At least 56 people, most of which are children, have died following a mysterious fever outbreak in Uttar Pradesh, a state located in Northern India. The yet-to-be-determined condition has symptoms including high fever, joint pains, headaches, dehydration, and nausea, as well some cases of rashes across upper and lower limbs.
None of the people reporting these symptoms have tested positive for COVID-19 and in the six districts affected by the illness, physicians suspect the outbreak is caused by a particularly severe form of dengue fever. Bloodwork from some patients showing declining numbers of platelets supports this scenario.
"The patients, especially children, in hospitals are dying very quickly," Dr Neeta Kulshrestha, the most senior health official of Firozabad district, told BBC News. Dr Kulsherestha has since been removed by the state Chief Minister Yogi Adityanath in what has been seen as a move to deal more immediately with the virus spread. A team of 11 specialist doctors has been sent to Firozabad along with medicines and other necessities.
Dengue fever is a viral disease spread by mosquitos found in the tropical and subtropical regions across the world, mostly in cities. There are four types of dengue virus, which means that an individual can be infected four times. Most cases are mild but it is possible for the virus to cause acute symptoms, which can be flu-like. Like the flu, this can be lethal, especially without proper medical care
Modeling from the World Health Organization estimates around 390 million dengue virus infections worldwide. One in ten people at risk from the disease becomes infected every year. The number of infections and deaths have been massively increasing in the last several decades, growing four-fold between 2000 and 2015 when 4,032 people died of the disease.
The other possibility, Japanese encephalitis, is also carried by mosquitos. The WHO estimates 68,00 clinical cases every year and is the main cause of viral encephalitis in several Asian countries. In general, this disease is rare but it has a high case-fatality ratio. Almost one-in-three people that contract the virus dies.
For both conditions, there is no known cure, but there are safe and effective vaccines that can prevent Japanese encephalitis. Tests and samples are being carried out to work out if either of these viruses or other causes are behind the deadly outbreak.
Weakened and ineffective mosquito control programs as well as the rise of insecticide-resistant vectors are seen as reasons why certain diseases have seen a dramatic and often fatal surge in recent decades. Renewed investment is key to tackle diseases that could lead to fatal outbreaks like the one happening now.