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Why India needs better surveillance and a national programme for encephalitis control

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Why India needs better surveillance and a national programme for encephalitis control


The World Health Organization (WHO) recently launched a technical brief highlighting encephalitis as an urgent public health priority, in response to the growing global burden of the disease. This call to action comes at a time when India continues to grapple with both a high number of, and the under-reporting of encephalitis cases, pointing to the need, experts say for a focused national strategy to tackle the disease effectively.

Encephalitis, an inflammation of the brain, presents a complex challenge due to its diverse etiology, ranging from viral and bacterial causes to autoimmune responses.

The nature of encephalitis cases in india

According to the WHO, Japanese encephalitis virus (JEV) , a flavivirus related to dengue, yellow fever and West Nile viruses, and spread by mosquitoes, is found in 24 countries across Southeast Asia and the Western Pacific, with India carrying a considerable portion of the disease burden. The annual incidence of JE globally can reach up to 10 cases per 1,00,000 population or even higher during outbreaks. In India, several States continue to struggle with high JE incidence. As reported by the National Center for Vector Borne Diseases Control (NCVBDC), Assam recorded 669 cases and 53 deaths in 2024, making it the most affected state. Other states, such as Uttar Pradesh and Bihar, also reported a substantial case numbers.

Also, as per a report published in The Lancet, India experienced the largest Chandipura virus (CHPV) outbreak in 20 years, with 245 cases of Acute Encephalitis Syndrome (AES) and 82 related deaths reported between early June and August 15, 2024. Of these, 64 cases were confirmed as CHPV infections, 61 in Gujarat and 3 in Rajasthan. The outbreak predominantly affected children under 15 years, with symptoms such as fever, convulsions, coma, and death within 48–72 hours.

Swati Bhayana, consultant in paediatric hematology and oncology at Fortis Hospital, Gurugram said that encephalitis is a major problem in paediatric patients, with viral infections being the major cause in children under 18. “Unlike adults, who report clear symptoms like severe headaches, children show signs like irritability, vomiting, seizures, or extreme tiredness, making early detection difficult yet crucial” she said.

While the number of new reported AES cases has shown a downward trend since July 19, 2024, further transmission remains possible due to factors like the upcoming monsoon season, and flooding in some States creating stagnant water pools, which serve as prime breeding grounds for disease-carrying insects.

No national surveillance in place

Despite these figures, experts state that sporadic data points fail to capture the full extent of the issue. Neha Rastogi Panda, a leading expert in infectious diseases from AIIMS, New Delhi, said one of the most significant hurdles to tackling the encephalitis burden in India was the lack of a unified reporting system. “What we follow now is a reactionary approach rather than an action-taking one. Cases often come to light only during outbreaks. There is no homogeneous reporting, and the absence of routine surveillance means we are likely just scratching the surface when it comes to the number of cases in the country,” she said.

This under-reporting is compounded by the unavailability of rapid diagnostic tools, especially in peripheral healthcare settings, Dr. Panda pointed out, adding: “Diagnosis often relies on MRI and brain sampling. While tertiary centers may have access to cerebrospinal fluid (CSF) testing and viral DNA analysis, such facilities are scarce in rural areas.”

Dr. Panda stressed the need for robust symptom-tracking systems. “We need to train frontline health workers to recognise early signs like sensitivity to light or sound, persistent headaches, or sudden behavioural changes so they can alert cases quickly,” she said.

She also noted the importance of mass vaccination drives, particularly for JE, and improved access to antiviral treatments. “Ninety per cent of viral encephalitis cases are self-limiting, but for the rest, timely antiviral treatment can be life-saving. Accessibility and affordability of these treatments must be ensured,” she added.

These infections spread fast in children with low immunity. So, early suspicion and diagnosis are key to preventing the spread to the brain, said Dr. Bhayana. “Once encephalitis hits a child, their developing brain is at risk and they may suffer with issues like permanent seizure disorders, or hemiparetic attacks. One missed infection now could mean 40 years of debilitated life,” she said.

Prevention, the need of the hour

A more proactive approach to tackling the encephalitis burden would include prevention, said P. Vijayashankar, neurologist at Apollo Hospitals, Chennai. “We don’t have a separate programme for encephalitis like we do for tuberculosis, for instance. We do have a JE vaccination programme, especially in high-risk regions like the Northeast and coastal areas, but for other forms of encephalitis, prevention remains difficult due to a lack of awareness and diagnostic gaps,” he explained.

Mosquito control, he emphasised, could serve as a crucial preventive measure: regular anti-larval operations, proper waste management, and public education about avoiding water stagnation during monsoons, could all go a long way. “There needs to be mass education on the basics about how viruses spread, what symptoms to watch for, and the significance of vaccination. A targeted public health campaign could help bridge this gap.”

A dedicated encephalitis prevention and control programme, separate from the existing vector-borne disease framework, experts said, would streamline diagnosis, improve vaccine coverage, and strengthen surveillance and eventually help decrease the disease burden in the country.



