India Launches Encephalitis Vaccination

The Associated Press
Wednesday, July 26, 2006; 5:13 AM

-- Last year, dying children stood outside hospitals in northern India waiting for an empty bed during one of the worst encephalitis outbreaks in recent memory. Now, they're lining up again for hours to receive a shot that could save their lives.

Since May, nearly 11 million children ages 1 to 15 have been vaccinated against mosquito-borne Japanese encephalitis in high-risk areas of four northern Indian states, U.S.-based nonprofit group PATH said Tuesday.

It was the first-ever mass immunization campaign to fight the brain-damaging virus, and many skeptics doubted it would ever happen this fast.

But the 2005 outbreak, which killed about 1,800 children and left many survivors permanently disabled with physical and neurological damage, sparked a wave of quick action rarely seen within India's bureaucracy-clogged government.

Critical news reports and images of unconscious children lying two to a bed led to a public outcry, and India's top health officials promised to take action before the next rainy season, said Dr. Julie Jacobson, director of PATH's Japanese Encephalitis Project.

"They latched on to the idea of vaccine being the answer," said Jacobson, who pushed for six years for the vaccination campaign. "All the rest of the stuff doesn't work. They've been (having outbreaks) for 30 years, and it keeps happening."

Most victims live in the poorest corners of India, typically surrounded by rice paddies in farming villages. The mosquitoes transmit the virus from pigs and birds to humans. Since most infected people never develop symptoms, many adults are immune from earlier exposure _ leaving young children most vulnerable.

Japanese encephalitis is closely related to West Nile virus but is found only in Asia. It attacks the central nervous system, damaging the brain and spinal cord. High fevers are often followed by seizures and comas, and many children need ventilators to breathe.

An estimated 50,000 cases _ more than 10,000 of them fatal _ occur annually, the World Health Organization says. Up to a third of survivors suffer problems ranging from paralysis to mental disabilities.

India's vaccination campaign was based on a partnership with China.

The Chinese have virtually wiped out the disease after making their own vaccine and distributing it widely since 1988. It is made from a weakened form of the virus and given in one shot that protects for a lifetime.

India produces limited amounts of another vaccine, used widely in Western countries. It is more expensive, harder to manufacture and requires multiple injections. Even at full capacity, the sole Indian manufacturer could only reach a fraction of children in need.

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