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Glimpses of IDSP Works, West Bengal Done by IDSP Units in WB, 2011

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Glimpses of IDSP Works, West Bengal Done by IDSP Units in WB, 2011 2012 Glimpses of IDSP works, West Bengal Done by IDSP units in WB, 2011 Team IDSP, SSU Swasthya Bhaban 3/28/2012 Preface This is a presentation of cumulative efforts of work done by the State Surveillance Unit along with all District Surveillance Units across West Bengal working in tandem for IDSP as a team. The compiled works which relates to the range from Outbreak Investigation, Data Management up to the stretch of detailed Entomological Survey and Lab Investigations. The compilations are fetched from the experience and /or achievements discussed by the various units of the State at Annual Meet 2012 held at Swasthya Bhaban. The presentation is also enriched with varied techniques, though as we say “Team Work”, it ultimately comes to a nut shell and published as a collaborative artifact. Hope this would help the readers for better understanding of not only the works of IDSP but a common message to all- “TEAM WORK”… We recognize and commend the diligent input of the Team IDSP SSU, WB lying behind this compilation. Without them letting their hair down, this publication would not have materialized... Addl. DHS( PH & CD) & State Surveillance Officer, IDSP, West Bengal Index Article Page No. Role of IEC and BCC in controlling Chikungunya outbreaks, Jalpaiguri: An experience in 2011 ----------------- 1-2 Outbreak Trend Analysis of Anthrax in Murshidabad from 2007-2011: A brief epidemiological report ------ 3-4 Epidemiological investigation of repeated Dengue and Chikungunya outbreaks at Domjur, Howrah, 2011 5-6 Japanese Encephalitis surveillance under IDSP, Darjeeling, 2011 ----------------------- 7-8 Epidemiological investigation identified the main source……...a diarrhoeal outbreak in Malda , 2011 -- 9-10 Inclusion of Municipalities & Pathological Lab.(Pvt.) makes a difference………………... Nadia, 2011 --- 11-12 An evaluation of IDSP activities; ……….knowledge & practices of the health workers, Hooghly, 2011 -- 13 Community behavior - a major factor behind Cholera outbreak, Bankura , 2011 --------------- 14-15 Identification of a cluster of kala-azar cases pre-empted an outbreak in a tribal village, Birbhum, 2011 - 16-17 Investigation determined contaminated water …….cause of a diarrhoeal outbreak at Burdwan , 2011 -- 18-19 Improvement in IDSP reporting and performance, Cooch Behar, 2011 ---------------------- 20-21 Rapid response to a food-borne diarrhoeal outbreak in “Badamile Mission”, Dakshin Dinajpur, 2011 --- 22-23 Consistency of the reporting units…: A success story of KMC, 2011 ------------------ 24 Investigation detected Vibrio parahaemolyticus in a food poisoning outbreak in North 24Pgs, 2011 ----- 25-26 Impact of intervention of LLIN in a Malaria Endemic block, Paschim Medinipur, 2009 – 2011 -------------- 27-28 Unknown fever in Bhagawanpur-I Block, Purba Medinipur, 2011 ---------------------------- 29-30 An effort to improve IDSP reporting by reporting units and maintaining its consistency: Purulia , 2011 - 31-32 A search for the gaps in data reporting for improvement in malaria surveillance, South 24 Pgs, 2011 -- 33-34 Implication of case definition and consistency of reporting in generation of EWS, Uttar Dinajpur, 2011 35-36 The scenario of Cholera disease in West Bengal over the last three years --------------------------------- 37-38 Man-made containers…………..are major causes for VBDs: Entomological experience in WB, 2011 --- 39-40 Role of IEC and BCC in controlling Chikungunya outbreak, Jalpaiguri: An experience in Jalpaiguri, 2011 Dr. Debasis Mandal1, Satinath Bhuniya2, Aparna Dutta3 1. Dy CMOH-II, Jalpaiguri, 2. Epidemiologist, DSU, Jalpaiguri; 3. Data Manager, DSU, Jalpaiguri Background: An outbreak of chikungunya fever characterized by joint pain, swelling and or rash occurred in the Tuslipara Tea Garden area (between 26047’36”N and 089012’26”E, altitude-700ft.) under Madarihat block of Jalpaiguri district, West Bengal near Bhutan International Boarder in the month of November 2011. Information of fever outbreak was reported by the Block Health department to the District Surveillance Unit within 48 hours of the onset of the outbreak. Subsequently dengue and chikungunya outbreak was also reported from the adjoining three Tea Garden areas of the same block situated in lower altitude (409 ft.) in the month of December 2011. This report illustrates in brief the results of epidemiological & entomological investigation and control measures undertaken during the chikungunya outbreak at Tulsipara Tea Garden area. Methods: (i) House to house search of fever cases was done and along with line listing during the outbreak. (ii) Blood samples were collected from suspected chikungunya/ dengue cases for lab confirmation at the School of Tropical Medicine, Kolkata, WB. (iii) Entomological investigation like larval survey was conducted in the affected area in consecutive four weeks. Containers cleaning in a weekly pulse mode along with larval survey were done during the period. Video clipping of the