They were as young as four years old. They all had bouts of epilepsy for about five minutes, memory loss, anxiety, vomiting, headaches and backaches. They fell unconscious from nausea and seizures.
In the southern Indian state of Andhra Pradesh, a wave of mystery illness has left hundreds of residents struggling with symptoms with no known cause, and the doctors baffled.
Some, especially the children, vomited after complaining of burning eyes. These symptoms afflicted over 400 people and killed at least one.
“We’ve never seen anything like this before in our district,” Dr Sunanda, the District Magistrate and Health Officer of district Eluru, where it all unravelled, told VICE World News.
In just a span of four days, this small Indian town has mystified the country, especially in the middle of its battle with the COVID-19 wave. On Sunday, Dec. 6, Vidyanagar area of Eluru reported the first casualty from this mysterious illness: a 45-year-old man. His family took his body home for last rites, but the police brought it back to the hospital to investigate the cause.
The authorities are quick to blame the water source in the region. “Even though it is not conclusive, there’s a high possibility that water contamination is the cause,” said Dr Sunanda. However, state Health Minister A Kali Krishna Srinivas, on Monday, Dec. 7, had already ruled out water or air pollution based on inspections by his officials.
“Water samples were sent for testing and no contamination was found. Blood samples of the patients have been sent to labs. No viral infection has been detected,” Srinivas told The Indian Express. “All the patients are COVID-19 negative. It is some mystery illness and only lab analysis will reveal what it is.” The minister further added that the patients in the hospital are “out of danger”.
In the meantime, multiple teams of experts arrived in Eluru to figure out what’s happening. This includes teams from the World Health Organization, the All Indian Institute of Medical Sciences (AIIMS) and the National Centre for Disease Control (NCDC), which comes under the Ministry of Health and Family Welfare.
District officials surveyed 57,863 families from the region, even as increasingly more people developed symptoms. Over 50 doctors and specialists, three microbiologists, 136 nurses have been deputed in different hospitals.
As days progressed, more cases were reported. Nearly 30 more people were hospitalised on Monday, Dec. 7. They all had the same symptoms.
On Tuesday, Dec. 8, at least six people, who had seizures on Sunday and Monday, had a second attack. They have been readmitted to the Eluru Government Hospital.
Indian authorities are also investigating the role of organochlorines, a chemical that is used as pesticides or in mosquito control. Organochlorine pesticides lead to symptoms such as convulsions, headaches, dizziness, nausea, tremors, confusion, et cetera. “It is one of the possibilities,” Geeta Prasadini, a public health director in Andhra Pradesh, told Reuters.
But all authorities VICE World News spoke with confirmed one thing: Nothing is conclusive right now. “We can only talk once the investigation yields results,” Dr Rakesh Kakkar, the Medical Superintendent and Head of Department at AIIMS in Mangalagiri, which sent a team to Eluru, told VICE World News. “All we can say is that all these cases have neurological symptoms. We’ve not seen anything like this.”
Unknown diseases afflict the whole world. Data shows that there are 1.67 million unknown viruses lurking across the world today. An estimated 827,000 can infect humans. Health experts also warn of ‘Disease X’, the one that we don’t know about, yet. COVID-19 was one of them. The ongoing pandemic is testament to the fact that countries—especially India—are not equipped to handle them.
Dr Sujeet K Singh, the director of NCDC, told VICE World News that they see over 200 outbreaks, including the unidentified ones, annually. “During COVID-19, the number of identifying these unknown cases is less. However, the total number of outbreaks is much more,” he said. Singh added that their team reached Eluru on Dec. 8, and will present the first report on Dec. 9.
In the recent past, India has seen a string of mysterious outbreaks. The most recent attack of an unknown disease was reported last month, on Nov. 16, when two adults and 10 children died of an unidentified disease across four villages in the eastern Indian state of Jharkhand.
In September, the health department of the eastern Indian state of Odisha initiated a probe after 17 people in a village of 260 were afflicted with mysterious symptoms such as swollen feet and stomach. Four of them died. Odisha had reported another mysterious outbreak in June, when 15 tribals—out of a population of 400 in Kenduguda village—died of the same symptoms.
Last year in September, a wave of undefined fever struck 1,000 people in the western Indian state of Rajasthan. Media reports show that there is still no conclusive information available on these mysterious outbreaks. In fact, in some places, they continue to afflict people.
“Every person who comes sick in the hospital has a mystery disease. When you diagnose it, the mystery disappears,” Dr T Jacob John, an Indian virologist, told VICE World News. The problem, he added, is that India does not effectively assign definitions to many mysterious cases.
John has investigated three mysterious diseases in the states of Uttar Pradesh, Bihar and Odisha. While his cases were defined, he said that most cases are not named, classified and numbered.
At the moment, the Integrated Disease Surveillance Programme (IDSP), initiated by the World Bank, is tasked with investigating outbreaks, including the one in Eluru. “But India is not surveilling any disease, except polio,” said John. “We don’t have a system of surveillance.”
Other health experts say that inefficiencies of government organisations such as the NCDC to identify pathogens leads to independent researchers and doctors—such as John, who was invited by the state government and also pursued cases independently—trying to demystify the illnesses. However, lack of government support in many cases means that a consensus on the cause of diseases is rarely reached.
The under-preparedness for the unknown reflects in the Eluru case too, where political mudslinging has taken over this health crisis management.
Singh from NCDC said that unknown diseases are always identified in “due course of time.” “Of course, there are challenges, such as in this one, where we are yet to ascertain the nature of the outbreak,” said Singh. “The outbreaks, however, are mostly dealt with on a state level. If they're not able to manage properly, they ask the central government to intervene.”
Not all are convinced with India’s response to unknown outbreaks. “For India, a disease is a money-spinner. We don’t have the heart or the will to prevent diseases for the sake of society,” said John. “We still have diseases that were eradicated in other countries in the 19th century. How come India continues to have the highest cases of Tuberculosis in the world?”
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