The World Health Organization (WHO) recently launched a technical brief that highlights encephalitis as an emergency public health priority to address the growing global disease burden. Experts say the call is directed to a report on key national strategies to effectively address the disease as India continues to struggle to cope with the large and insufficient number of cases of encephalitis.
Encephalitis is an inflammation of the brain, and poses complex challenges due to its diverse causes, ranging from viral and bacterial causes to autoimmune responses.
The nature of cases of encephalitis in India
According to the WHO, Japan’s encephalitis virus (JEV) is a flavivirus associated with dengue, yellow fever and West Nile virus and is transmitted by mosquitoes and is found in 24 countries in Southeast Asia and the Western Pacific, with India carrying a considerable burden of disease. The annual incidence of JE globally can reach up to 10 cases per 1,00,000 people during outbreaks, or even higher. In India, several states continue to struggle with high incidence rates. Assam recorded 669 cases and 53 deaths in 2024, making it the most affected state, as reported by the National Center for Vector Transmission Disease Control (NCVBDC). Other states, such as Uttar Pradesh and Bihar, have also reported large numbers of cases.
Also, according to the The LancetIndia has experienced the largest outbreak of Chandipura virus (CHPV) in 20 years, including 245 cases of acute encephalitis syndrome (AES) and 82 related deaths reported initially on June 15, 2024. Among them, 64 cases of CHPV infection were CHPV infection, 61 cases of Gujarat and 3 cases of Rajasthan. The outbreak mainly affects children under the age of 15, and symptoms range from fever, convulsions, coma and death within 48-72 hours.
Swati Bhayana, a consultant for pediatric hematology and oncology at Fortis Hospital, said gurugram said encephalitis is a major problem for pediatric patients and viral infection is the main cause of children under the age of 18.
The number of newly reported AES cases has shown a downward trend since July 19, 2024, but it is possible further spread due to factors such as the upcoming monsoon season and flooding of stagnant pools in some states, which is the main breeding site for raising insects.
No state surveillance
Despite these numbers, experts point out that sporadic data points fail to capture the full scope of the problem. Neha Rastogi Panda, a leading expert in the field of infectious diseases in AIIMS in New Delhi, said one of the most important obstacles to addressing the burden of encephalitis in India is the lack of a unified reporting system. “What we are following now is a reactionary approach, not an action approach. Cases are usually only revealed during outbreaks. “No uniform reporting, no routine surveillance means we may just scratch the surface when the number of cases in the country,” she said. ”
Dr. Panda noted that such inadequate reporting makes the diagnostic tools of this inadequate unavailable, especially in peripheral health care settings. While tertiary centers may be able to use cerebrospinal fluid (CSF) testing and viral DNA analysis, such facilities are rare in rural areas. ”
Dr. Panda stressed the need for a powerful symptom tracking system. “We need to train frontline health workers to identify early signs such as light or sound, persistent headaches or sudden behavioral changes so that they can quickly alert the case,” she said.
She also noted the importance of mass vaccination drives, especially for JE, and improved the opportunity for antiviral treatment. “Ninety percent of cases of viral encephalitis are self-limiting, but in the rest of the cases, timely antiviral treatments may be life-saving. Accessibility and affordability of these treatments must be ensured,” she added.
These infections spread rapidly in low-immune children. Therefore, early suspicion and diagnosis are key to preventing the brain from spreading, Dr. Bhayana said. “Once encephalitis hits a child, their brains are at risk and they may suffer problems such as permanent seizures or hemiplegia attacks. “A missed infection can mean 40 years of a weak life,” she said. ”
Prevention, hourly demand
A more positive way to address the burden of encephalitis will include prevention, says P. Vijayashankar, a neurologist at Apollo Hospital in Chennai. “For example, we don’t have a separate encephalitis encephalitis program. We do have a JE vaccination program, especially in high-risk areas such as the Northeast and coastal areas, but for other forms of encephalitis, prevention is still difficult due to lack of awareness and diagnostic gaps,” he explained.
He stressed that mosquito control could be a crucial preventive measure: regular anti-large operations, proper waste management, and public education on avoiding water stagnation during the monsoon could go a long way. “Massive education is needed on the basics of the spread of the virus, the symptoms to be paid attention to, and the meaning of vaccination. Targeted public health campaigns can help bridge this gap.”
Experts say a dedicated prevention and control program separate from the existing vector disease framework will simplify diagnosis, improve vaccine coverage, and strengthen surveillance and ultimately help reduce the country’s disease burden.
publishing – February 28, 2025, 6:00 pm IST
