100-bed paediatric ICU to be set up in SKMCH, Muzaffarpur within a year: Centre to SC

Source: asianage.com

New Delhi: The Centre on Monday filed a reply in the Supreme Court on the AES outbreak in Bihar, saying that a decision has been taken to set up a 100-bedded paediatric ICU at Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur in one year with funds from it.

Five virology labs were set up in different districts of the state and 10-bedded paediatric ICUs will also be established in different districts, it said.

The reply submitted that despite the fact that health is a state subject, the central government had taken all steps for giving necessary help and assistance to the Bihar government to contain the outbreak.

The death toll due to Acute Encephalitis Syndrome (AES) mounted to 140 in Muzaffarpur district on Friday.

As per official data, 119 deaths have been reported at the government-run SKMCH, which is handling the largest number of patients in the district, while 21 deaths have been confirmed at Kejriwal Hospital.

The state has been battling with the vector-borne disease for the past several weeks.

AES is a viral disease that causes flu-like symptoms such as high fever, vomiting and in extreme cases, brain dysfunction, seizure, and inflammation of heart and kidney.

The Supreme Court had on June 24 expressed “serious concern” over the rising number of deaths due to the disease.

Bihar Chief Minister Nitish Kumar has announced a compensation of Rs 4 lakh each to the families of the children who died due to AES.

AES in Bihar: Providing all support to contain it, Centre tells SC

Source: business-standard.com

The Centre told the Supreme Court Wednesday that it was proactively providing all support to Bihar in containing and managing Acute Encephalitis Syndrome (AES) in which more than children have died.

In an affidavit filed on a plea seeking measures for containment of the disease, the Centre said Union Health Minister Harsh Vardhan had visited Bihar on June 16, to review the situation in Muzaffarpur.

It said that after the visit several decisions were taken including construction of a 100 bed Paediatric Intensive Care Unit (ICU) at SKMCH hospital in Muzaffarpur by the state government in one years from the funds of National Health Mission (NHM).

“The land for the same (100-bed Paediatric ICU) is available in the premise of the SKMCH hospital and will be provided by the state,” the affidavit said.

It said a decision has been taken to set up five virology labs in different districts of the state from the NHM funds and the location of the districts will be decided in consultation with the state government.

Detailing further decisions taken, the Centre said: “In the adjoining districts, 10-bed Paediatric ICUs to be setup so that such cases can be treated early and there is no unnecessary load on the facilities available at SKMCH. Funds for this are to be provided through NHM.”

The ministry said that to enable early detection and treatment of the hypoglycemia cases, a dedicated team of doctors will be placed in endemic Primary Health Centres with required facilities, at least for three-four months before and during expected onset of disease.

“As for present, the concerned PHCs and CHCs (Community Health Centres) should take prompt corrective measures for hypoglycemia at the facility itself to utilize the golden hour”, the affidavit said.

It said that a Super Speciality Block is being constructed at SKMCH hospital, Muzaffarpur and it would start functioning by first week of December.

Besides these steps, the affidavit said that Ministry of Earth Sciences has been requested to upgrade its IMD Observatory facility for improved monitoring of climate related parameters such as temperature humidity, rainfall and share it with the state government for better preparedness and management of AES.

It said the minister has decided to constitute inter-disciplinary, high quality research team for ascertaining the case of AES with specific reference to Muzaffarpur.

“The vacant positions of district epidemiologist and entomologist in Muzaffarpur to be filled up immediately by the state government,” the health ministry said added that health is a state subject as per the Constitutional provisions.

The apex court is hearing a petition filed by advocate Manohar Pratap who has said that he was deeply “pained and saddened” by the deaths of more than 126 children, mostly in the age group of one to 10 years, in Bihar due to AES.

Besides Centre, the apex court had also asked Bihar government to file its response on the issue.

In a shocking revelation about medical care facilities in Bihar, which is facing an outbreak of acute encephalitis syndrome, the state government Tuesday told the Supreme Court that there are only 5,205 doctors in government-run health centres against the sanctioned strength of 12,206.

