Every year, 3 months before the monsoon arrives, 900 and 1200 children between the ages of 2-5 are afflicted with a mystery illness. It starts with lethargy and a light fever but shows the 1st signs of worsening towards the morning. Many of the children are dead before they can reach a hospital.
The district saw 44 deaths in 2011, 121 in 2012, and 39 this year . Bihar Health Secretary Sanjay Kumar admits they don't know the reason for this decline. "The cases have dropped this year " he says. "We don't know what we have done right. Right now, we are all groping in the dark."
The latest to draw a blank is a team from the Centers for Disease Control (CDC) in Atlanta, USA, which was roped in by the National Centre for Disease Control (NCDC) to test samples from this year . A report submitted to the state and Centre by the NCDC in the 1st week of September 2013 said the results have been negative for several known viruses, including Japanese encephalitis (JE), enteroviruses, West Nile virus, dengue, Chandipura and Nipah. In fact, after testing blood samples, rectal swabs and cereobrospinal fluids of patients, as well as brain tissues collected from deceased patients, researchers have not been able to isolate a single strand of a virus. The question now staring them in the face is: is it even a virus?
When the 1st locally tested samples tested negative for JE virus, tests were repeated by multiple agencies last year  and again this year , including the National Institute of Virology in Pune, the NCDC in Delhi, units of the Indian Council of Medical Research such as Patna's Rajiv Memorial Research Institute (RMRI), Delhi's Safdarjung Hospital and Lady Hardinge Medical College, and a team from the CDC, Atlanta. However, all ruled out JE [virus infections].
"Since the disease was not found in patients, we decided to look for it in the vectors, mosquitoes which carry the JE virus from hosts such as pigs, water birds or other livestock to humans," says Dr Pradip Das, director of RMRI. However, no known vector of JE was found on the scene. "Now, we have eliminated the theory of JE [virus] completely," Dr Das says. The RMRI and NCDC conducted similar tests, but to no avail.
Admits Dr Das: "There are several characteristics which make this disease different. JE is a post-monsoon disease, while all the cases here are seen before the rains."This article was sent to ProMED-mail by Ronan Kelly of FluTrackers; the moderator asks for more reports on the cases.