Kerala grapples with viral fever, lakhs affected

Official figures put the number of deaths at 203 but non-government organizations say the actual figures could be much higher. Pathanamthitta, Kottayam, Idukki, Alappuzha and Ernakulam are the worst-hit districts.

The first few cases of viral fever were detected in Pathanamthitta in late April and the fever wave slowly spread northward. Sever pain in the joints, inflammation of limbs, ulcers and rashes keep the affected people bed-ridden for at least two to three weeks.

Initially, central teams were rushed in May and even the assistance of the armed forces was sought on the request of the state government. Subsequently, the state government seemed to have got the grip of it last month but with recurrence of many incidences in July, a central government team, led by N.K. Ganguly, director-general of the Indian Council for Medical Research came to survey the affected areas early this week. The team confirmed that it was an outbreak of chikungunya.

Chikungunya fever is a viral illness that is spread by the bite of infected mosquitoes. The disease resembles dengue fever, and is characterized by severe, sometimes persistent, joint pain (arthritis), as well as fever and rash.

In 2006, 151 districts in nine regions--Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala and Delhi, witnessed sporadic incidences of chikungunya affecting more than 1.25 million.

Kerala health minister P K Sreemathy said in the state assembly on Wednesday that tests conducted by central medical experts on the blood samples collected from patients suffering from fever have confirmed that they were infected with chikungunya, allaying fears that some other kind of “mysterious" fever was spreading in the state. Ganguly said the incidence of chikungunya was on the decline -- from 25% of the viral fever cases to about 5%.

The state government was ready to get a study done by World Health Organisation, if necessary, Sreemathy said. The best way to check the spread of the disease was to destroy mosquito breeding centres and reduce the density of the insects, she said.

Sreemathy said the state government has recruited 748 doctors to the health department and deputed them to the affected areas. Admitting that the viral fever has been unprecedented, she claimed there has not been a single death due to the fever alone and it has proved fatal in those cases where the patients had other chronic ailments.

C.R. Soman, a public health expert and chairman of the activist organization Health Action by People, says such an epidemic threat has been in the offing for quite sometime. Soman, as well as other public health experts such as S Ramankutty, blame ecological changes. “When agriculture was the activity in the state, the use of pesticides in the paddy fields helped vector control. But in the ‘80s, agriculture land shrunk and the man-made pools, potholes and marshes became breeding grounds for mosquitoes," Soman says.

Blaming the state government for the collapse of the public health system, Soman added: “Lopsided views of development have changed the concept of public health with preventive action giving way to hospital-based curative activities."

Ramankutty says the government’s priorities have also changed. “Prevention and other such activities at the community level which was a major strength of the state in the ‘60s and ‘70s has not been the case any more," he says. “These outbreaks are outward manifestations of environmental degradation with no political party or group willing to intervene. Even at the community level, things do not go beyond temporary crisis management."

Economist and Kerala Planning Board member K.K. George says that such outbreaks point to the collapse of the much-acclaimed Kerala Model’. Strides made in public health and education in the ‘60s and ‘70s that gave the state high social indices has even been praised by Nobel laureate Amartya Sen as a model for development.

“The government has abdicated its role in public health and intervenes only during times of crisis," insists George. “It’s a hospital-centric health system and the public participation is lacking. Even local bodies whose traditional function is to ensure proper sanitation, sewerage system and waste management have abandoned their prime roles for the sake of local development activities."

PTI also contributed to the story.

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