics had been started in medical colleges and Government hospitals. Medical camps were being conducted in problem areas. Medicines needed for the next two weeks had been stocked. Committees had been formed with district collector as chairman to monitor disease control activities.

Youth dies of suspected dengue fever in MCH

By Our Staff Reporter

THIRUVANANTHAPURAM July 4. A 30-year-old youth hailing from Kattakkada died due to viral fever complications at the Medical College here today.

According to hospital sources, the youth, Aji Kumar, had been admitted to the hospital on Thursday and died this morning due to gastrointestinal bleeding brought on by a suspected dengue attack.

Though the death has not been serologically confirmed as being due to dengue fever, the nature of death had a striking resemblance to a dengue-triggered fatality, hospital sources said.

Meanwhile, seven new cases of confirmed dengue were reported today with at least four of them from the Corporation area. Four of the patients, all children, were admitted to the SAT Hospital, two to the General Hospital and one to a private hospital.

The dengue cases were reported from Karamana, Pattoor, Karakkamandapam, Poonthura, Pangappara, Kachani and Kallara. One case of malaria has also been confirmed in a 26-year-old youth from the Thonnackal Primary Health Centre.

According to the District Medical Officer, the highest number of concentration of dengue positive cases has been in the Corporation area, with 56 cases being reported from various wards in the city.

The number of total confirmed dengue cases for the entire district currently stands at 175. Children have borne the brunt of the mosquito-transmitted infection with an estimated 126 children being treated at the SAT Hospital alone.

The health squads of the City Corporation today conducted medical camps in the Sasthamangalam and Kanjirampara wards and undertook house-to-house visits to spread awareness on preventing infectious diseases.

Meanwhile, the CPI(M) district secretary, M. Vijayakumar, has alleged that the Government was slack in launching preventive measures to check the spread of infectious diseases in spite of diseases like dengue and leptospirosis taking a heavy toll of children and adults across the State.

The CPI(M) leader said that shortage of staff and medicines persisted at Government hospitals. The party would stage a dharna involving representatives of the Corporation, municipality, district panchayat, block and grama panchayats, in front of the University college from 10 a.m. to 5 p.m. on Monday in protest against the allegedly lax response of the Government to the serious situation, the statement said.

Kerala disputes death toll due to dengue fever

IANS

THIRUVANANTHAPURAM: The Kerala government on Friday disputed reports putting fatalities in the state due to dengue fever at over 150, and said the disease had claimed only 34 lives in the last six months.

Kerala Health Minister P. Sankaran told a news conference here that 28 deaths were reported last month, the largest number in a single month since January.

"Leptospirosis has also accounted for 32 deaths in the past six months and the total deaths including in private hospitals is 99," said Sankaran, who was flanked by three doctors from the National Institute of Communicable Diseases (NICD) in Delhi.

He said that the state health department was working overtime and had started fever clinics at six medical colleges, district hospitals and block hospitals.

"We have spent close to Rs.20 million for purchase of medicines to tackle this," he said.

In sharp contrast to the government's figures, media reports have indicated that there has been a drastic increase in people arriving at hospitals across the state with fever over the last 10 days.

These reports have put deaths due to dengue fever alone at over 150.

State health secretary K. Ramamoorthy disputed this figure and said the exaggeration is due to clubbing of deaths due to other forms of fever with dengue cases.

"We have now asked even private hospitals to report the actual admission of patients identified with dengue fever and also other deaths," said Ramamoorthy.

U.V.S. Rana of NICD said the Kerala government was doing a "great job" of educating people and helping them face the outbreak of dengue fever. Rana, however, admitted that there was a shortage of facilities in hospitals for clinical examination.

"As per the World Health Organisation guidelines, in case of epidemics, tests need be done for five percent cases, while treatment is given to all patients suspected of having the disease," said Rana.

Sankaran noted the state was facing a severe shortage of doctors in government hospitals and only 41 new posts for doctors had been created since 1961.

"We have been conducting walk-in interviews for doctors to meet any case of urgency. Fifteen doctors were selected today," he said.

