Lok Sabha Question No. 3763 (UNSTARRED), answered on 2017-03-24
Subject: Viral Hepatitis Infections
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAMA DEVI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUEST ION NO. 3763 TO BE ANSWERED ON 24 TH MARCH, 2017

## V IRAL HEPATITIS INFEC TIONS

## 3763. SHRIMATI RAMA DEVI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether cases of viral hepatitis infections are on the rise in different parts of the country including Bihar and if so, the details thereof and the reasons therefor;
- (b) the details of various types o f hepatitis infections reported during the last three years and current year, type and State/UT - wise;
- (c) whether viral hepatitis is a major public health concern in the country and is hyper for HAV and HEV and if so, the details thereof alon g with the funds allocated and utilized for its prevention and cure during the last three years, State/ UT - wise; and
- (d) the details of efforts taken by the Government to take rapid action to create awarenes the disease and to increase access for screening and treatment services?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA P ATEL )

- (a) & (b) : Yes. The number of cases due to Viral Hepatitis as reported by the States/UTs Central Bureau of Health Intelligence (CBHI) in the last three years is given at Annexure I. Separate figures for various types of Hepatitis are not collected at present.
- (c) : Yes, Viral Hepatitis is a major public health problem in the country and surveillan describe trends in type specific acute hepatitis including HAV and HEV. A Nation al Programme on  Surveillance  of  Viral  Hepatitis  under  the  12 th Five  Year  Plan  has  been  launched  by  the Government with an estimated budget of 30 crore. National Centre for Disease Control (NCD Delhi is coordinating the various activities under this prog ramme. The initial funds have been released to NCDC and the surveillance activities have been initiated.

Contd……..

NCDC also provides technical guidance to State Governments/UTs on prevention and control of water borne diseases including Hepatitis, and helps them in carrying out inves of outbreaks of such diseases under Integrated Disease Surveillance Programme (IDSP). NCDC also  provides  laboratory  support  for  outbreak  investigations  and  etiological  diagnosis conducting regular training courses for development of trained manpower. Funds are releas States/UTs under Integrated Disease Surveillance Pro gramme (IDSP) to strengthen surveillance and to detect and respond to outbreaks of epidemic - prone diseases. The detail of funds released and  expenditure  incurred  to  States/UTs  during  last  three  years  and  current  year Annexure II.

( d) : The main cause of Hepatitis A & E is consumption of contaminated water and provision of  safe  drinking  water  is  the  main  strategy  to  control  diseases  caused  by  drink contaminated water. Rural water supply is a State subject. Government of India supplements the efforts of the States by providing technical and financial assistance under the centrally National Rural Drinking Water Programme (NRDWP) for providing safe and adequate drinking water supply facilities in rural areas of the coun try.

Hepatitis B vaccination is included under the Universal Immunization Programme (UIP) of Government of India. Government is using auto - disabled (AD) syringes for all vaccinations under the UIP in all States. AD syringes are single use, self - locking syringes that cannot be used more than once. This prevents misuse and contamination/cr oss infection through repeated use of unsterile injection/equipment.

Screening  of  blood  reduces  the  risk  of  transmission  of  Hepatitis  B  and  C  by  b transfusion.  Therefore,  blood  banks  mandatorily  screen  for  Hepatitis  B  &  C  as  per  Dr Cosmetics Act 19 40 and rules thereof.

………………..

