Lok Sabha Question No. 4556 (UNSTARRED), answered on 2019-07-19
Subject: Vaccination for Vector Borne Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Manickam Tagore B

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

LOK SABHA UNSTARRED QUESTION NO. 4556 TO BE ANSWERED ON 19 TH JULY, 2019

## VACCINATION FOR VECT OR BORNE DISEASES

## 4556. SHRI MANICKAM TAGORE B.:

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

- (a) whether the Government is concerned that every year during the months between August October, prevalence of Dengue and other vector borne diseases is being experienced for t several years across the country especially in the State of Tamil Na du;
- (b) if so, whether the Government is contemplating any plan of action to take preventive including timely vaccination to control such diseases; and
- (c) if so, the details thereof and the action taken by the Government in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a): Yes, during post - monsoon season (August to October) prevalence of Dengue and other Vector Borne Diseases (VBD) is being experienced for the last several years across the country including in Tamil Nadu.   However, the cases of VBDs have declined in the country and al Tamil Nadu in these months in the last three years (2016, 2017 & 2018) as shown in Annexure.

## (b )& ( c) : Malaria:

The Government has l aunched the National Framework for Malaria Elimination (NFME), 2016 -2030 in India to eliminate malaria in a phased manner by 2027 and to sustain till 2030. NFME, 15 low burden States (Category -1) are targeted for elimination by 2020, the 11 moderate burden States (Category -2) by 2024 and remaining 10 high burden States (Category - 3) by 2027. The action taken for prevention and control of malaria is as under:

1. Ensuring availability of Rapid Diagnostic Tests (RDTs) and anti - malarials with Accredited Soci al Health Activists ( ASHAs) and other health workers for Early Diagnosis and Complete Treatment (EDCT) at community level.
2. Distribution of Long Lasting Insecticidal Nets (LLINs) to the people living in high endemic  areas  of  the  country.  So  far,  5.0  crore  LLINs  have  been  distributed  to community in various malaria endemic States.
3. Regular  monitoring  of  the  reports  re ceived  from  the  States  and  provision  of  feedback accordingly.
4. Regular monitoring through field visits by  officers/consultants of National Vector Diseases Control Programme (NVBDCP).
5. Issue of advisories to the States before the monsoon season to ups cale their activities and to make all the necessary preparations.
6. Technical support and guidance.
7. The Anti - malaria month is observed every year in the month of June.

## Dengue and Chikungunya:

In  the  absence  of  a  specific  drug  for  treatment  and  vaccine  fo r  prevention  of  Dengue  and Chikungunya,  these  cases  are  treated  symptomatically.  Government  of  India  (GOI)  provi Technical Guidelines to the States for prevention and control, case management and eff community participation.

In  addition,  Go I  has  taken  the  following  steps  for  prevention  and  control  of  Dengue  a Chikungunya: -

- Monitoring and supervision for early case detection, prevention and control.
- Periodic reviews done at the higher level.
- Advisories are issued to sensitize the States.
- Conduct  trainings for capacity building of doctors on case management.
- Free diagnostic facilities through Sentinel Surveillance Hospitals (SSHs) and Apex Re laboratories (ARLs) identified across the country. Till date, 673 SSHs and 16 ARLs been identified across the country. Test kits are supplied by GOI free of cost.
- National Dengue Day is observed on 16th May across the country.
- Information  Education  Communication (IEC)  /  Behaviour  Change  Communication  (BCC) activities to disseminate knowledg e for prevention and control.

## Lymphatic Filariasis (LF):

For the elimination of LF, Mass Drug Administration (MDA) is provided to the endemic dist in 21 states.  MDA was done with 2 drugs earlier but now combination of 3 drugs has introduced i n selected districts. MDA is carried out during specific period in the year.  T it has been carried out in August and will also be carried out in  November, 2019. Each r MDA  is  accompanied  with  IEC  campaigns  like  Inter - personal  contact  with the  beneficiaries, Distribution  of  pamphlets,  Flipcharts,  Display  of  banners,  Radio  Jingles  and  Newspa advertisements etc.

## Japanese Encephalitis (JE)/ Acute Encephalitis Syndrome (AES):

Under the National Programme for Prevention and Control of JE/AES , following measures have been carried out for  prevention and control of JE in the country, including in Tamil Nadu

- JE vaccination campaign is carried out in children (1 - 15 years) followed by introduction of routine immunization in children of new cohort s with 2 doses of vaccine, one at 9 months age and second at the age of 16 - 24 months. So far, 234 districts have been covered under JE vaccination in children including 13 districts of Tamil Nadu.
- Adult  (>15 - 65  years)  JE  vaccination  campaign  has  also  been carried  out  in  identified districts.
- Establishment  of  10  bedded  Pediatric  Intensive  Care  Unit  (PICU)  in  60  high  burden districts of 5 States which includes 5 districts of Tamil Nadu.
- Establishment of Sentinel Sites for the testing of JE wherein diagnosti c kits are supplied free of cost. In Tamil Nadu 6 SSH have been identified and in 2019 (till 08.07.2019)  29 J kits have been supplied
- Funds have been provided for strengthening of 10 Physical Medicine Rehabilitation (PM in identified Medical Colle ges of 5 states. This includes one PMR Department  in Tamil Nadu.

