Mixed Outbreak DD 2012

7/30/2019 Mixed Outbreak DD 2012

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WEST BENGAL

Uttar Dinajpur

N

Dakshin Dinajpur


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Block - Khaspur Block - Kumarganj


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Dakshin Dinajpur, a remote and backwarddistrict covered by international border with

Bangladesh from three sides

Paddy, the main economic produce, is

cultivated by flooding irrigation and jute is

drenched in dirty cesspools for fibre

breeding grounds of mosquitoes

Crises in agriculture enhances massivemigration of work force throughout India


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Outbreaks of Acute Encephalitis Syndrome

(AES) & influenza are common in North

Bengal districts; kala-azar endemic

Occasionally malaria, dengue & chikungunia

are reported

Outbreaks are usually

Not reported

Not investigated


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25th August: 2012 Four children of Narayanpur, Chakjayanti, Kuchila &

Kamarara villages suffered from acute onset of high

fever, headache, convulsion & loss of sensorium

They were admitted in District Hospital and then

referred to North Bengal & Maldah Medical Colleges

Several villagers from Narayanpur, Munglishpur,

Madhavpur were suffered from fever, chill, malaise,

anorexia, weakness, with or without severe joint painand admitted to Kumarganj BPHC & Balurghat DH


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26thAugust to 25th September 2012:

Total 384 fever cases from 15 and two villages of

Kumargunj and Khaspur blocks were reported

Few cases from adjacent Tapan and Gangarampur

blocks & Balurghat municipality

33 patients were admitted in different hospitals

Seven patients died

Several guardians brought their children with feverand vesicular eruptions at different OPDs


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Local health authorities initiated control

measures and sent Block RRT

House to house visit, fever surveillance,line listing, symptomatic treatment, blood

slide & sample collection, admission of

serious patients and health education

Outreach fever clinics, BCC, convergence

with block administration, PRI, ICDS &

schools, lab. investigation, daily reporting


9/17

District Rapid Response Team intervened

Visited all affected villages

Intensified and supervised control measureCoordinated with all line departments

Prompt & extensive IEC - meeting, miking,

leafleting, flex, television advertisement

Opening of health facilities on holidays

Arrangement of lab. investigation at NBMC


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Treatment & critical care support to serious

cases at District Hospital & NBMC&H

Visit by State Level Team from MaldaMedical College to affected villages

Visit & collection of species by Central Level

Entomological Team from ICMR (Madurai)

IRS with focal spraying in affected villages

ULV insecticide fogging in municipality area


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Blood samples of earlier cases not sent RDK & blood slides for malaria: - ve

208 blood samples were investigated

JE: 3 + ve, 6 equivocal;Dengue: 4 + ve, 40

reactive; Chikungunia: 2 + ve

Influenza & HFMD could not be tested

Attack Rate: 0.76; Case Fatality Rate: 1.92


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It was a mixed outbreaks of Japanese

Enchephalitis (JE), Dengue, Chikungunia

and suspected Influenza & Hand Foot

and

Mouth Disease (HFMD) at a time Influenza and HFMD were clinically

diagnosed, not confirmed in laboratory


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Continuation of lab tests at NBMC&H, a

overnight journey

Management of post

AES complications Posts of BSI, MI & MTs in blocks and

Epidemiologist, VBD consultant, AMO & DSI

in the district are vacant

Most of the spray workers are old and sick

Existing agriculture & animal rearing pattern


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Introduce use of impregnated bed nets

Induce cleanliness, personal protection,

source reduction, landscaping, proper waterstorage, increased treatment seeking

Segregation of pets from living rooms and

proper hand washing & hygiene practice

Fogging with neem cake in the evening

Special care and protection for children


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Strengthen disease surveillance & IDSP

Develop Fever Clinics and Drug Depots

Perform RDK & rk 39 testing, blood slides &sample collection where indicated

Availability of Mak Eliza kit at District Lab

Introduction of JE vaccine in routineimmunization

Commissioning CCU/ITU at District Hospital


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Director of Health Services, Government of West Bengal

DDHS (Malaria), Government of West Bengal

State Nodal Officer, IDSP, West Bengal The Principal, Head & faculties, Pathology, NBMC&H

Chief Medical Officer of Health, Dakshin Dinajpur

Dy.Chief Medical Officer Health-I, Dakshin Dinajpur

DMCHO, Dakshin Dinajpur

ACMOH (Sadar), Dakshin Dinajpur Superintendent, Balurghat District Hospital, Dakshin Dinajpur

Chairperson & Health Officer, Balurghat Municipality

BMOHs, Kumarganj & Khaspur and all BPHC staff

MO,Pathologist & his team, Balurghat District Hospital

IDSP Data Manager, DEO IDSP, HS (M), NVBDCP file

All staff, Public Health Wing, CMOH Office, Dakshin Dinajpur


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Mixed Outbreak DD 2012