Video Editor: Shubham Khurana
After 1-year-old Daksh developed a fever on 28 August in west UP's Baghpat, the family rushed him to several doctors before admitting him to a hospital. The private hospital doctors assured the family he would be better in two days, but five days later the family was asked to admit him elsewhere. Four days later, Daksh was diagnosed with the Scrub Typhus disease.
Scrub Typhus, also called Bush typhus, is a bacterial disease that spreads to people through bites of infected larval mites. The Quint was informed that Baghpat has not seen a Scrub Typhus case for several years, but the increase in rains this year must have led to the spread in this part of west UP. After Mathura, Firozabad, Agra, Mainpuri and Etah, Baghpat is another district to report the disease. Scrub typhus and dengue have combined killed at least 100 people in the state.
While his anxious family patiently waits to see Daksh for 5 minutes four to five times a day, back in his village his neighbours and family members told The Quint that the administration and the village pradhan Dinesh Tyagi have been laidback in taking necessary steps to curb the spread of the disease.
Daksh's mother, 26-year-old Jyoti Kumar said he would mainly play at home, so she was not sure where or when he was bitten by a bug. "We are worried. We have four other children in the family. My son's is the first such case in Baghpat," Jyoti said.
Doctor Says Prevention is Crucial
After Daksh was brought to Aastha Hospital, Dr Tomar, who heads the department of Paediatrics and Neonatology said he informed the Baghpat Chief Medical Officer on the morning of 4 September itself. "Then again I informed the office on 6 September, when we got the confirmed test results from a private laboratory in Meerut," Dr Tomar added.
However the administration's response was lacking in urgency. "The procedure to be followed is that you have to inform the administration and CMO office. Scrub is spread through an insect bite. A larva that is found in bushes, and it is through that bite that the disease spreads. So if any member of the family goes to the bushes or the grass, they are bitten by the insect there. It is a painless bite so one does not come to know. Symptoms start showing 4-5 days later. These include fever, body ache. Hence identifying the locality is extremely important. To spray the insecticide is crucial," Dr Tomar explained.
Parallelly, another report was sent for in PGI Lucknow. He explained that the CMO's office insists on a test from a government lab which contributes to the delay in taking preventative steps.
Speaking about the importance of prevention, he said, "If the numbers increase and we do not control it on the administration level, then it can lead to problems. Since it rained more here than what it does generally, naturally more grass and bushes grew. This is why this insect is breeding here more, otherwise it would not show up in this region. Scrub is new in the region. This is the first case recorded in Baghpat in several years," Dr Tomar explained.
Dr Suranjeet Chaterjee, an internal medicine specialist at Indrapastha Apollo Hospital, said that the diagnosis for Scrub Typhus is not thought of as it is an uncommon disease. He said the administration must spread awareness of the cases in the district, so that the diagnosis can happen on time. "If there is a delay in treatment, then the patient could die," he explained.
What the Admin Did versus What They Should Have Done
The villagers say that the administration did not show up to clean or spray the area from when Daksh fell ill till 7 September. When they did show up, their work has been far from satisfactory. On 8 September morning 2 ASHA workers came and asked only a few homes if anyone had fever or cough, they said.
"They came home and asked if anyone had fever or cough at home, they made some notings and left," Akshay, who was at home, said.
This is not everything the administration was supposed to do.
Baghpat Chief Medical Officer Dinesh Kumar had outlined a detailed plan of what the state was doing to combat the rise in mosquito-related illnesses. He said 464 teams of two people each were made, from the Anganwadi or ASHA, and tasked with the responsibility of visiting fifty homes every day between 7 and 18 September across the district.
Kumar said they were supposed to ask the following four queries to each home:
People with fever, cough are being asked to identify themselves.
People who have had a cough for a prolonged period of time are being identified for possibly having TB.
A list of kids who are younger than 2 years and have not been completely vaccinated (routine) is being made.
A list of people above 45, who have not even got one dose of the Covid vaccine, is also being prepared.
The Quint asked Daksh's neighbours if the two administration workers had asked them the four queries. While in a few homes they asked if any child had cough or fever, they skipped many houses close to Daksh's home. They did not ask the four queries in any home.
Rahul Kumar who lives right outside the lane from Daksh's home said, "No one has come to our home. They went to their home (Daksh's home) and left this way." Another neighbour said, "I saw the two women but they skipped my home and went to other homes. My home is closer to their home," Pooja, 26, said. Shiva, a 14-year-old, who was home also said that he saw the two women ask other homes but they skipped his house.
In the homes the workers did go to, they did not ask all the queries.
Another man Sushil Kumar said they had come home but only asked if anyone in the family had cough or fever and left. Priyanka, 32, who lives close by, said, "They barely stayed for two minutes and were on their way out. They asked about someone having cough or fever and then left. They took my phone number too." Similarly, another neighbour Seema, said they had come and asked the same queries as they did to Priyanka and left. Even in Daksh's home, the workers only asked if anyone was unwell.
Regarding the cutting of grass and spraying of insecticides on the grass and bushes, Daksh's family and the neighbours said that no cleaning had happened yet. When we confronted the CMO with these queries, he said it was the job of the village pradhan to get the spraying and cutting done. "We have told him. This is under the Nagar panchayat and not our job," Dinesh Kumar said.
Till 9 September, the insecticides had been sprayed only in Daksh's home. "They did not cut any grass, just sprayed something and left," his uncle Devender Kumar told The Quint. Regarding the village and the nearby fields, he said that nothing had been done. The village sarpanch told us that the work was ongoing. When asked, why there was such delay, he reiterated that the work was was ongoing and would be completed soon.
(At The Quint, we question everything. Play an active role in shaping our journalism by becoming a member today.)