Yogi Adityanath’s Claim on Encephalitis Deaths In Gorakhpur Not Entirely True. Deaths Have Reduced But Not To 0
While there has been a significant drop in encephalitis cases and deaths since 2017, the state still reported 36 acute syndrome encephalitis and Japanese encephalitis deaths in 2022
“Nowadays, no one dies of encephalitis,” claimed Uttar Pradesh (UP) Chief Minister Yogi Adityanath, on April 1, 2023, when talking about Gorakhpur. He also spoke about how UP was a model for the country in curbing communicable diseases, and that cases and deaths from encephalitis, kala-azar, malaria, dengue and chikungunya in various cities and districts in the state were under control.
To verify this, FactChecker visited Baba Raghav Das (BRD) Medical College, where doctors say most cases of encephalitis in Gorakhpur are treated, and found that though the number of cases and deaths have dropped between 2017 and 2023, the medical college reported 28 encephalitis deaths in 2022 and one death in 2023.
Gorakhpur’s BRD medical college and the Union government’s National Center for Vector Borne Diseases Control classifies encephalitis as Japanese encephalitis (JE) and acute encephalitis syndrome (AES).
The Ministry of Health and Family Welfare defines a case of AES as “a person of any age, at any time of year with the acute onset of fever and a change in mental status (including symptoms such as confusion, disorientation, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures).” JE is a mosquito-borne zoonotic viral disease that is one of the causes under AES.
“In 2022, 238 patients were admitted for AES, out of which 28 died,” Dr Ganesh Kumar, Principal and Dean of Baba Raghav Das Medical College, told FactChecker on April 17, 2023. While deaths were reported for AES, no deaths were reported for JE. “In 2022, 22 JE patients were admitted. Not a single death happened,” Dr Kumar confirmed.
“Earlier there were 217 beds in the encephalitis ward, which has been increased to 428. Patients coming here get treatment absolutely free of cost. All facilities are provided inside the ward so that the patient can get better treatment in time,” said Dr Kumar.
“Due to awareness, clean drinking water, vaccination, this disease has been controlled to a great extent,” he added.
Between January and March 2023, BRD college reported one death due to AES in which the deceased was a resident of Bihar, said Dr Kumar.
Until September 2017, daily case and fatality figures were released by the medical college. When asked the reason for not releasing it post 2017, the Dean said, “Now the number of patients has become very less, so the publication of the figures has been stopped.”
UP has had outbreaks of the disease since 1978. According to a study published in the National Center for Biotechnology Information in February 2022, the AES outbreak in 2005 was the most devastating epidemic in the state, which caused more than 5,000 cases and 1,300 deaths. Between 2006 and 2018, more than 41,500 cases and 6,800 deaths were recorded.
Further, AES cases in UP have declined by 74.6% and deaths by 95% between 2017 and 2022, as per data from the National Center for Vector Borne Diseases Control. Cases of JE have reduced 82% and deaths by 95.6% in the same period.
Across India, states such as Assam, Bihar and West Bengal accounted for 36.5% of AES and over half (54.3%) of JE deaths in 2017. In Bihar, between 2017 and 2022, AES deaths reduced from 54 to nine while JE deaths reduced from 11 to nine. Similarly, AES deaths in West Bengal have dropped by 77%, from 169 deaths in 2017 to 39 in 2022, while JE deaths reduced from 40 to seven in the same period. However, deaths in Assam have increased more than two fold, from 40 JE deaths in 2021 to 96 deaths in 2022, and 91 AES deaths to 162.
The control of communicable diseases was made a public health priority in UP, Dr Preeti Kumar, vice president, Public Health System Support at Public Health Foundation of India told FactChecker.
“The 2018 JE deaths were also a trigger,” she said. UP had reported 230 AES and 28 JE deaths during that year, as per government data.
“An important factor which emerged was that JE constituted only 10% of AES cases while nearly 50% were due to scrub typhus - a disease which has a simple treatment of oral antibiotics. So accurate diagnosis and appropriate treatment helped in improved outcomes,” said Dr Kumar.
Kala-azar cases reduced by 81% in UP, with only 5 deaths reported between 2017 and 2022. “Kala-azar elimination has been a national priority with intensive and dedicated interventions in affected districts,” Dr Kumar from PHFI told FactChecker. “Only 9-11 districts in UP with low prevalence are there and dedicated efforts of NGOs, WHO [World Health Organization] and UNICEF teams, led by state and local health officers, have spent considerable effort in moving towards elimination,” she added.
Similarly, there has been a decline in cases of malaria. As per government data, no malaria death has been reported in UP since 2018.
However, an epidemiologist and Bhubaneswar-based medical consultant with the WHO, told FactChecker on the condition of anonymity, that there may have been a few sporadic malaria deaths in the last four years. “Malaria deaths are underreported throughout the country but [also] UP doesn’t have the type of malaria that is fatal.”
Malaria deaths in Chhattisgarh, Jharkhand and Odisha are also declining, he said. Chhattisgarh reported an average of 35 deaths till 2021. In 2022, this dropped to 11 deaths, data show. In Maharashtra, there was a 78.5% rise in deaths, from 14 in 2021 to 25 in 2022.
Unlike malaria and kala-azar, chikungunya cases have surged nearly three-fold, from 70 cases in 2021 to 200 in 2022, as per government data. Dengue deaths have also marginally increased from 29 in 2021 to 33 in 2022.
FactChecker reached out to Durga Shanker Mishra, Chief Secretary to the government of Uttar Pradesh, for clarification on the time period of CM’s claim and a comment on the measures taken by the UP government to curb encephalitis and other communicable diseases. We will update the story when we receive a response.
(With inputs from Mithilesh Dubey, principal correspondent at IndiaSpend Hindi.)