Funds have also been provided to the States for undertaking public health measures inc vector control and awareness activities.

## Kala- Azar:

For elimination of Kala -Azar following preventive action is taken by the Government:

- Treatment with Single day single dose of  Liposomal Amphoterecin B injection (LAMB).
- Continuous case search by health workers for both Visceral Leishmaniasis (VL) and Po -Kala- Azar Dermal Leishmania sis  (PKDL).
- Intensive IEC/BCC activities in hot spot villages.
- Regular review with States and stakeholders on monthly basis by officers and consultan monitoring and  supervision.
- Review of Kala - azar elimination activities regularly by District Colle ctors .
- Online entry on KA MIS portal for follow up of Kala Azar patients at Block level.
- GoI also provides incentives to VL and PKDL treated patients and for referral to ASHAs

(Kala Azar is not endemic in Tamil Nadu)

| Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          | Annexure                                                                                                          |
|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------|
| The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 | The details of cases of VBDs in the country and in Tamil Nadu during August to October for the years 2016 to 2018 |
|                                                                                                                   |                                                                                                                   | Malaria                                                                                                           | Malaria                                                                                                           | Malaria                                                                                                           | Kala-Azar                                                                                                         | Kala-Azar                                                                                                         | Kala-Azar                                                                                                         | Dengue                                                                                                            | Dengue                                                                                                            | Dengue                                                                                                            | Chikungunya                                                                                                       | Chikungunya                                                                                                       | Chikungunya                                                                                                       | JE                                                                                                                | JE                                                                                                                | JE                                                                                                                |
|                                                                                                                   |                                                                                                                   | Aug                                                                                                               | Sept                                                                                                              | Oct                                                                                                               | Aug                                                                                                               | Sept                                                                                                              | Oct                                                                                                               | Aug                                                                                                               | Sept                                                                                                              | Oct                                                                                                               | Aug                                                                                                               | Sept                                                                                                              | Oct                                                                                                               | Aug                                                                                                               | Sept                                                                                                              | Oct                                                                                                               |
|                                                                                                                   | Country Total                                                                                                     | 141396                                                                                                            | 132119                                                                                                            | 106831                                                                                                            | 541                                                                                                               | 471                                                                                                               | 372                                                                                                               | 16252                                                                                                             | 29894                                                                                                             | 34700                                                                                                             | 2743                                                                                                              | 12856                                                                                                             | 19324                                                                                                             | 212                                                                                                               | 333                                                                                                               | 313                                                                                                               |
|                                                                                                                   | Tamil Nadu                                                                                                        | 670                                                                                                               | 573                                                                                                               | 536                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | 199                                                                                                               | 264                                                                                                               | 311                                                                                                               | 2                                                                                                                 | 13                                                                                                                | 10                                                                                                                | 5                                                                                                                 | 4                                                                                                                 | 17                                                                                                                |
|                                                                                                                   | Country Total                                                                                                     | 103249                                                                                                            | 90951                                                                                                             | 62923                                                                                                             | 504                                                                                                               | 412                                                                                                               | 375                                                                                                               | 18108                                                                                                             | 28504                                                                                                             | 56965                                                                                                             | 10753                                                                                                             | 9107                                                                                                              | 8510                                                                                                              | 318                                                                                                               | 359                                                                                                               | 180                                                                                                               |
|                                                                                                                   | Tamil Nadu                                                                                                        | 735                                                                                                               | 778                                                                                                               | 548                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | 2194                                                                                                              | 2687                                                                                                              | 6124                                                                                                              | 21                                                                                                                | 11                                                                                                                | 2                                                                                                                 | 6                                                                                                                 | 36                                                                                                                | 0                                                                                                                 |
| 2018                                                                                                              | Country Total                                                                                                     | 45682                                                                                                             | 64283                                                                                                             | 57813                                                                                                             | 379                                                                                                               | 337                                                                                                               | 308                                                                                                               | 10092                                                                                                             | 16877                                                                                                             | 30125                                                                                                             | 6406                                                                                                              | 7542                                                                                                              | 9458                                                                                                              | 339                                                                                                               | 413                                                                                                               | 361                                                                                                               |
| 2018                                                                                                              | Tamil Nadu                                                                                                        | 408                                                                                                               | 319                                                                                                               | 321                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | Nil                                                                                                               | 178                                                                                                               | 240                                                                                                               | 605                                                                                                               | 11                                                                                                                | 26                                                                                                                | 40                                                                                                                | 5                                                                                                                 | 1                                                                                                                 | 14                                                                                                                |

Lymphatic Filariasis(LF) : Currently 256 districts in 21 States/UTs are endemic for Lymphatic Filariasis (LF). As on June, 2019, 96 districts have achieved  microfilaria  rate  <1%  and  stopped  Mass  Drug  Administration  (MDA).  As in December, 2018,  a  total  of  9,03,865  and  3,94,398 Lymphoedema and Hydrocele cases respectively are reported from 21 endemic States and UTs.

In Tamil Nadu, out of total 32 districts, all endemic 20 districts have achieved microfilaria rate <1% and stopped Mass Drug Administration (MDA) validated  through  Transmission  Assessment  Survey  (TAS).  As  on  Dec  2018,  a  total  of  40059  and  9266  Lymphoedema  and  Hydrocele  cases respectively are reported.