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When it comes to edible oil, finding the right balance is key

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When it comes to edible oil, finding the right balance is key


The debate on how much edible oil, and what kind of oil, is good or bad for health seems never-ending. But the trick here is finding the right balance as moderation is key, say experts.

Importance of fats in a balanced diet

Meenakshi Bajaj, dietician, Tamil Nadu Government Multi Super Speciality Hospital, said it is essential to understand that all three macronutrients (carbohydrates, fats, and proteins) play a crucial role in an individual’s health. “Fat is an indispensable component of a balanced diet, necessary for the absorption of fat-soluble vitamins, synthesis of hormones, as well as several vital physiological and metabolic functions in the body. Dietary fat comprises both visible and invisible sources. Visible sources include fats and oils, ghee, vanaspati and butter used for cooking. Invisible sources encompass whole eggs, milk and milk products, nuts and oilseeds, meat, poultry, and fish,” she said.

Edible fats and oils have benefits and drawbacks, she said, adding: “There are three types of fatty acids present in our diet: saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA). A healthy diet should incorporate varied sources of fats and oils, maintaining an ideal ratio of healthy fats (mono and polyunsaturated fats) to unhealthy fats (saturated fat).”

Choosing and using oils wisely

Daphnee Lovesley, chief clinical dietitian, Apollo Hospitals, Chennai, points out, “Oils are essential in our diet as they provide essential fatty acids that the body cannot produce. Like everything else, moderation is key. Oils are calorie-dense, providing about 9 calories per milliliter, and in Indian cooking, there is often a tendency to use them generously, particularly in fried foods. Reducing oil intake by four to five teaspoons per person per day can make a big difference. Nuts like almonds, walnuts, or peanuts can be enjoyed in moderation—a handful a day is sufficient.”

The National Institute of Nutrition (NIN) suggests incorporating a diverse variety of oil seeds, nuts, and whole grains, Ms. Bajaj pointed out. “Studies indicate that consuming nuts like almonds and cashews can improve lipid profiles and reduce blood pressure in individuals with type 2 diabetes. However, moderation is key,” she said.

Blending oils to achieve a balance of fatty acids and antioxidants is beneficial, she said, noting: “NIN advises combining oils such as groundnut, sesame, rice bran, and mustard oils, which have been shown to reduce the risk of type 2 diabetes and metabolic syndrome.”

Health risks associated with reheated oils and trans fat

Ms. Lovesley further adds. “Oils rich in monounsaturated fats—such as sesame oil, groundnut oil, and rice bran oil—are good options and are readily available locally. Using a blend of oils is often considered a safer and more balanced approach.”

However, reusing oil is harmful, she adds. “Repeated heating at high temperatures causes chemical changes that lead to the formation of polycyclic aromatic hydrocarbons, which are carcinogenic. Reheated oils have been linked to an increased risk of cancer, cardiovascular diseases, and elevated cholesterol and blood pressure levels. When consuming food outside, it is difficult to know how many times the oil has been reheated—this could contribute to inflammation and, subsequently, obesity.”

Ms. Bajaj emphaised that trans fats from reheated oil, bakery items (such as cakes, pizza, puffs, pastries, biscuits, cookies, doughnuts), and partially hydrogenated edible fats in packaged and processed snacks increase triglycerides and LDL cholesterol (bad cholesterol), lower HDL cholesterol (good cholesterol), and heighten the risk of cancers and cardiovascular diseases. Check food labels on ready-to-eat foods for partially hydrogenated fats (unhealthy fats), she added .

The impact of cooking methods on the nutritional quality of oils should be considered. “Oils exposed to high temperatures for extended periods can lose antioxidants and generate toxic compounds and trans fats. Repeated heating of cooking oils produces harmful compounds and should be avoided. On a household level, vegetable oil once used for frying should be filtered and reused for sautéing purposes within the next 24 hours. Remove food particles from oil during frying before they turn black. Oils repeatedly heated should not be mixed with fresh oil but can be used for seasoning,” she said.

Healthy eating as preventive care

With obesity being a major public health concern, it’s important to recognise the key contributing factors: poor dietary habits, a sedentary lifestyle, and inadequate sleep. Stress can also play a role in some individuals. “However, we should focus on what we can control—eating balanced meals, staying physically active, and maintaining good sleep hygiene—to prevent obesity. Childhood obesity is growing too, making it crucial to encourage healthy habits early in life,” Ms. Lovesley said.

Ms. Bajaj reiterates that intake of oils and fats should be moderated. “It’s not about restriction; it’s about smart and healthy choices for improved metabolic health. By making informed choices regarding the types and quantities of fats in our diets, we can promote better health and well-being for ourselves and our families,” she said.