## Annexure I

| State - wise Cases due to Viral Hepatitis (All Causes) reported during 2014 - 2016   | State - wise Cases due to Viral Hepatitis (All Causes) reported during 2014 - 2016   | State - wise Cases due to Viral Hepatitis (All Causes) reported during 2014 - 2016   |   State - wise Cases due to Viral Hepatitis (All Causes) reported during 2014 - 2016 | State - wise Cases due to Viral Hepatitis (All Causes) reported during 2014 - 2016   |
|--------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------|
| Sl. No.                                                                              | State / U.T.                                                                         | 2014                                                                                 |                                                                                 2015 | 2016 (Prov.)                                                                         |
| 1                                                                                    | Andhra Prad esh                                                                      | 3716                                                                                 |                                                                                 3358 | 2662                                                                                 |
| 2                                                                                    | ArunachalPrad esh                                                                    | 378                                                                                  |                                                                                  292 | 271                                                                                  |
| 3                                                                                    | Assam                                                                                | 2033                                                                                 |                                                                                  809 | 2688                                                                                 |
| 4                                                                                    | Bihar                                                                                | 20670                                                                                |                                                                                26729 | 28578                                                                                |
| 5                                                                                    | Chhattisgarh                                                                         | 548                                                                                  |                                                                                  532 | 547                                                                                  |
| 6                                                                                    | Goa                                                                                  | 182                                                                                  |                                                                                  162 | 121                                                                                  |
| 7                                                                                    | Gujarat                                                                              | 4808                                                                                 |                                                                                 3736 | 3573                                                                                 |
| 8                                                                                    | Haryana                                                                              | 1934                                                                                 |                                                                                 5184 | 2274                                                                                 |
| 9                                                                                    | Himachal Pradesh                                                                     | 2808                                                                                 |                                                                                 1739 | 2716                                                                                 |
| 10                                                                                   | J & K                                                                                | 5110                                                                                 |                                                                                 4028 | 3581                                                                                 |
| 11                                                                                   | Jharkhand                                                                            | 1052                                                                                 |                                                                                 1258 | 1406                                                                                 |
| 12                                                                                   | Karnataka                                                                            | 6402                                                                                 |                                                                                 6026 | 6013                                                                                 |
| 13                                                                                   | Kerala                                                                               | 5567                                                                                 |                                                                                 3965 | 5327                                                                                 |
| 14                                                                                   | Madhya Pradesh                                                                       | 16145                                                                                |                                                                                14030 | 12158                                                                                |
| 15                                                                                   | Maharashtra                                                                          | 6753                                                                                 |                                                                                 9738 | 12156                                                                                |
| 16                                                                                   | Manipur                                                                              | 443                                                                                  |                                                                                   88 | 182                                                                                  |
| 17                                                                                   | Meghalaya                                                                            | 643                                                                                  |                                                                                  299 | 236                                                                                  |
| 18                                                                                   | Mizoram                                                                              | 194                                                                                  |                                                                                  209 | 276                                                                                  |
| 19                                                                                   | Nagaland                                                                             | 113                                                                                  |                                                                                   76 | 86                                                                                   |
| 20                                                                                   | O disha                                                                              | 5069                                                                                 |                                                                                 5146 | 3481                                                                                 |
| 21                                                                                   | Punjab                                                                               | 4525                                                                                 |                                                                                 9330 | 8833                                                                                 |
| 22                                                                                   | Rajasthan                                                                            | 9719                                                                                 |                                                                                 3247 | 2471                                                                                 |
| 23                                                                                   | Sikkim                                                                               | 556                                                                                  |                                                                                 1344 | 800                                                                                  |
| 24                                                                                   | Tamil Nadu                                                                           | 880                                                                                  |                                                                                 1066 | 715                                                                                  |
| 25                                                                                   | Telangana                                                                            | NA                                                                                   |                                                                                 1735 | 2175                                                                                 |
| 26                                                                                   | Tripura                                                                              | 177                                                                                  |                                                                                  183 | 363                                                                                  |
| 27                                                                                   | Uttarakhand                                                                          | 9243                                                                                 |                                                                                10242 | 10930                                                                                |
| 28                                                                                   | Uttar Pradesh                                                                        | 16037                                                                                |                                                                                11188 | 12530                                                                                |
| 29                                                                                   | West Bengal                                                                          | 4444                                                                                 |                                                                                 3948 | 2898                                                                                 |
| 30                                                                                   | A & N Islands                                                                        | 262                                                                                  |                                                                                  123 | 177                                                                                  |
| 31                                                                                   | Chandigarh                                                                           | 766                                                                                  |                                                                                 1249 | 1179                                                                                 |
| 32                                                                                   | D & N Haveli                                                                         | 32                                                                                   |                                                                                   48 | 7                                                                                    |
| 33                                                                                   | Daman & Diu                                                                          | 65                                                                                   |                                                                                   77 | 31                                                                                   |
| 34                                                                                   | Delhi                                                                                | 6965                                                                                 |                                                                                 9145 | 10281                                                                                |
| 35                                                                                   | Lakshadweep                                                                          | 16                                                                                   |                                                                                   12 | 10                                                                                   |
| 36                                                                                   | Puducherry                                                                           | 299                                                                                  |                                                                                  520 | 416                                                                                  |
| Total                                                                                |                                                                                      | 138554                                                                               |                                                                               140861 | 142148                                                                               |

Source:  National Health Profile brought out by CBHI, D te. GHS

## Note :

1.  2014: Andhra Pradesh Excludes data of 10 districts of Telangana from July 2014.
2.  2015 & 2016: Data is different for different reference period.
3.  NA stands for Not Available.

