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Climate change fuels rise of Japanese Encephalitis in Madhya Pradesh

Madhya Pradesh reports rising Japanese Encephalitis cases, with climate change fueling outbreaks. Experts link erratic weather to mosquito breeding. The govt has launched vaccination drives, mosquito control, and awareness campaigns to curb the spread.

By Wahid Bhat
New Update
Japanese Encephalitis in Madhya Pradesh

A young patient in the pediatric ward battles Japanese Encephalitis (JE) as Madhya Pradesh faces a surge in cases. Photo credit: Ground Report

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In the past six years, Madhya Pradesh has reported 295 cases of Japanese encephalitis and 10 deaths. The most recent victim is a 15-year-old girl from Gwalior, who is battling for her life in a private hospital. The girl is hospitalised in critical condition with symptoms of vomiting, severe headaches, and high fever.

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Japanese encephalitis also abbreviated as JE has become a growing health concern in Madhya Pradesh. Experts attribute the rise in cases to extreme weather events such as erratic rainfall and heatwaves. The state’s vulnerability to these climatic shifts has prompted the government to include JE in its climate action plan. Traditionally, cases of this mosquito-borne disease were limited, but recent years have seen a significant increase, with cases reported across 29 districts. The viral infection, which causes severe brain inflammation, can be fatal. 

The disease caused by the Japanese Encephalitis Virus (JEV), transmitted primarily by Culex mosquitoes, has become a public health concern, exacerbated by extreme weather events like erratic rainfall and heatwaves. Reportedly  25.4% of pediatric Acute Encephalitis Syndrome (AES) cases in the state tested positive for JE, with outbreaks peaking during monsoon seasons. In response, the state government has launched vaccination campaigns, integrated JE prevention into its climate action plan, and implemented mosquito control and public awareness measures to address the rising threat.

A study conducted in northeastern Madhya Pradesh revealed that 25.4% of pediatric patients with Acute Encephalitis Syndrome (AES) tested positive for the Japanese Encephalitis Virus (JEV). The disease was more prevalent among male children, with the highest number of cases reported in Rewa, Satna, Sidhi, and Shahdol districts.

The study highlighted that most Japanese Encephalitis (JE) cases occurred during the monsoon and post-monsoon seasons, as these periods provide ideal conditions for mosquito breeding, a critical factor in virus transmission. It noted, “Climate change can influence the spread of diseases like Japanese Encephalitis by altering temperatures. Warmer conditions may extend or shorten the mosquito breeding season, increasing the likelihood of virus transmission.”

Extreme weather increases Japanese encephalitis 

Similar research done around the world has shown that extreme weather events, erratic rainfall, and extreme heat influence the risk of JE infections. A 2013 study in China revealed, “Global warming can change temperature and rainfall patterns, which may impact how mosquitoes and the JE virus develop and spread. Humidity is also crucial, as mosquitoes can live longer and travel further in areas with the right moisture levels, increasing the risk of transmission”.

Saraswati river Indore
Saraswati River of Indore. Photo credit: Ground Report

Other research from Taiwan also highlights that both climate change and agricultural practices, such as rice farming and pig rearing, are major factors in JE outbreaks. Since pigs are key carriers of the virus, changes in farming create more breeding grounds for mosquitoes.

Closer home, a study conducted in Assam and Manipur found a surge in JE cases during the monsoon season.  As per the study, warmer weather is extending the rice-growing season, leading to prolonged mosquito breeding. The Culex mosquito, which spreads JE, thrives in stagnant water, commonly found in paddy fields. 

Madhya Pradesh is experiencing more frequent extreme weather events than any other state in India, including heatwaves, heavy rainfall, and droughts. According to the State of Extreme Weather 2024 report by the Centre for Science and Environment (CSE), the states faced 176 days of extreme weather in 2024, almost double the national average of 90 days. Reports suggest warmer temperatures accelerate mosquito life cycles and enhance the replication of pathogens within them, leading to higher transmission rates of diseases such as dengue and malaria.

Similarly, changing rainfall patterns, including heavy precipitation and flooding, create ideal mosquito breeding conditions, raising the risk of disease outbreaks. Madhya Pradesh’s rainfall data reflects these fluctuations, with 2,174.5 mm recorded in 2021 and 2,614.7 mm in 2022. Rainfall statistics show that Madhya Pradesh recorded 2174.5 mm of rainfall in 2021 and 2614.7 mm in 2022, reflecting significant weather fluctuations. 

Knowing the virus

The mosquitoes that cause JE breed in stagnant water, often in agricultural lands and areas with high humidity. While the virus typically affects animals like pigs and water birds, humans can also be infected when bitten by an infected mosquito. However, humans are considered "dead-end" hosts, meaning they cannot transmit the virus to other humans.

Contaminated water tribals use in Patalkot
Muddy water that Tribals in Kaream use for their daily chores Photograph: (Ground Report)

 According to the World Health Organisation (WHO), the disease has acute symptoms like high fever, headache, vomiting, and neck stiffness, progressing to confusion, seizures, and coma. Children are particularly vulnerable, with a high risk of long-term neurological disabilities in survivors.

According to experts, JE can cause permanent nervous system damage, with a high mortality rate of 30% to 50% among survivors. Given the absence of antiviral treatment, prevention through vaccination and mosquito control remains the best strategy to mitigate the disease's impact.

