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From The Desk of the Director

Issue Highlight

NCDC completed glorious 110 years of its existence on 30 July 2019. Hon’ble Union

Minister of Health and Family Welfare, Dr. Harsh Vardhan acknowledged the work

done by the institute in the field of public health and also inaugurated a state-of-art

laboratory in the august presence of Sh. Ashwini Kumar Choubey, Hon’ble State

Minister for Health and Family Welfare. Last decade was recorded as hottest in India.

This issue of newsletter has a lead story on steps taken by Ministry of Health and Family

Welfare to contain health related effects of heat wave.

This issue also carries the findings of AES outbreak investigation in Bihar. Young malnourished children were

found to be at high risk of illness in the current outbreak and various short and long term measures were

suggested to help prevent future outbreaks.

NCDC news section reports various important activities carried out by NCDC during the quarter including

various trainings and expert group meetings. I hope you enjoy reading the newsletter and I look forward to any

feedback from you.

Highlights in this issue

Issue Highlight……………………...1 Lead Story…….....……..…….…..…2

Heat and Human Health: Steps Taken by

NCDC

Outbreak Section…….………...…..6 AES Outbreak in Muzaffarpur, Bihar, June -

July 2019

NCDC News………........………..…9 Capacity Building of NCDC officials on

Laboratory Biosafety

NCDC conducts Team Building Workshop

Containment of Kyasanur Forest Disease:

NCDC organizes National Consultation in

Bengaluru

NCDC observes World Rabies Day

News From Around........……….….14 India celebrates World Population Day Disease Trends………………..........15 Viral Hepatitis Surveillance under IDSP

NCDC Buzz…...……………............16

Volume 8, Issue 3

July to September 2019

NCDC celebrated 110 Institute Day on 30 July 2019. On this occasion,

Hon’ble Union Minister of Health and Family Welfare, Dr. Harsh Vardhan

inaugurated a state-of-art laboratory for high consequence pathogens in the

august presence of Sh. Ashwini Kumar Choubey, Hon’ble State Minister

for Health and Family Welfare. He acknowledged the work done by the

institute in the field of public health. He congratulated NCDC for its

contribution in containing Nipah outbreak in Kerala and in supporting the

state of Bihar in managing AES. While laying down future road map for

NCDC he mentioned that the NCDC’s upgradation plan has been

envisaged to keep pace with the changing public health needs of the

country. He further stated that six centres of NCDC will soon be set up

across the country in Lucknow, Ranchi, Patna, Imphal, Dimapur and

Thiruvananthapuram. Hon’ble State Minister for Health & Family Welfare,

Sh. Ashwini Kumar Choubey also addressed the gathering. The dignitaries

also planted saplings in the institute.

Speaking on the occasion, Dr. Sujeet K Singh, Director NCDC informed

about various technical activities carried out by the institute and the

achievements of NCDC in the field of public health. The institute is also

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working on Non Communicable Diseases, Climate

Change, Anti-Microbial Resistance, Training and

Manpower Development in Public Health. Apart

from these, NCDC is always at forefront of public

health response in the events of emerging public

health challenges.

A scientific symposium on the theme “Climate

Change Resilience in Health Sectors” was organized.

Speakers from NCDC, Indian Meteorological

Department, WHO, AIIMS apprised the

audience on National Programme on Climate

Change and Health, Monitoring of Climate

Change and Heat Waves, Global perspective on

Climate Change and Ambient Air Pollution.

The technical programme was followed by a

lively cultural programme.

Glimpses of Institute Day Celebrations

Contributed By: Drs. Suneet Kaur, SK Jain

Heat and Human Health: Steps Taken by NCDC

The latest World Meteorological Organization

statement on global climate during 2018 indicates

that the global temperature continues to increase.

Heat waves are projected to increase in frequency,

intensity and duration over most of the land area in

21st century. Over the past several years, India too

has witnessed an increasing trend of heat wave that

affected several states/districts/cities/towns.

According to the India Meteorological Department

(IMD),

the five warmest years on record were: 2016

(+0.72 0C), 2009 (+0.56 0C), 2017 (+0.55 0C),

2010 (+0.54 0C), 2015 (+0.42 0C).

In India, heat wave conditions are considered if

maximum temperature of a monitoring station

reaches at least 40 0C or more for plains, 37 0C

or more for coastal areas and at least 30 0C or

more for hilly regions.

Lead Story

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Heat related illnesses: The effects of exposure to

heat can be directly heat-related (heat related

illnesses) or it can contribute to worsening of

respiratory and cardiovascular diseases, electrolyte

disorders and kidney problems. Heat-related

illnesses occur on a continuum from mild symptoms

to fatalities.

Types of heat related illness:

Minor heat related illnesses: Heat rash, Heat

edema, Heat tetany, Heat cramps, and Heat syncope.

Major heat related illnesses: Exertion associated

collapse, Heat exhaustion and Heat Stroke

The vulnerable population for heat related illnesses

are people aged 65 and older, infants and young

children, pregnant women, people with chronic

medical conditions like diabetes mellitus,

cardiovascular disease, mental disorders,

neurological diseases, on medications, outdoor

workers, destitute and low income population,

people who exert in hot environment etc.

