In Chitwan, where the development of modern settlements flourished after malaria (malaria) disease caused by mosquitoes was brought under control, even now, other diseases spread due to mosquito bites are very annoying from time to time. Chitwan, the main center of dengue disease caused by mosquitoes, has recently been affected by an infectious disease called Japanese Encephalitis (JE). JE is caused by the bite of an infected mosquito of the Culex species.

The woman who migrated from Lamjung with her family to Chitwan in 2014 is now 78 years old. At that time, malaria was under control in Chitwan and settlement expansion was just beginning. Last July 28, he had diarrhea. Vomiting started the next day. The sons went to a nearby medical center and asked for medicine for their mother. The medical director asked to bring the mother. The sons were scared and took their mother. Upon seeing the mother, the medical director suggested to take her to the hospital immediately. 

On the evening of 29th July, the old lady was kept in the emergency room of Bharatpur government hospital. As his condition worsened, he was placed in the intensive care unit (ICU) on July 30 and treatment began. On August 2, a blood sample was taken and sent to the Central Public Health Laboratory for testing. According to the younger son, who was with him in the hospital, the information that the test confirmed that the mother has JE came on August 9. Chitwan Jhare had not been affected by any disease when she was afraid of mosquitoes. In the latter part of her life, she will be under treatment for a few more days after she contracted 'JE', a contagious disease caused by mosquito bites.

In Chitwan, this time 'JE' infection has increased. According to Ram KC, Inspector of Vector (Insect Disease) Control of Public Health Office, JE infection has been confirmed in 14 people from last July 1 to August 10. KC informed that four of them died. 

He said that JE infection started to appear since July 23. In the last financial year, only three people were infected with JE. Before that, 9 people got JE in financial year 079/80. In 080/81, the data of JE infection is not visible. 'JE, which is considered to be a major problem in the West Terai, has troubled Chitwan this time. Many of those who died are from Chitwan, said KC, vector control inspector. 50/60 years ago in Chitwan, malaria i.e. malaria, which was considered dangerous, was seen in 4/500 people a year around the 50s. In recent years, there has been a committee of 10 people. "Looking at the data of the last three financial years, in 077/78, one person, then 9 people and in 079/80, 10 people were found to have malaria," said KC, the vector control inspector. He said that instead of being infected in Chitwan itself, Malaria appeared among those who returned from India for work.

But KC says it was due to the bite of an infected mosquito in JE Chitwan. Before JE, in 2004, dengue was found infected for the first time in the country in Chitwan. Since 2010, dengue has taken the form of an epidemic in Chitwan for three years. After dengue, the risk of a new infectious disease called scrub typhus started to increase in Chitwan. Typhus is caused by the bite of small beetles or moths in rats.

Harassing from mosquitoes to mosquitoes 

KC, who started working as an assistant inspector in 2052 from Chitwan, became an inspector from 2064. He is working in Chitwan except for two years between his working life. In Chitwan, it is his experience that people's nature to avoid diseases has not changed according to the level at which mosquitoes and ticks that cause malaria, dengue, scrub typhus and Japanese encephalitis have increased.

The mosquitoes that cause malaria, dengue and Japanese encephalitis are of different species. Humans are also infected by female mosquitoes of those species that are infected with the virus that can cause the disease. Therefore, avoiding such diseases means not allowing mosquitoes to breed and grow. Avoid mosquito bites. This work can be done by individuals, families and communities," says Casey.

Scrub typhus disease is caused by the bite of a tiny worm-like parasite that infects rats. Infected people were seen in Chitwan before but it was not sure where they got infected from. In 2072, a study was conducted by the Department of Health Services, Epidemiology and Disease Control Division, Insect Disease Research and Training Center, National Public Health Laboratory and the then District Public Health Office. The joint study took the blood samples of rats and tested them. After that, it was confirmed that the scrub is in Chitwan,' KC said. 

In the financial year 078/79, 268, 503 in 079/80, 552 in 080/81, scrub typhus infection was found. In the last financial year, 496 people were infected and one person died. There was no death in the previous three financial years. 

Dengue, which was first seen in Chitwan in 2004, remained rampant until 2009, KC said. In 2010, dengue appeared in 745 people and became an epidemic. Dengue, which used to slow down in some years, has become very annoying in the space of three years. In the financial year 076/77, dengue infection was confirmed in 4 thousand 803 people of Chitwan. Last year too, dengue spread in Ichchakamana, a hilly area of ​​Chitwan. KC informed that dengue infection was confirmed in 3 thousand 20 people in Chitwan alone last year. Along with dengue affecting thousands, scrub typhus in hundreds, Japanese encephalitis infection has also started in Chitwan. Compared to dengue and scrub typhus, Japanese encephalitis infects very few people, but it is more dangerous. Because up to 30 percent of those infected with JE die.

Unchanged human nature

Although diseases other than scrub typhus are caused by mosquitoes, the symptoms and prevention methods of all these diseases are similar to a large extent. If there is cleanliness in the house yard, village neighborhood, rats and mosquitoes cannot grow. Dinesh Rupakheti, Head of Public Health Office, argues that even though precautions are not taken to avoid diseases in Chitwan, the problem is recurring because the geography and climate are favorable for mosquitoes. To avoid mosquitoes and rats, those who have a good financial situation build their houses accordingly. But in rural areas, everything is not managed," said Rupakheti. He said that since Chitwan is a district with high risk of insect-borne diseases due to the past history and the fact that infected people are found here even though they are not in other districts, the community should adopt the same awareness. The risk of insect-borne diseases is higher in rural areas. Among them, the outbreak of dengue is towards the city. Even though the locals know how to avoid such infections, it seems that they do not want to take precautions," said Rupakheti. He suggests wearing clothes with long sleeves to avoid mosquito bites and mosquitos, as dengue-causing mosquitoes are attracted to black and should not wear such colored clothes.