Filaria
Lymphatic Filariasis is a serious debilitating and incapacitating disease. The transmission of filaria is through mosquitoes namely Culex quinquefasciatus. The infected person may develop swellings of limbs and genitals which keep on increasing, making the person incapacitated and suffering from social stigma as well. The person also suffers from frequent attacks of lymphangitis; high fever, swelling and pain. There is no cure at this stage and person is forced to live with huge swellings prone to secondary infections. This disease has been reported from over 250 districts in 20 States and UTs wherein over 500 million people live.
The National Filaria Control Programme is being implemented in the country since 1955. At present, about 52 million urban populations is being protected through recurrent antilarval measures by 206 control units and 199 filaria clinics. Delimitation of the problem is being done by 27 filaria survey units.
A pilot project on single dose annual mass DEC drug administration was undertaken during 1997 in 13 districts of 7 endemic states, covering a population of about 41 million. By 2003, 31 districts were brought under Mass Drug Administration. The National Health Policy (2002) has envisaged goal of Lymphatic Filariasis Elimination by the year 2015. In the year 2004, 202 endemic districts of 20 States in the country with a target population of 407 million were targeted for MDA. A population of 276.2 million was covered against eligible population of 380.2 million indicating the coverage rate of 72.6 per cent. In 2005, 229 districts in 19 States/UTs implemented MDA except Tamil Nadu where MDA could not be implemented due to unprecedented rain and flood. On account of intensive advocacy drive from the highest level of the Government of India to the District levels and massive social mobilisation, 346.89 million population was covered against eligible population of 434.49 million indicating the coverage rate of 79.84 per cent.
Dengue Fever/Dengue Haemorrhagic Fever
Dengue fever is a viral disease, which is transmitted by Aedes aegypti mosquitoes. The Aedes mosquito's breed in clean water in man made containers such as water coolers, discarded tyres, disposable cups, flower vases and other water storage containers. The first outbreak of Dengue fever/DHF was reported from Kolkata in 1963. All the four serotypes of dengue are prevalent in India. Dengue viral infection may remain a symptomatic or manifest either as undifferentiated febrile illness (viral syndrome), Dengue Fever (DF) or Dengue Hemorrhagic Fever (DHF).
However, in recent years, Dengue is increasingly being reported from Semi-urban and rural areas, due to expanding urbanisation and lifestyle changes. The most affected areas are West Bengal, Delhi, Kerala, Tamil Nadu, Gujarat, Karnataka, Maharashtra, Rajasthan, Punjab and Haryana. During 2005, 11985 cases and 157 deaths were reported, mainly on account of an outbreak in West Bengal. During 2006, so far 744 cases with 5 deaths (upto June) have been reported. As there is no specific treatment for Dengue, the emphasis is on avoidance of mosquito breeding conditions in homes, workplaces and minimising the man-mosquito contact. Community awareness and participation as well as inter-sectoral collaboration are crucial for effective control of Dengue. In addition, enactment and enforcement of appropriate Civic bye laws and Building bye laws should also be stressed upon in all urban areas to prevent mosquitogenic conditions in line with the Delhi, Mumbai, Goa, Chandigarh, etc.
Japanese Encephalitis
Japanese Encephalitis is an acute viral illness with high case fatality and long term complications. The vector breeds in large paddy fields and similar large water bodies. The vector is an outdoor rester and feeder. This habit of vector mosquito makes the control strategy difficult. J.E. has acquired serious magnitude in the states of Uttar Pradesh, Andhra Pradesh, West Bengal, Assam, Tamil Nadu, Karnataka, Kerala, Bihar, Goa, and Haryana. During 2005, there was an epidemic outbreak in Uttar Pradesh which increased the total number of cases to 6727 and deaths to 1682. During 2006, 72 suspected cases of JE/viral encephalitis have been reported with 30 deaths till May. There is no specific treatment for JE. Efforts were being made by States and Government of India to contain JE outbreaks by instituting various public heath measures including selective JE vaccination. Considering the value of vaccination in prevention of JE, the Government of India has launched a JE vaccination programme during 2006 for children between 1 and 15 years of age in 11 districts of 5 states (Uttar Pradesh, Bihar, Assam, Karnataka, and West Bengal). This has been made an integral component of Universal Immunisation Programme. Other endemic districts will also be covered with JE vaccination in a phased manner using single dose live attenuated SA-14-14-2 vaccine.