Eight new dengue cases reported from city

By Our Staff Reporter

THIRUVANANTHAPURAM July 3. Dengue infection has intruded into the heart of the city on Thursday with at least four of the eight new admissions of confirmed dengue cases being reported from the Corporation precincts.

Four children with confirmed dengue cases hail from the Medical College, Manacaud, Pettah and Ambalathara areas. Three other children with confirmed cases are from Nedumangad, Balaramapuram and Kachani, and a 40-year-old patient from Venganoor was also admitted with dengue fever to a private hospital.

Of the child patients, three are under treatment at the SAT Hospital, two at the Women and Children's Hospital and two in private hospitals.

Meanwhile, an 11-year-old girl from Nalanchira has been admitted to the SAT Hospital with confirmed leptospirosis. According to the District Medical Officer, there were more than 4,053 viral fever admissions at health centres in the district.

Epidemic control drive on: Health squads of the Corporation are fanning out across the city to intensify the epidemic control programme taken up by the local body. The squads have started house-to-house visits to spread awareness on various diseases and methods to prevent them. Neighbourhood meetings and distribution of medicines are also progressing.

Two medical teams deputed by the Ayurveda Medical Education Directorate today visited the Chengalchoola colony in the Secretariat ward and Lenin Nagar in the Palayam ward. They distributed water purifying agents, preventive medicines and mosquito repellents.

The Health standing committee chairman, K.C. Vikraman, the working group chairman, Attipra Asokan, ward councillors and officials led the campaign. A release issued here today said the campaign would cover the Sasthamangalam and Kanhirampara wards on Friday. A meeting of Ayurveda, Allopathic and Homoeopathic medical officers will be convened to review the progress of the drive.

Top medical team lands in Kochi to study fever outbreak

KOCHI: A high-level team of medical experts landed here on Tuesday to collect details regarding fever outbreak in the district.

The team which includes Dr U V S Rana, Dr S K Jain and Dr V K Reina, Joint Directors of National Institute of Communicable Diseases (NICD), met district health officials and visited areas from where cases of fever have been reported in the last few days.

Meanwhile, two new cases of dengue fever were reported from the district on Tuesday. Anand Ram Sharon of Kakkanad and Ammini Amma from Kalady were diagnosed to be suffering from dengue fever and are undergoing special medical treatment. District Medical Officer (DMO) Dr V K Sumathi called a a meeting of district-level programme officers to evaluate measures to control fever.

And to tackle the issue, health officials have directed hospital development committees to buy medicines for the treatment of viral fever. A technician has been appointed at the Public Health Lab to test blood samples.

The Cochin Corporation has intensified measures to control the spread of fever with awareness campaigns and mosquito eradication programmes.

The Ayurveda and Homoeopathy departments are also taking active part in the campaign by distributing medicines to prevent fever. Camps have been opened at various Ayurveda hospitals to give medicines and treat fever cases.

Outbreak of epidemics: Corporation chalks out preventive measures

THIRUVANANTHAPURAM: The Thiruvananthapuram Corporation has chalked out various preventive programmes against communicable diseases.

A meeting was convened on Monday at the Corporation lounge for discussing the urgent measures taken for preventing dengue fever and other diseases.

Mayor J.Chandra, who inaugurated the meeting, said that five workers each had been assigned on a daily-wage basis to clean open drains in the wards. These workers were in addition to the regular workforce of the Corporation. She said that tipper lorries were also provided for the speedy removal of waste accumulated in the drains.

The Mayor said that power spraying machines had been provided to health committees to eradicate mosquitoes. A worker each had been provided to each ward to use hand sprayer in individual households as part of the programme.

Extra power sprayers would be provided for eradicating mosquitoes from larger water bodies, she said.

Chandra said that fogging would be resumed in the city soon.

She recalled that fogging was stopped earlier following complaints that it increased the tendency for respiratory diseases.

Measures had been taken to remove waste materials from collection points and councillors had been asked to oversee the removal of waste.

The Corporation had allotted a vehicle to Manacaud market for collecting waste of meat. Stringent measures would be taken against dumping of waste by the roadside. Health inspectors and junior health inspectors would be assigned to monitor the situation.

Health standing committee chairman K.C.Vikraman said that medicines for fever had been made available at the primary health centres of the Corporation.

He said that ward-level committees would be constituted to curb the dumping of waste on the roads and to oversee the health sanitation measures.

The councillor and the health inspector would be the chairman and the convener of the committee. He said that litter-free zone programmes would be spread to all wards in the city. The meeting was also addressed by ayurveda and allopathy medical practitioners.

Dr Jyothilal of Government Ayurveda College said that special teams had been constituted to visit those areas from where fever cases had been reported.

The hospital had also been distributing medicines for improving the overall health status of people, he said.

Dengue fever: 9,337 hospitalised

THIRUVANANTHAPURAM: Health Minister P.Sanakaran on Tuesday said that so far 9,337 persons affected by dengue and viral fever had been admitted to various hospitals in the State.

He was inaugurating the distribution of the State-level awards for best doctors for 2000 and 2002 on the Doctor’s Day at the Kanakakkunnu Palace here.

The Minister appealed to the doctors and the public to be vigilant and active in checking the spread of epidemics.

The Health Department had already spent Rs 5.35 crore to control the diseases and sought Central and WHO aid.

Sankaran presented the awards to eleven best performing doctors in different fields.

They were Dr.K Jyothindrakumar, Dr.N.Subramania Iyer, Dr.Fazil Marickar, Dr.Charles.J.Mandi and Dr.N.N.Asokan (for year 2000) and Dr.V.Rajan, Dr.T.U.Sukumaran, Dr.K.Rajukumar, Dr.V.V.Radhakriahnan, Dr.R.Rajendran, Dr.V.Bharathan (for year 2002).

Dengue fever: 66 admitted to various district hospitals

KOZHIKODE: As many as 66 persons were admitted to various hospitals in the district on Tuesday following acute fever, said an official release.

Among them, three are suffering from dengue fever. However, no rat fever case was reported from the district on Tuesday.

Around 28 persons were admitted to the Government Hospital in Vadakara alone. Ten others were admitted to Malabar Institute of Medical Sciences (MIMS), here.

Eight persons are undergoing treatment at the Government District Hospital at Beach, here.

Dengue incidence high in seven districts

By Our Staff Reporter

THIRUVANANTHAPURAM July 2. An expert group, which met here on Wednesday to review the upsurge of Dengue fevers sweeping across the State, has concluded that the incidence of mosquito-transmitted disease was highest in seven districts.

According to the panel, the highest concentration of Dengue cases were in Thrissur, Kannur, Kottayam, Ernakulam, Malappuram and Kozhikode.

According to statistics, 31 dengue-related deaths and 584 seriously diagnosed cases have been reported so far.

The alacrity of the Health services and Medical College teams in launching containment measures such as establishment of fever clinics, space spraying, fogging and intensive information, education and communication campaigns for propagation of personal protection measures was pointed out by the group.

The panel noted that though there might have been more variants of viruses and different serotypes, the epidemic was brought under rein and had started showing a declining trend. The panel recommended stepping up the IEC campaign to dispel apprehension and panic among the masses.

According to the experts, dengue fever is usually mild and required no special treatment other than with paracetamol, rest and fluid intake. Only a fraction of dengue patients develop Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Dengue fever has been described as a non-specific fever like any common viral fever with muscular pain and body ache as associated features.

Specific advice to the people is not to use any antipyretic other than paracetamol, refer fever cases to the neighbourhood physician, and suspected DHF/DSS should be reached to a major hospital as soon as possible.

The only preventive measures available for mosquito control are the resort to personal protective methods such as use of net, ointments and other repellents besides cleaning the environment by eliminating mosquito breeding sources.

The panel meeting chaired by Health Secretary, K. Ramamoorthy, was represented by Rajamohan, SAT Superintendent, K. Sreekanthan, associate professor and head of infectious diseases, MCH, K. T. Shenoy, Head of Gastroenterology, MCH, Noel Narayanan, paediatric expert, A. Joesph, research director, KIMS, L. S. Valsala, Head of MCH PEID Cell, K. L. Sarada Devi, Regional Institute of Microbiology, A. Aysha Beegom officer on special duty, Health Services and S. P. Ravikumar, mass education officer.