## ANNEXURE II

| INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   | INTEGRATED DISEASE SURVEILLANCE PROGRAMME   |
|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|---------------------------------------------|
|                                             |                                             | SUMMARY OF FINANCIAL STATUS OF STATE        | SUMMARY OF FINANCIAL STATUS OF STATE        | SUMMARY OF FINANCIAL STATUS OF STATE        | SUMMARY OF FINANCIAL STATUS OF STATE        | (Rs in Lacs) As on 27.2.2017                | (Rs in Lacs) As on 27.2.2017                | (Rs in Lacs) As on 27.2.2017                | (Rs in Lacs) As on 27.2.2017                |
| Sl. No.                                     | States/UTs                                  | GIA released                                | GIA released                                | GIA released                                | GIA released                                | Expenditure                                 | Expenditure                                 | Expenditure                                 | Expenditure                                 |
|                                             |                                             | 2013-14                                     | 2014-15                                     | to 2015-16                                  | States 2016-17                              | 2013-14                                     | 2014-15                                     | 2015-16                                     | 2016-17                                     |
| A                                           |                                             |                                             |                                             |                                             |                                             |                                             |                                             |                                             |                                             |
| 1                                           | Andhra Pradesh                              | 198.31                                      | 122.48                                      | 112.5                                       |                                             | 229.2                                       | 140.83                                      | 186.99                                      | 163.85                                      |
| 2                                           | Gujarat                                     | 270                                         | 400                                         | 325                                         | 262.5                                       | 477.07                                      | 549.25                                      | 656.39                                      | 319.4                                       |
| 3                                           | Karnataka                                   | 124                                         | 270.5                                       | 300                                         | 160                                         | 308.53                                      | 374.59                                      | 425.13                                      | 296.64                                      |
| 4                                           | Maharashtra                                 | 183.5                                       | 280                                         | 225                                         | 240                                         | 239.44                                      | 248.59                                      | 240.49                                      | 142.33                                      |
| 5                                           | Punjab                                      | 120.2                                       | 168.75                                      | 325.92                                      | 157.5                                       | 201.9                                       | 281.94                                      | 375.94                                      | 489.17                                      |
| 6                                           | Rajasthan                                   | 195.32                                      | 325                                         | 325                                         | 262.5                                       | 293.04                                      | 328.44                                      | 477.72                                      | 586.66                                      |
| 7                                           | Tamil Nadu                                  | 98.26                                       | 325                                         | 350                                         | 330                                         | 287.2                                       | 401.18                                      | 499.91                                      | 375.96                                      |
| 8                                           | Uttarakhand                                 | 60.93                                       | 45                                          | 200                                         | 187.5                                       | 165.14                                      | 172.73                                      | 214.87                                      | 87.46                                       |
| 9                                           | West Bengal                                 | 120.11                                      | 250                                         | 200                                         | 100                                         | 221.81                                      | 182.7                                       | 215.9                                       | 184.82                                      |
| 10                                          | Andaman & Nic. Islands                      | 19.87                                       | 9                                           | 5.25                                        |                                             | 11.37                                       | 12.91                                       | 24.19                                       | 11.08                                       |
| 11                                          | Bihar                                       | 164.69                                      | 200                                         | 210                                         | 172.5                                       | 190.84                                      | 263.63                                      | 272.24                                      | 142.43                                      |
| 12                                          | Chandigarh                                  | 19.92                                       | 40                                          | 23.25                                       | 30                                          | 28.31                                       | 28.33                                       | 41.06                                       | 26.79                                       |
| 13                                          | Chhattisgarh                                | 29.67                                       | 60                                          | 200                                         | 150                                         | 147.47                                      | 134.84                                      | 155.35                                      | 114.1                                       |
| 14                                          | Dadra & N. Haveli                           | 22.36                                       | 21                                          | 32.17                                       | 17.5                                        | 23.96                                       | 27.8                                        | 43.13                                       | 27.34                                       |
| 15                                          | Daman & Diu                                 | 31.32                                       | 6.01                                        | 50                                          | 17.5                                        | 31.44                                       | 24.75                                       | 33.7                                        | 7.49                                        |
| 16                                          | Delhi                                       | 34.9                                        | 56.25                                       | 105                                         | 75                                          | 57.41                                       | 93.87                                       | 79.99                                       | 45.72                                       |