larvae collected from the containers was sent to the CRME-ICMR, Madurai and State Entomological section, IDSP, WB for confirmation. Preserved adult mosquitoes were used for species identification by the Scientist of CRME. Results: A number of 780 suspected Chikungunya cases were reported from Tulsipara Tea Garden locality within a period of 39 days with an attack rate of 17.8. Amongst the cases 52% are female Fig: Epi-curve of Chikungunya Outbreak at Tulsipara TG (N=780) 140 Treatment & IEC 120 Pulse cleaning started cleaning & spray 100 started 80 60 No case found No. of cases of No. 40 20 0 5/11/2011 8/12/2011 3/11/2011 7/11/2011 9/11/2011 2/12/2011 4/12/2011 6/12/2011 11/11/2011 13/11/2011 15/11/2011 17/11/2011 19/11/2011 21/11/2011 23/11/2011 25/11/2011 27/11/2011 29/11/2011 31/11/2011 10/12/2011 12/12/2011 14/12/2011 Date and remaining 48% are male. More than 50% of the cases occurred within 9 days of the onset of outbreak. Serologically, one sample out of ten was found to be Chikungunya reactive from Tulsipara Tea Garden area. After one month another five samples out of ten from adjoining three TG areas were found to be only 1 Chikungunya IgM reactive and four samples found both Chikungunya and Dengue IgM reactive at the School of Page Tropical Medicine, Kolkata. Entomological investigation reveals that the main breeding sources of the mosquitoes were the domestic and peri-domestic containers like cement tanks, plastic containers, metal containers, tyers, earthen pots, tree stumps and discarded containers. Aedes aegyptii was predominantly present in the outbreak affected area. Initially the House Index was 78.43% and Container Index was 80.88% and both were extremely higher than the threshold values. Both the indices started to decline with continuous containers cleaning in a weekly ‘Pulse’ mode, as a result number of cases also started to decline. Fig: House Index, Container Index and Fever cases during conjecutive cleanings at Tulsipara TG, Madarihat, Jal HH Index Container Index No. of Cases in between two cleanings 90.00 426 450 80.00 400 70.00 350 60.00 227 300 50.00 250 40.00 200 30.00 75 150 20.00 100 Index (%) Index 41 10.00 11 50 cases Fever of No. 0.00 0 1st Cleaning: 1st Pulse: 2nd Pulse: 3rd Pulse: 4th Pulse: 11th Nov'11 22nd Nov'11 29th Nov'11 6th Dec'11 13th Dec'11 Container No. of HH found positive for larvae Date of Cleaning HH Index Index House Index = ---------------------------------------------------- × 100 1st Cleaning: 11th No. of HH inspected Nov'11 78.43 80.88 1st Pulse: 22nd Nov'11 43.41 44.19 No. of containers found positive for larvae 2nd Pulse: 29th Nov'11 2.95 2.82 Container Index = ---------------------------------------------------------- × 100 3rd Pulse: 6th Dec'11 0.52 0.47 No. of containers inspected 4th Pulse: 13th Dec'11 0 0 Discussion & conclusion: To our best knowledge this outbreak of chikungunya was reported for the first time in the health record of Jalpaiguri. The causative organism was probably imported from some local migrant labours, working in Kerala (which is an endemic district for chikungunya), who had visited their native place of the affected block of the village during the Diwali celebration. High density of Aedes aegyptii and its profuse available of breeding site played a major role in rapid transmission of chikungunya in the affected area. Prompt control measures indicate that the ‘weekly pulse cleaning’ and covering all the potential (man-made) breeding sites of mosquitoes played a crucial role in controlling the transmission of the disease in the outbreak affected area within a month with a comparatively decreasing attack rate. Applying the same strategy another Dengue-Chikungunya outbreak in the adjoining three Tea Garden areas was controlled within a short time with an attack rate of less than three per hundred populations. 2 Page Outbreak trend analysis of Anthrax in Murshidabad from 2007-2011: A brief epidemiological report. Dr.B.P Shaw1, Nizamuddin Mondal2 1. Dy CMOH-II, Murshidabad, 2. Epidemiologist, DSU, Murshidabad; Murshidabad is one of the large districts in Mid Bengal, surrounded 110 km by Bangladesh in the East, and 50 km by Jharkhand at North East, Nadia & Burdwan in South, Birbhum in the West and Malda and the Ganges in the North (Padma & Bhagirathi). Heavy rainfall, hot humid weather and mostly alluvial soil have made this district a victim of vector borne diseases. District has a very poor rank (15th out of 17) in the Human Development Index (HDI). In the Gender Development Index (GDI) its rank is 16th out of 17. The district has been reporting cutaneous anthrax on regular basis for the last 10-12 yrs. From the period 2007 to 2011, 532 cutaneous anthrax cases have been reported. All these cases have been reported from 10 blocks out of 26 blocks. Nearly 26 Gram Panchayets have been affected, some of the Gram Panchayets have reported a single outbreak and some of them have reported more than 5 outbreaks Fig-1: Reported anthrax cases 2007-2011, Murshidabad 45 250 40 35 200 30 150 25 20 100 15 10 50 5 0 0 Jalngi Kandi Domkol Nowda Berhampur Nabagram Hariharpara Raninager-IRaninager-II Bhababangola-1 No.
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