The state government, in an affidavit filed in the apex court, said that only 5,634 nurses were there in government run hospitals and health centres against sanctioned strength of 19,155.

The court had on June 24 directed the state to apprise it about the status of public medical care facilities, nutrition and sanitation within a week in view of deaths of over 100 children in Muzaffarpur due to the outbreak of AES.

Regarding AES cases, the state government said 824 cases have been reported and the number of deaths was 157.

It, however, said that it was not known whether 24 deaths out of 215 cases were due to AES.

“State of Bihar had already taken all possible steps to prevent the spread of the disease by providing additional medical facilities at the affected region, public awareness campaign at the village level, involving various agencies to assist the government etc,” it said.

Symptoms of AES include high fever, convulsions and extremely low blood sugar levels. Among the factors said to trigger the syndrome are malnutrition.

There were more than 44,000 cases and nearly 6,000 deaths from encephalitis in India between 2008 and 2014, said a 2017 study published in The Indian Journal of Medical Research (IJMR).

Researchers said the patients often report acute onset of fever and altered consciousness, with a rapidly deteriorating clinical course, leading to death within hours.

Litchis grown in Muzaffarpur, the country’s largest litchi cultivation region, are said to contain a toxin which can cause a drop in blood sugar levels if consumed by a malnourished child.

Bihar’s affidavit in SC depicts poor state of healthcare facilities in state

Source: business-standard.com

In a shocking revelation about medical care facilities in Bihar, which is facing an outbreak of acute encephalitis syndrome, the state government Tuesday told the Supreme Court that there are only 5,205 doctors in government-run health centres against the sanctioned strength of 12,206.

The state government, in an affidavit filed in the apex court, said that only 5,634 nurses were there in government run hospitals and health centres against sanctioned strength of 19,155.

The court had on June 24 directed the state to apprise it about the status of public medical care facilities, nutrition and sanitation within a week in view of deaths of over 100 children in Muzaffarpur due to the outbreak of AES.

Regarding AES cases, the state government said 824 cases have been reported and the number of deaths was 157.

It, however, said that it was not known whether 24 deaths out of 215 cases were due to AES.

“State of Bihar had already taken all possible steps to prevent the spread of the disease by providing additional medical facilities at the affected region, public awareness campaign at the village level, involving various agencies to assist the government etc,” it said.

Giving details of the status of available clinical human resource, the Bihar government said there was 57 per cent and 71 per cent vacancy of doctors and nurses respectively.

In case of lab technicians and pharmacists, the vacancy stands at 72 per cent and 58 per cent of the sanctioned strength, the affidavit said.

“It is respectfully submitted that the overall human resources available in health system in the state is not as per standard norms,” the affidavit said, adding that health department has taken steps to recruit medical officers, para-medical and other technical support staff.

It said that requisition for recruitment of 4,012 general duty medical officers and 2,425 specialist doctors has been sent to the Bihar technical services selection commission.

The state government said that Chief Minister Nitish Kumar himself “is personally involved and actively engaged in finding ways and means to control and treat the dreaded AES disease” in Bihar.

It said that the state, in cooperation with the Centre, All India Institute of Medical Sciences and other agencies, has simultaneously provided all medical facilities to treat the affected children.

“The steps taken up by the State has prevented spread of the disease and has reduced the fatality rate arising out of the AES disease,” it said, adding, “In view of the steps taken by the state of Bihar, the fatality rate has come down to 19 per cent whereas the global fatality rate of AES is around 30 per cent”.

“In view of the constant and consistent efforts taken by the state of Bihar and in view of the change in weather conditions, there is a substantial reduction in number of reported cases of AES and JE in the State. The state of Bihar would continue its efforts to prevent any such condition in future,” it said.

The state government said that malnutrition is associated with the issue of sanitation and safe drinking water and they are already working on sanitation and hygiene issues under the ‘seven-nischay yojana’.

“It is respectfully submitted that the state government has initiated a socio-economic survey in affected areas to ascertain socio-economic factors behind AES incidence to initiate vigorous and coordinated campaign with the active involvement of the concerned departments to bring about speedy improvement/change in the socio-economic status of the relatively poor people who are mainly susceptible and vulnerable to the threat of AES disease,” it said.

