The recent report by the Health Ministry of the four Japanese encephalitis (JE) infection deaths and several people testing positive for the Japanese encephalitis virus (JEV) is indeed disturbing.
It has sent chills down the spine of many who still remember the deadly Nipah virus outbreak that killed more than 100 people and maimed many more in the late 1990s.
Although the JE and Nipah viruses have different modes of transmission, the fact that both originate from domestic pigs is worrying.
According to the WHO reports, JE is said to be a leading cause for viral encephalitis (brain swelling) in Asia with 50,000-70,000 cases reported annually.
However only a small fraction of people infected with JE develop encephalitis. Of those who do, 20-30% die.
Among those who survive the JE infection, about 50% end-up with various degrees of permanent brain damage that require long-term medical management and care.
Studies indicate JE infections occur primarily in areas where pigs are raised and particularly in regions where pig farms are located in close proximity with paddy fields that are reported to be ideal breeding grounds for mosquitoes.
In Japan it is estimated that a single rice or paddy field has the potential to generate up to 30,000 mosquitoes a day.
These mosquitoes are naturally attracted to pig farms closer to these fields for their blood meal. Mosquitoes that bite JE virus harbouring pigs subsequently transmit the virus to humans in the environment.
Since domestic pigs are ideal JE virus amplifying animals, the JE virus is well maintained in the pig population. Pig farms closer to human habitats and paddy fields are ideal environments for mosquito borne diseases to spread to humans.
Studies have also shown that intensive livestock farms operating closer to human habitats pose a potential public health risk too.
I have nothing against pig farms but in view of the obvious high risk of zoonotic disease transmission (diseases that spread from animals to humans) like JEV, the authorities should find ways and means to help pig farmers relocate their businesses to safer and more suitable locations.
I am sure that with the right incentives and a sincere approach, our pig farmers will willingly cooperate in the interests of public health.
The authorities should also reconsider integrating all small pig farms into one or two large consortium farms in the respective states.
The benefits derived from such a move is immense in terms of economic returns as well as public and environmental health. It is my gut feel that present day livestock farmers being more educated, will better understand the health and environmental implications of their livestock rearing activities.
In the meanwhile, in order to prevent a major outbreak of JE in endemic areas, the authorities should explore the merits of immunising (vaccinating) vulnerable populations closer to pig farms.
Alternatively we should consider making it mandatory for pig farms located closer to human settlements to vaccinate their animals against JE and other zoonotic diseases if it is practical.
Detection for the JE virus infection should be made a routine examination for patients living closer to pig farms.
Lastly, veterinary authorities should also intensify animal health monitoring and surveillance activities on these pig farms while a proper vector control and prevention programme should be in place in JE endemic areas coupled with public education.