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Tamil Nadu bans mayonnaise made from raw eggs for one year

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Tamil Nadu bans mayonnaise made from raw eggs for one year


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| Photo Credit: Getty Images/iStockphoto

Tamil Nadu has banned the manufacture, storage and sale of mayonnaise prepared from raw eggs for a period of one year with effect from April 8. The ban, issued in the interest of public health, is on the basis that mayonnaise made of raw eggs is a “high risk food”, carrying a risk of food poisoning.

According to a notification issued in the Government Gazette by Principal Secretary and Commissioner of Food Safety R. Lalvena, any activities related to any stage of manufacture, processing, packaging, storage, transportation, distribution, food services, catering services and sale of mayonnaise prepared from raw egg is prohibited in the State under section 30 (2) (a) of Food Safety and Standards Act, 2006 and order of the Commissioner of Food Safety of Tamil Nadu.

Mayonnaise is a semi-solid emulsion generally composed of egg yolk, vegetable oil, vinegar and other seasonings served along with food items such as shawarma. Mayonnaise made of raw eggs is a high-risk food as it carries a risk of food poisoning especially from Salmonella bacteria, Salmonella typhimurium, Salmonella enteritidis, Escherichia coli and Listeria Monocytogenes, the notification said.

It has come to notice that a number of food business operators use raw egg for preparation of mayonnaise, improper storage facilitates contamination by microorganisms that creates a public health risk particularly by Salmonella typhimurium, Salmonella enteritidis, Escherichia coli and Listeria Monocytogenes, it said.

In any specific circumstances, on the basis of assessment of available information and if the possibility of harmful effects on health is identified but scientific uncertainty persists, provisional risk management measures to ensure that health is protected can be adopted as per the Act, pending further scientific information for a more comprehensive risk assessment.

The notification said that no food business operator should manufacture, store, sell or distribute any food which for the time being is prohibited by the Food Authority or the Central Government or State government in the interest of public health.



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Indigenously developed HPV test kits for cervical cancer screening launched in Delhi

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Indigenously developed HPV test kits for cervical cancer screening launched in Delhi


The test kits have been developed under the Department of Biotechnology’s (DBT) partnership programme Grand Challenges India (GCI) at the Biotechnology Industry Research Assistance Council (BIRAC).
| Photo Credit: Getty Images

Indigenously developed (Human papillomavirus) HPV test kits for cervical cancer screening were launched on Wednesday (April 23, 2025).

The test kits have been developed under the Department of Biotechnology’s (DBT) partnership programme Grand Challenges India (GCI) at the Biotechnology Industry Research Assistance Council (BIRAC).

The DBT supported research coordinated by the All India Institute of Medical Sciences (AIIMS) Delhi, with testing done at laboratories at AIIMS, National Institute of Cancer Prevention and Research (NICPR), Noida; and the National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, in collaboration with World Health Organisation (WHO) International Agency for Research on Cancer (IARC).

“The key feature of these kits is the inclusion of only the seven-eight most common cancer-causing types that will allow a very efficient and cost-effective screening programme which will be most suitable for India,” Dr Neerja Bhatla, former head of the department of Obstetrics and Gynaecology at AIIMS, Delhi and chief coordinator of the programme said.

The study titled ‘Validation of Indigenous Human Papillomavirus Tests for Cervical Cancer Screening in India (i-HPV)’ validated indigenously developed, rapid, point-of-care, RTPCR-based HPV diagnostic test kits for screening cervical cancer in premier research and development laboratories of India.

“Given the enhancement of RTPCR-based diagnostic facilities across the nation in the post-COVID era, the introduction of sensitive RTPCR-based HPV testing kits might prove to be cost effective screening method over classical HPV DNA and Pap smear for deployment in the national cancer screening programme,” Dr Bhatla said.

Cancer of the uterine cervix is the second most common cancer among Indian women. According to WHO data, one out of every five women in the world suffering from the disease is an Indian, Dr Bhatla stated.

Besides the high incidence of cervical cancer owing to its late diagnosis and with consequent poor survival, 25% of global mortality due to cervical cancer occurs in India, she said.

Thus, there has been a pressing need for the development of control strategies for the prevention and screening of cervical cancer. The currently available methods of screening of cervical cancer include Visual Inspection with Acetic Acid (VIA), Papanicolaou test (Pap test or Pap smear) and HPV DNA testing, she stated.

Regular population screening by Pap smears has been successfully implemented in the developed world. Nevertheless, it is costly, resource-intensive and only moderately sensitive. VIA screening requires considerable training and re-training for quality assurance and has high false positivity rates with programmatic challenges, she said.

HPV testing has the best diagnostic accuracy if it conforms to international standards of validation. As part of the Global Declaration for Cervical Cancer Elimination, WHO recommends a transition to HPV testing in all countries, whereby only two tests in a lifetime, at age 35 and again by age 45 years, will be sufficient. The target is to set up processes to screen 70% of eligible women by 2030, Dr. Bhatla stated.



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