The state government said that they are fully aware and “quite conscious of recurrent resurfacing” of AES cases in Bihar and has been continuously taking steps to protect and save precious human lives.

Besides Bihar, the apex court had also asked the Centre to file response on the issue.

The apex court is hearing a petition filed by advocate Manohar Pratap who has said that he was deeply “pained and saddened” by the deaths of more than 126 children, mostly in the age group of one to 10 years, in Bihar due to AES.

“The deaths of children are a direct result of negligence and inaction on the part of the respective state governments of Bihar, Uttar Pradesh and Union of India in handling the epidemic situation which arises every year due to outbreak of AES also called Japanese encephalitis,” the plea said.

The petitioner has also sought directions for all possible steps to stop the disease outbreak in the earlier epicentre, Gorakhpur in Uttar Pradesh, and to create awareness about preventive steps and first aid.

Symptoms of AES include high fever, convulsions and extremely low blood sugar levels. Among the factors said to trigger the syndrome are malnutrition.

There were more than 44,000 cases and nearly 6,000 deaths from encephalitis in India between 2008 and 2014, said a 2017 study published in The Indian Journal of Medical Research (IJMR).

Researchers said the patients often report acute onset of fever and altered consciousness, with a rapidly deteriorating clinical course, leading to death within hours.

Litchis grown in Muzaffarpur, the country’s largest litchi cultivation region, are said to contain a toxin which can cause a drop in blood sugar levels if consumed by a malnourished child.

Drunk occupants of pvt vehicles can be prosecuted under Bihar prohibition law: SC

Source: business-standard.com

The Supreme Court Monday said that a private vehicle in Bihar is defined as a “public place” by the state’s prohibition law and if a person is travelling drunk, police have the power to prosecute.

A bench comprising Justices Ashok Bhushan and K M Joseph made the observation while deciding on an appeal filed by some persons, who were travelling to Patna from Jharkhand’s Giridih on June 25, 2016 in a private vehicle after consuming liquor, and were arrested by police.

Their vehicle was stopped for routine checking at a police post in Nawada district of Bihar and when subjected to breath analyser test, it was found that they were drunk.

Though, no liquor bottles were found in the vehicle, they were arrested by the police and remained in custody for two days.

They had moved the apex court challenging a Patna High Court’s February 16 last year judgement dismissing their application seeking to set aside an order passed by the magistrate who had taken cognisance of the offence punishable under the provision of the Bihar Excise (Amendment) Act, 2016.

The counsel appearing for them contended before the apex court that no offence was made out under the provision of the 2016 Act and the vehicle in which they were travelling cannot be said to be a “public place” within the law.

The counsel appearing for Bihar countered the submissions and said that their vehicle was intercepted at a public road and no error was committed by the magistrate in taking cognisance of the offence.

“We have to further take into notice that private vehicle of the appellants was intercepted when it was on the public road. When private vehicle is passing through a public road it cannot be accepted that public have no access. It is true that public may not have access to private vehicle as matter of right but definitely public have opportunity to approach the private vehicle while it is on the public road,” the bench said in its verdict.

“Hence, we are not able to accept the submission that vehicle in which appellants are travelling is not covered by definition of ‘public place’ as defined in Section 2(17A) of the Bihar Excise (Amendment) Act, 2016,” the bench said.

The bench also dealt with the contentions of the counsel appearing for the appellants who said that offence under the provision of the Act can only be committed when liquor was consumed in a public place.

The bench noted that as per Bihar Prohibition and Excise Act, 2016, even if a person consumes liquor outside the state and enter into the territory of Bihar and is found drunk or in a state of drunkenness, he can be charged with offences under section 37(b) of the Act.

“We, however, cannot take a decision on the above issue in this appeal. Whether charge that consumption of liquor has taken place within the state of Bihar is made out in the facts of the present case are questions which need to be decided by the Magistrate after looking into the materials brought on record by means of the charge sheet,” the bench said.

The bench granted liberty to the petitioners to file an application seeking discharge before the magistrate.