New Delhi (NVI): A number of diseases remain “unknown and unnamed” in India because of limited diagnostic facilities and poor testing available, according to an investigation report that was released at a webinar today hosted by Centre for Science and Environment (CSE).
At the webinar on “Mysterious diseases: The failure of disease surveillance in India” organised by CSE, experts agreed on the report which noted that India’s surveillance system is in shambles at a time when mysterious diseases grip the country.
The coronavirus (Covid-19) pandemic is a little reminder that how limited we understand about a disease and how it can wreak havoc across sections of society- be it poor or rich, according to the report. Thanks to a global research base and WHO, we at least know that it is caused by a coronavirus (SARS-CoV-2).
However, in the case of many “mystery diseases” that were discussed at the webinar, there has been no proper investigation to get to the root cause of the disease, says the report published by Down to Earth Magazine. Such diseases have affected children the most in some parts of the country and left the families devastated.
Vibha Varshney, associate editor, Down To Earth and the researcher-writer behind the investigation highlighted in her report that at a time when ‘mystery diseases’ grip India, surveillance is almost non-existent.
“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,” said Varshney in her presentation at the webinar.
“What we have found is that the system is in shambles,” she added.
The Down to Earth investigation has also listed some of the major mysterious outbreaks that have happened in the recent past.
For instance, since 2005, encephalitis cases have been reported every year from Gorakhpur and its neighbouring districts in Uttar Pradesh. It has been variously identified as Japanese encephalitis or connected to an enterovirus or the scrub typhus – mistakenly because the disease continues to kill.
In September 2019, more than 1,000 cases of fever were reported from village Chaan in Sawai Madhopur (Rajasthan). Just 28 blood samples were collected — 15 of these were found positive for dengue, chikungunya and scrub typhus.
Out of another 15 throat swab samples, three were found positive for the diphtheria pathogen; only two of the 570 blood smears tested positive for malaria. This still left many undiagnosed patients.
In February 2020, 15 deaths were reported from just one village, Kenduguda, in Malkangiri district of Odisha. The patients complained of swelling in the legs and stomach and acute respiratory problems. Medical teams from Malkangiri diagnosed that the deceased could be suffering from kidney or heart ailments, or anaemia, or tuberculosis.
“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,” said Varshney.
“The Nipah virus, for instance, was reported from Siliguri in 2001,and became an outbreak in Kerala in 2018. Cases of kalaazarare 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,” she said.
Also present at the webinar, Sunita Narain, Director General, Centre for Science and Environment (CSE), who anchored the webinar and moderated its discussions, said that such diseases if remain untraced, have the potential to turn in a Covid-19-like pandemic.
“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,” she said.
CSE DG Sunita Narain said that there is a need for the medical community to collaborate with media to indicates the first alarms of the outbreak of such diseases.
“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” she said.
-ARK