Rise in Japanese Encephalitis cases

According to the National Centre for Vector Borne Diseases Control data, in 2018, the state reported no cases. However, in 2019, there were 42 cases and one death. In 2020, cases dropped to 11, but three deaths occurred. In 2021, cases increased again, with 29 cases and four deaths. In 2022, there were 70 cases but no fatalities. In 2023, there were 34 cases but no deaths. In 2024, JE cases surged again with 109 cases and two deaths, underscoring the virus’s unpredictability.

In Madhya Pradesh, particularly around Rewa, cases of Japanese Encephalitis (JE) among children surged between August 2020 and October 2021. A study at Gandhi Memorial Government Hospital in Rewa revealed nearly 25% of acute encephalitis syndrome (AES) cases tested positive for JE, mostly during the monsoon and post-monsoon seasons, the peak period for vector mosquitoes. The research, which included 110 pediatric patients, highlighted the severe impact of JE, with 11 deaths. This marked an alarming trend, suggesting a rising prevalence of JE in Madhya Pradesh, an area historically not known for such large-scale outbreaks.

According to various studies, JE cases in Madhya Pradesh are reported in both rural and urban areas, with Bhopal and Rewa experiencing significant outbreaks. The state's health department is grappling with controlling the disease alongside other mosquito-borne diseases like malaria, dengue, and chikungunya. The rise in JE cases has raised concerns about public health preparedness and the ability to address the virus's spread.

Why in State’s climate action plan?

Madhya Pradesh has integrated the control of JE and other vector-borne diseases into its climate action plan. The state is experiencing changing weather patterns, including extreme temperatures, varying rainfall, and fluctuating humidity, creating an ideal environment for mosquito breeding. These shifts have made vector-borne diseases like JE more prevalent, necessitating a multifaceted approach to disease control and climate adaptation.

Madhya Pradesh launched a statewide vaccination campaign to combat Japanese Encephalitis (JE), targeting children aged 1 to 15 in high-risk areas like Bhopal and Rewa. The campaign aims to inoculate over nine lakh children, with plans to integrate the JE vaccine into routine immunization—administering the first dose at nine months and a second at 16 months.

Japanese Encephalitis in Madhya Pradesh1
The entrance to the Pediatric Ward, where young patients are treated for serious illnesses like Japanese Encephalitis. Photo credit: Ground Report

Bhopal's Chief Medical and Health Officer, Prabhakar Tiwari, emphasizes JE's high fatality risk for children under 16 and the importance of vaccination, as there is no natural immunity. While recent cases in Bhopal saw full recoveries, proactive immunization remains crucial in preventing outbreaks.

Dr Tiwari confirms,

"Once this campaign is completed, we plan to include the vaccine in routine immunisation. In this phase, children will receive two doses: the first at nine months and the second at 16 months. It is crucial to administer this vaccine to all children, as there is no natural immunity against Japanese encephalitis."

Besides vaccination, the health department is emphasising vector control measures, including eliminating mosquito breeding sites. Awareness campaigns are urging citizens to reduce mosquito populations by avoiding stagnant water and maintaining cleanliness. These measures are crucial in preventing JE spread, especially during the monsoon season when mosquitoes thrive.

The state government is strengthening its healthcare infrastructure to cope with the increasing burden of climate-sensitive diseases. The Health Adaptation Plan on Vector-Borne Diseases aims to raise awareness about the links between climate change and the rise in mosquito-borne illnesses. The plan includes training for healthcare workers, community health workers, and district officials to recognise and respond to outbreaks of JE and other vector-borne diseases.

The plan focuses on integrating climate data, like temperature, humidity, and rainfall patterns, into the disease surveillance system to predict outbreaks and allow for timely interventions. Increased rainfall during the monsoon season may lead to more mosquito breeding, prompting heightened vigilance and control efforts.

Public awareness and capacity building

The government claims that they are investing in public education to reduce JE transmission risk. Information Education and Communication (IEC) campaigns are informing vulnerable communities about mosquito control and vaccination. These campaigns target rural and urban populations, as JE can affect both. Community health workers, like ASHAs and Anganwadi workers, are being trained to educate families about the disease, its symptoms, and prevention.

Handpump in DObra Village of Sehore
Government hand pump installed in Dobra village, Photo credit: Ground Report

As part of the initiative, the government has introduced training programs for medical officers and healthcare providers to enhance their ability to diagnose and manage JE cases. District-level workshops focus on disease surveillance, early detection, and post-disaster vector-borne disease management. These efforts aim to strengthen the healthcare system’s capacity to respond effectively to outbreaks.

While Madhya Pradesh is the focal point of the current JE outbreaks, the disease remains a major public health crisis across India, especially in the east and north. Uttar Pradesh, Bihar, Assam, and West Bengal have reported significant JE cases, with Uttar Pradesh being one of the most affected. In Uttar Pradesh, as in Madhya Pradesh, the disease is linked to the monsoon season when mosquito populations peak.

The National Centre for Vector-Borne Diseases Control (NCVBDC) and other health authorities in India are combating JE through vaccination campaigns, mosquito control programs, and public awareness initiatives. Despite these efforts, the disease remains a challenge, especially in rural areas with limited healthcare and vaccination access. 

Edited by Diwash Gahatraj

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