| 17                                          | Goa                                         | 28.23                                       | 45                                          | 40                                          | 37.5                                        | 33.62                                       | 43.8                                        | 43.91                                       | 34.92                                       |
| 18                                          | Haryana                                     | 71.32                                       | 150                                         | 180                                         | 150                                         | 169.1                                       | 178.65                                      | 150.02                                      | 96.94                                       |
| 19                                          | Himachal Pradesh                            | 73.06                                       | 70                                          | 70                                          | 60                                          | 56.98                                       | 62.91                                       | 64.22                                       | 33.74                                       |
| 20                                          | J&K                                         | 82.22                                       | 127.5                                       | 250                                         | 187.5                                       | 120.77                                      | 128.74                                      | 226.95                                      | 160.96                                      |
| 21                                          | Jharkhand                                   | 119.25                                      | 112.5                                       | 220                                         | 100                                         | 133.4                                       | 120.66                                      | 183.45                                      | 65.94                                       |
| 22                                          | Kerala                                      | 106.21                                      | 101.25                                      | 150                                         | 127.5                                       | 144.87                                      | 130.14                                      | 130.07                                      | 101.48                                      |
| 23                                          | Lakshadweep                                 |                                             |                                             |                                             |                                             | 0.82                                        | 2.63                                        | 1.09                                        | 0.37                                        |
| 24                                          | Madhya Pr.                                  | 246.51                                      | 350                                         | 300                                         | 150                                         | 340.66                                      | 364.6                                       | 399.12                                      | 193.54                                      |
| 25                                          | Orissa                                      | 92.72                                       | 350                                         | 325                                         | 150                                         | 245.86                                      | 297.76                                      | 351.82                                      | 251.02                                      |
| 26                                          | Puducherry                                  | 43.6                                        | 70                                          | 65                                          | 37.5                                        | 60.07                                       | 61.26                                       | 74.93                                       | 50.43                                       |
| 27                                          | Uttar Pradesh                               | 203.88                                      | 300                                         | 300                                         | 337.5                                       | 383.69                                      | 479.91                                      | 524.13                                      | 449.58                                      |
| B                                           | Telangana                                   | 0                                           | 87.53                                       | 125                                         |                                             | 0                                           | 128.35                                      | 160.09                                      | 117.57                                      |
| 28                                          | Arunachal Pr.                               | 181.69                                      | 152.24                                      | 220                                         | 152.25                                      | 192.01                                      | 129.57                                      | 273.96                                      | 116.71                                      |
| 29                                          | Assam                                       | 129.91                                      | 206.25                                      | 404                                         | 187.5                                       | 177.79                                      | 305.12                                      | 398.19                                      | 264.04                                      |
| 30                                          | Manipur                                     | 25.69                                       | 96.25                                       | 75                                          | 75                                          | 42.89                                       | 87.95                                       | 94.4                                        | 48.74                                       |
| 31                                          | Meghalaya                                   | 20.25                                       | 45                                          | 100                                         | 52.5                                        | 57.85                                       | 39.6                                        | 76.95                                       | 57.35                                       |
| 32                                          | Mizoram                                     | 70.44                                       | 97.5                                        | 100                                         | 67.5                                        | 84.27                                       |                                             | 96.05                                       | 62.85                                       |
| 33                                          | Nagaland                                    | 115.84                                      | 120                                         | 150                                         |                                             |                                             | 80.23                                       |                                             |                                             |
|                                             |                                             |                                             |                                             |                                             | 105                                         | 110.16                                      | 108.38                                      | 192.37                                      | 130.75                                      |
| 34                                          | Sikkim                                      | 30                                          | 50                                          | 40                                          | 37.5                                        | 38.12                                       | 48.92                                       | 45.45                                       | 21.1                                        |
| 35                                          | Tripura Grand Total                         | 15.32 3349.5                                | 50 5160.01                                  | 40 6143.09                                  | 37.5 4214.75                                | 23.61 5330.67                               | 44.81 6110.37                               | 39.78 7469.95                               | 29.65 5308.92                               |