Q: I am a resident of siliguri in west bengal. We are in a state of panic due to the outbreak of a mysterious disease. Medical experts from all over india who came here to investigate, but they too are not sure what type of disease this is. Patients are being admitted with high temperature, severe headache along with vomiting and body ache. Most of them are dying within a time span of forty eight to seventy two hours. Some of the doctors are of the opinion that these are the cases of encephalitis, while others feel that this is malignant malaria. May I get your opinion and advice in this regard?

A:As you realize it is very difficult to make a diagnosis of an illness which experts at the site are still evaluating. My guess is that it is "encephalitis". Encephalitis is an infection of the brain usually due to virus. It may well be due to a viral infection called Japanese B encephalitis. This has had many epidemics all over East and South India and is the commonest Epidemic encephalitis in India. The reason for the delay in diagnosis is that to establish a diagnoses the blood and autopsy samples would have to go to Viral Laboratories at nodal centers like Calcutta, Vellore or Pune and then the organisms and antibodies have to be checked. The usual result is that if there are 50 patients tested 5-10 will show definite positive results and these have to be checked among the 3 centers. It may be worth noting

• The treatment does not depend on finding the organism. All cases of viral encephalitis have the same treatment.
• These epidemics have an explosive start and terminate rapidly. So you are probably at the end of the attack now.
• It may be worth avoiding places where many people congregate e.g. theatre, cinema house, etc. especially if such meetings can be avoided conveniently.