Meanwhile, at least six fresh cases of confirmed Dengue, including a nine-month-old infant, and one case of Leptospirosis were reported in the city and suburbs on Wednesday.

Three children, including the nine-month-old child who hails from Vithura, have been hospitalised in the SAT, and two children have been admitted to a private hospital, while a 55-year-old adult patient is under treatment at the General Hospital.

The Leptospirosis case was reported at the Kesavapuram PHC in the district, officials said.

Intensified drive to control epidemic

By Our Staff Reporter

THIRUVANANTHAPURAM June 30. The City Corporation is embarking on an intensified epidemic control programme from July 1.

The first phase of the integrated ward-level programme will be organised from July 1 to July 10, the Mayor, J. Chandra, said here today. She was inaugurating a meeting to review the activities under the action plan to combat the outbreak of dengue and viral fever.

The meeting decided to divide the 81 wards into three sectors and launch a grassroots level campaign for epidemic prevention and treatment. To monitor health and sanitation activities, a 30- member ward committee will be constituted with the councillor as chairman and the Health Inspector as convener. The committees will be formed before July 5.The campaign will integrate Allopathic, Ayurveda and Homoeopathy systems of medicine. All the Public Health Centres, Ayurveda dispensaries and Homoeo hospitals in the city limits will remain open from 10 a.m. to 5 p.m. Kudumbasree units and Area Development Societies will coordinate with Public Health Centres and dispensaries to convene neighbourhood meetings to create awareness about the epidemic threat.

The 23 Mother and Child Welfare Centres under the Corporation will function from morning to evening under Junior Public Health nurses. Mike announcements will also be organised in all the 81 wards.

The meeting decided to ensure daily removal of garbage from collection points. Vector control activities will also be stepped up. Household-level larvicide spraying will be supplemented with power spraying and hand fogging.

The Corporation has directed hotels to avoid dumping animal wastes by the roadsides. They have been instructed to take animal wastes to the Manacaud dumping site between 6 p.m. and 8 p.m. The local body has procured sufficient stocks of medicines for distribution.

The chairman of the Health Standing Committee, K.C. Vikraman, presided over the meeting. The health and sanitation working group chairman, Attipra Asokan, the Health Officer, L. Jayalakshmy, councillors and Corporation officials, medical officers of PHCs and hospitals, community organisers and health workers participated in the meeting.

Seven new dengue cases in city

By Our Staff Reporter

THIRUVANANTHAPURAM June 30. At least seven new confirmed cases of dengue were reported in the city and suburban panchayats on Monday.

While five patients, including four girls, from Kannanmoola, Vembayam, Manamboor, Kallara and Povatthur, were admitted to the SAT Hospital, two adult patients from the Palode and Amboori areas were hospitalised at the Medical College Hospital (MCH).

As part of the Health Department's preventive campaign against vector-borne diseases, children at the Naduveli Government School in Vembayam, undertook a pledge to contribute to personal and environmental cleanliness at their school and home to ward off infectious diseases.

The District Collector, E. Ayyappan, the district panchayat president, Sasikala Sivasankar, the District Medical Officer, E. K. Madhavan, and the panchayat member, Anil Kumar, were among those present. Similar pledges will be administered at school assemblies at all educational institutions in the district.

Health promotion teams have been constituted at ward-levels to carry out vector control measures primarily by focusing on cutting off breeding sites for the mosquitoes by maintaining environmental hygiene. Besides respective ward members, the involvement of junior public health nurses and `ayalkoottams' would be enlisted for the sustained campaign. Each team has been assigned to visit 250 houses.

Later, the Collector chaired a meeting of panchayat officials to review the dengue threat in the district and to decide on further course of action.

A special meeting of grama panchayat heads is scheduled for the second week of July to review the effects of the measures taken so far and to strengthen preventive measures.

2003-06-30T11:11:00.000-07:00

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.

2003-06-24T20:55:00.000-07:00

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.

2003-06-24T20:48:00.000-07:00

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.

2003-06-20T20:42:00.000-07:00

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.