Weak surveillance led to zika outbreak in MP

BHOPAL: Concluding that weak routine surveillance was a major contributor to zika cases spiralling in Madhya Pradesh, the Centre will soon start a fourday surveillance and outbreak investigation training programme for epidemiologists in the state.

“There will be two training modules on surveillance and investigation. It won’t just be zika-specific but for most communicable diseases,” said Dr BN Chouhan, director, state health department, who met the team members on Friday.

Since October 23, when the All India Institute of Medical Sciences (AIIMS), Bhopal, confirmed the first case, 128 cases of zika have been reported from six districts. Results of 16 samples

SINCE THE FIRST CASE WAS CONFIRMED BY THE ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS) BHOPAL ON OCTOBER 23, 128 CASES OF ZIKA HAVE BEEN REPORTED FROM SIX DISTRICTS.

sent for testing on Friday are awaited.

“Unlike in Rajasthan, where cases were picked up in routine surveillance and intensified measures put in place immediately after the first case, things got delayed in MP as cases did not show up in surveillance,” said an official from the Union health ministry, requesting anonymity.

Bhopal, Vidisha and Sehore districts have reported 122 cases, with Sagar, Raisen and Hoshangabad districts reporting two cases each.

An 18-year-old man and a 23-year-old woman who died during the corresponding period tested positive for zika, but their deaths were not documented as zika deaths as they were carrying other, more deadly infections.

The man also suffered from Japanese encephalitis and the woman had uncontrolled diabetes and sepsis (severe blood infection)

The state health department officials said routine surveillance had been going on since June for all vector-borne diseases, including malaria and dengue.

“We didn’t intensify surveillance to begin house-to-house surveys and mass testing for zika because no cases showed up in routine tracking,” says Dr Ajay Baroniya, joint director, state health department.

There were no delays at the state level, he said. “During an outbreak situation, the intensified drive starts on the directive of the Centre.

The central team reached Bhopal on October 30 and asked us to intensify our surveillance and we immediately did so on November 1. If they had directed us earlier, we would have started accordingly,” said Baroniya.

Manoj Jhalani, mission director, National Health Mission, who visited the state on Tuesday, said, “The teams should have got active when three cases were reported from different places. There should be better coordination among agencies, such as health, civic and urban development.”

At times a week is all that’s needed for vector-borne diseases to spread, say experts.

“Though it also depends on population density, vector-control measures should start from the detection of the very first case for maximum benefit.

“Since zika is a new infection, we need to see how the virus behaves,” said Dr Neena Valecha, director, National Institute of Malaria Research.

Dr Sarman Singh, director, AIIMS, Bhopal, said, “Luckily for us, it isn’t a virulent virus, at least not the strain that is in circulation.

It will die down on its own, especially with drop in temperature.

The next two to three weeks are critical.”