Diseases and outbreaks remain “unnamed and unknown”. One-third of fever outbreaks in India remain undetected because of limited diagnostic facilities and poor testing
Investigation report released at a webinar here today
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New Delhi, July 27, 2020: India’s National Centre for Disease Control (NCDC) has a special programme called the Integrated Disease Surveillance Program or IDSP, which brings together information of outbreaks from every part of the country. A new investigation by Down To Earth, the science and environment fortnightly, has found that despite such an elaborate system in place, a number of diseases remain
“unknown and unnamed” in India.
Says Vibha Varshney, associate editor, Down To Earth and the researcher-writer behind the investigation: “COVID-19 has changed our lives. But this cannot be the only new microbe which triggers diseases and kill people. There have been regular and numerous reports of outbreaks happening across the country – the first step in combating such outbreaks is understanding their nature, identifying them. Surveillance of diseases is the best way to keep a tab on emerging and re-emerging diseases. Our investigation was done to find out if India’s disease surveillance system is effective enough in taking that first step.”
She adds: “What we have found is that the system is in shambles.”
The Down To Earth investigation lists some of the major mysterious outbreaks that have happened in the recent past.
Down To Earth’s analysis of investigations by the IDSP covered the weekly outbreak reports available on the Programme’s site for 2019 and 2020 – IDSP reported 33 outbreaks of fever and 12 of acute encephalitis syndrome (AES) till week of March 16-22, 2020. While it kept the outbreak under surveillance in some cases, IDSP has not made the final outcomes public; neither are the results of further investigations on samples available. Says Varshney: “The Programme categorises these as ‘fever’, which is a symptom and not a disease -- hence, these can be referred to as fevers of unknown origin.”
Down To Earth researchers found that IDSP uploads its reports retrospectively – its last weekly alert is from as far back as March 2020. All states do not report; the report for March 16-22, for instance, is based on information received from only 17 states and Union territories (UTs).
Moreover, there are wide discrepancies in the number of states and UTs mentioned in the total tally and in the description list of the outbreaks. The IDSP also gives monthly reports, but these rarely provide any detailed information of all outbreaks. IDSP fails to use its allocated budget – “in 11 of the 13 years between 2004-05 and 2016-17, its expenditure was lower than the allocated budget,” says the Down To Earth investigation.
Says Varshney: “These ‘mystery’ diseases are of concern as there is an increased fear of emerging and re-emerging diseases. Researchers have identified 43 emerging and re-emerging viral diseases that threaten India today -- 23 of these are of zoonotic origin. There are reports that zoonotic diseases are spreading very fast across the country. The Nipah virus, for instance, was reported from Siliguri in 2001, and became an outbreak in Kerala in 2018. Cases of kala azar are coming up in Kerala, though the disease is typically reported from Bihar. These outbreaks can be fatal in absence of strategies and policies to fight them.”
Speaking at the webinar, Sunita Narain, director general, Centre for Science and Environment (CSE), who anchored the webinar and moderated its discussions, said: “What is alarming today is the declining interest in infectious diseases and in their control and prevention. We must remember that each of these mysterious diseases – perhaps perceived as ‘diseases of the poor’ -- have a potential to turn into a COVID-19-like pandemic. Today, COVID-19 has shown us that there is no class divide: the ‘diseases of the poor’ can affect and ravage the rich as well with equal ferocity.”
Summing up the discussions, she added: “We must have the wherewithal to find the causes of these diseases – we must catch it before it happens, in the words of the speakers who addressed today’s webinar. And in all this, the role that media plays is critical, especially in a scenario where official surveillance agencies are faltering – in many a case, the media’s has been the first voice to call out that there is a problem. This call must be heeded. The medical community can collaborate and work with the media to investigate these first alarms.”
For any other help on this subject, or to speak with our experts, please contact: Sukanya Nair of The CSE Media Resource Centre, firstname.lastname@example.org, 8816818864.
|The mystery behind mysterious diseases
By: Vibha Varshney, Associate Editor,
Down To Earth
|Demystifying a Mysterious Disease
By: Vipin M. Vashishtha, MD, FIAP Consultant Pediatrician, Mangla Hospital & Research Center, Bijnor
|“MYSTERIOUS” Disease OutbreaksA Symptom of Sick Disease Surveillance system
By: Dr. Rajan R Patil
Epidemiologist. Associate Professor, school of Public Health, SRM University, Chennai
|DTE: Cover story|
|STILL A MYSTERY
Annual tryst with unknown disease outbreaks once again highlights India’s defunct health surveillance system
|Anchor and Moderator|
director general, CSE,
associate editor, Down To Earth
|DR VIPIN VASHISHTHA
paediatrician, Mangla Hospital, Bijnor, Uttar Pradesh
|DR RAJAN R PATIL
associate professor, School of Public Health, Division of Epidemiology, SRM University, Tamil Nadu
|DR RAJIB DASGUPTA
professor, Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi