At Baba Raghav Das (BRD) Medical College and Hospital in the eastern district of Gorakhpur, over 250 kilometers from the capital Uttar Pradesh, 15-year-old Lalita is battling for her life. She has been on a ventilator for the past 10 days.

Like Lalita, there are over 60 children battling the scourge of encephalitis in a crowded ward. Many lie unconscious or are on a drip. Often two or three children are squeezed onto a single bed.

Once again, Japanese encephalitis has struck parts of Uttar Pradesh, India's most northern state. The district typically experiences an outbreak of the disease after the monsoon season when moribund water left after the rains becomes an ideal breeding ground for mosquitoes, which transmit the disease.

The flooding of fields at the start of each cropping cycle often leads to an explosive build-up of the mosquito population and this can cause the circulation of the virus to spill over from usual hosts (mainly birds and pigs) into the human population.

Brain fever

The disease, which is referred to locally as brain fever since it causes inflammation of the brain tissue, causes high-grade fever, headaches, respiratory problems and convulsions and can lead to death.

"This dance of death has become an annual feature," cries Lalita's distraught father Jagdish Singh. "Why can't the government do something? Why can't this stop?"

"If this has been the case every year, what is the district administration doing about it?" agrees Janali, whose six-year-old daughter was recently admitted to the hospital. "Isn't this a shame?"

Working against the clock

Doctors in Uttar Pradesh are struggling to cope with the situation and health and social welfare departments, are working overtime to arrest the spread of the disease, which has killed over 500 people, mostly children, over the past two months.

"Even though the change in the weather has now reduced the daily inflow of patients to the nodal centre in the hospital, the virus is still killing at least two people every day," Dr K P Kushwaha, the head of the encephalitis programme at BRD medical college, told Deutsche Welle.

Last year 560 out of 3,300 admitted to the hospital for the disease died. The Uttar Pradesh government has sanctioned three million US dollars to combat the disease.

By declaring a "national health emergency," the government, which has come under criticism for failing to do enough to contain the disease, has now decided to pull out the stops. Indian Health Minister Ghulam Nabi Azad has hurriedly formed a task force to curtail the outbreak of the killer virus and rush in medical teams. "This will require intervention from the ministries of drinking water and sanitation, social justice and empowerment and women and child development," he said.

So far this year, seven people have tested positive for the virus in the capital New Delhi. Since 1978, an estimated 50,000 people have died of the disease in India.

Author: Murali Krishnan
Editor: Anne Thomas