Syndrome (SARS) to the Avian
Influenza, the Acute Respiratory
Syndrome from Nipah virus, Swine
Flue, MERS, Kendra to Ebola and Zika—
every global epidemic has been a zoo-
notic disease. Armed with a host of
emerging viruses, they are rising: over
one billion and more cases of zoonotic
disease are estimated to occur among
humans every year, reports the WHO.
About 60 per cent of the roughly 400
emerging infectious diseases since 1940
have been zoonotic.
The warning signs have been there.
Forest cover in Bihar came down sharply
after bifurcation with Jharkhand in 2000,
and stood at a poor 7.23 per cent. Even
now, the state is a long way off from the
desired mandate of 33 per cent.
Muzaffarpur was known for its forests
and wildlife once. The district is com-
pletely devoid of any forest now. “With
continuous extension of the area under
cultivation, wild buffaloes, gazelle, deer
and tiger have disappeared,” reports a 2016 central government
report. The only wild animals sometimes seen are the fox and
the jackal, besides nilgais and wild boars. Rampant construc-
tion of roads and dams, commercial plantations, indiscriminate
and illegal sand mining by the “balu mafia” has narrowed down
the width of most rivers: the Sarayu is a haunt of smugglers.
Tinkering with nature has made the Muzaffarpur area
particularly vulnerable to infectious zoonotic diseases.
These diseases appear in areas that have gone through
large-scale change in land use and human activity, leading to
ecological degradation. Infections spread fast here, because
wild life—carriers of some of the viruses—move closer to
humans. In case of AES, fruit bats have migrated in thou-
sands to the edges of villages, cities and towns in search of
food, and started living in litchi orchards, in close proximity
to humans—as with the Ebola and the Nipah outbreaks. “The
virus spread from animal faeces, fluids, infected fruits, meat,
milk or water,” says Nina Sengupta, ecologist and biodiver-
sity conservation consultant, Pondicherry. “Children gorging
on litchis can easily pick up fruits contaminated by the saliva,
urine, or guano of bats.” Bats host more than 60 human-inf-
ecting viruses—including the Ebola and
Nipah viruses, which cause deadly brain
fevers in people. Wading birds are the
natural maintenance hosts of many of the
AES viruses, pigs are known to be the
main amplifying hosts, while mosquitoes
and sandflies, that thrive near litchi trees
and feed on bats, are the primary vectors,
she explains.
Others point to ground water con-
tamination with faeces in open-defe-
cation villages. “Several enteroviruses,
primarily spread by faecal-hand-oral
contamination, are known to cause fatal
encephalitis in children,” says Dr Pratip
Kundu, director of the Calcutta School of Tropical Medicine.
In Bihar, the groundwater in many of the villages has been
found to be 35.7 times more at risk of faecal contamination,
according to a UNICEF 2019 study. Shallow wells and hand
pumps contaminate drinking water with faecal matter are
also a major problem in Bihar. A recent study by Girish Kumar
Singh, director of AIIMS, Patna, uses virus-tracking software
to show how open defecation flows into the Sarayu river in
Muzaffarpur, Bihar, down the Gandak river in Gorakhpur,
Uttar Pradesh, causing AES in that area. Muzaffarpur is
also well-known for using human faeces as fertilisers in
litchi orchards. Scientists are now linking the AES deaths to
unhygienic conditions of households and rod ent infestation.
Rats carry parasites, like, rat flea, chigger mites, ticks and
lice—all established scrub typhus vectors.Panic button
AES and the dying children of Bihar have evoked sharp
reaction from all quarters. There is finger-pointing at
India’s creaking healthcare—the stench of urine, chlorine,
vomit, the dearth of health workers and absence of basic
provisions at district hospitals. Senior
doctors are being suspended for “neg-
ligence”. Protest marches are being
organised against government “apathy”.
Muzaffarpur-based Dr Arun Shah of the
Indian Association of Paediatrics has
touched a raw nerve by pointing a finger
at chief minister Nitish Kumar for not
implementing guidelines drafted in 2015
to prevent future attacks: “Anganwadi
and ASHA workers were supposed to
spread awareness. Instead they were
busy with election duties.”
Bihar minister of health Mangal Pandey,
who initially refuted reports of childrenliFe suPPOrT a child showing aes symptoms being treated in MuzaffarpurThese diseases
appear in areas
that have
gone through
large-scale
ecological
disturbances.8 July 2019 OutlOOk 39
PTi