An Approach of Acute Encephalitis Syndrome in Muzaffarpur, Bihar; A Different Perspective | Chapter 13 | Innovations in Medicine and Medical Research Vol.2

Acute encephalitis syndrome (AES) is a disease characterized by fever and mental confusion, disorientation, delirium, or coma. It could be due to various causes such as viruses, bacteria, fungus, parasites, spirochetes, chemical, and toxins. This chapter is an outcome of an Epidemiological investigation of AES occurred in Muzaffarpur, Bihar in 2011 which was done by a team consisting of experts from various disciplines. The team visited Muzaffarpur, from 14th to 20th July 2011 and reviewed the situation of deaths among children due to AES, as directed by the Authorities. A total of 147 cases of fever with altered sensorium were admitted between 11th June to 18th July 2011 in a private hospital and a Medical College Hospital of Muzaffarpur. Out of these, 54 patients died indicating case fatality rate of 36.73%. Clinico-epidemiological and environmental evidence supports the diagnosis of Acute Encephalitis Syndrome which has significant mortality, affecting predominantly rural population with poor sanitation and presence of wild rats. No significant association of litchi consumption and poor nutritional status of children with AES disease were found. Evidences suggest that there were increased chances of contacts between cases and wild rats during the period of occurrence of outbreak. Key observation was the sudden drop in incidence of cases with rainfall as during and just after the rain children abandons the outdoor games in farmlands/ litchi gardens due to accumulation of water in these areas and exposure from the rodents prevented Etiological agent could not be identified by laboratory tests. Time, place and person distribution of cases is suggestive of infectious disease of short incubation period (<1 day) having wider spectrum of sub clinical and clinical phases & lifelong immunity after first infection.

Author(s) Details
Dr. Anil Kumar
Directorate General of Health Services, Ministry of Health & Family Welfare, India.

Deepika Karotia
National Leprosy Eradication Program, India

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Knowledge and Awareness of Anthrax among the Community People at High, Medium and Low Risk Areas of Bangladesh | Chapter 04 | Emerging Research in Medical Sciences Vol. 3

A cross-sectional survey was conducted to assess information about the awareness, attitudes and management practice towards Anthrax. Administrative areas of Bangladesh had been classified as high, medium, and low risk anthrax areas by assessing the risk of anthrax from reports published in daily newspapers and journals. The selected high, medium and low risk areas were Kushtia, Pabna and Mymensingh, respectively. The animal owners and family members, butchers, affected people by cutaneous anthrax were considered as the key informants. Data of management practice including feeding, awareness of zoonosis; vaccination and formal education were collected using interview-questionnaire method. A total data of 622 was collected and uploaded to the data collection tools “Magpi” and the data analysis was carried out using Epi Info™. We found a great worry about educational status in our study sites. Among the interviewers, we found about Half of people had no formal education (46.46%, 289/622). Farmers in the high risk districts significantly more aware of anthrax compared to those from medium-(p=0.000) and low-(p=0.000) risk districts. Knowledge of zoonosis of Anthrax and vaccination of Anthrax were also very poor among the people from low and medium risk areas. For treatment purpose, most of the farmers (about 98%) of high and low risk areas depend on village doctors. We also found that Improper washing of grass-(p=0.000) and flood-(p=0.000) were significantly responsible for Anthrax outbreaks. Finally we suggest, proper washing of grass, increase awareness towards zoonosis of Anthrax and vaccination, proper treatment by veterinarian should be insured to reduce Anthrax outbreak in Bangladesh.

Author(s) Details

K. H. M. Nazmul Hussain Nazir
Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymeinshg-2202, Bangladesh.

Md. Ariful Islam
Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymeinshg-2202, Bangladesh.

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