Problem Statement: From year 2015-2019, the

number of deaths in India due to heat related illnesses

was 3775. (Figure 1)

Figure 1. District wise distribution of heat related illnesses deaths in India 2019 (N=191)

Detailed analysis of heat related deaths in 2019

shown maximum temperature (Tmax) for the day

within which deaths reported due to heat related

illnesses ranges from 33 oC to 46 oC. When the Tmax

reaches 40 0C or above the number of deaths increase

which may be due to the fact that most of the deaths

are

reported from plain areas and the heat wave is

considered if maximum temperature of a station

reaches at least 40 oC or more in plains. After

rapid rise in number of deaths at Tmax 41 oC, the

number of deaths decreases at 42 oC and 43 oC

followed by rise at 44 oC. At Tmax 46 oC only

one death was reported which may be due to the

fact that estimated number of days with Tmax 46 oC or above was less. (Figure 2)

Early warning and communications with

respect to heat wave: Forecasting and issuance

of heat alerts or heat warning is being carried out

by IMD, Ministry of Earth Sciences which is the

nodal agency for providing current and forecast

weather information, including warnings for all

weather related hazards. IMD issues forecasts

and warnings for all weather related hazards in

short to medium range (valid for the next five

days) every day. These warnings are available at

http://www.imd.gov.in/pages/allindiawxfcbull

etin.php

A new system of exclusively heat-related

warnings has been introduced with effect from 03

April, 2017. These warnings, valid for the next

four days, are issued around 1600 hours IST daily

during heat wave season NCDC is sending these

alerts to the respective State’s health department

on daily basis for better preparedness activities

since 2019. (Figure 3)

IMD currently follows a single system of issuing

warnings for the entire country through a colour

code system as given below (Table 1). This

system advises on the severity of an expected

heat hazard.

Figure 2. Heat related illnesses deaths and maximum temperature recorded (Tmax) on same day in

respective block/mandal of four States, India, 2019 (N=191)

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Table 1. Colour code signals for heat alert and suggested actions

Alert Warning Impact Suggested Actions

Normal day Maximum temperature are near normal Comfortable temperatures Normal activity

Heat Alert Heat wave conditions at isolated pockets

persists for 2 days

Moderate temperature.

Heat is tolerable for general public

but moderate health concern for

vulnerable people e.g., infants,

elderly, people with chronic

diseases

a. Avoid heat exposure b. Wear

lightweight, light-coloured, loose cotton

clothes

c. Cover your head

Severe Heat Alert for

the day

(i) Severe heat wave conditions persists

for 2 days

(ii) Though not severe, but heat wave

persists for 4 days or more

High temperature.

Increased likelihood of heat illness

symptoms in people who are either

exposed to sun for a prolonged

period or doing heavy work.

High health concern for vulnerable

people e.g., infants, elderly, people

with chronic diseases

a. Avoid heat exposure- keep cool, avoid

dehydration

b. Wear lightweight, light-coloured,

loose cotton clothes

c. Cover your head

d. Drink sufficient water-even if not

thirsty

e. Use ORS, homemade drinks like lassi,

torani (rice water), lemon water,

buttermilk, etc

f. Avoid alcohol, tea, coffee and

carbonated soft drinks which dehydrates

the body

g. Take bath in cold water frequently.

Extreme Heat Alert

for the day

(i) Severe heat wave persists for more

than 2 days,

(ii) Total number of heat/severe heat

wave days exceeding 6 days

Very high likelihood of

developing heat illness and

stroke in all ages.

Along with suggested action for

Orange alert, extreme care needed for

vulnerable people.

Heat wave health impact containment measures

Prime Minister’s Council on Climate Change

suggested “Health Mission” as one of the new

missions proposed under the National Action

Plan on Climate Change on 19 January 2015.

NCDC has been identified as the nodal agency

for ‘Health Mission’ by MoH&FW to

recommend strategies for health adaptation and

prepare response plan for diseases occurring due

to climate variability and change. Accordingly,

National Action Plan for Climate Change and

Human Health (NAPCCHH) was prepared

under National Programme for Climate Change

and Human Health. Various groups of climate

sensitive illnesses have been listed in the

NAPCCHH. These illnesses will be monitored

with respect to various weather parameters.

Integrated Disease Surveillance Programme

(IDSP) is collecting and compiling the data of

heat related illnesses from 17 states.

A centre of Excellence (CoE) has been

identified to study impact of heat wave on

human health, based on which health adaptation

plan under NPCCHH will be prepared.

NCDC has shared the “Guidelines for preparation of

Action Plan-Prevention and Management of Heat-

Wave” prepared by National Disaster Management

Authority and “Guidelines on Prevention and

Management of Heat Related Illnesses” prepared by

MoH&FW to all the States, available on

mohfw.gov.in. The States have been advised to

prepare their State

specific health sector heat action plan. Till

now Gujarat and Punjab have prepared

health sector heat action plan.

On the basis of seasonal forecast issued by

IMD, NCDC is issuing advisory to all States

before the start of heat wave season. Also

based on exclusively heat-related warnings

from IMD (valid for next 4 days) daily

advisory is being issued by NCDC to

respective States during heat wave season.

NCDC has prepared an IEC for general and

vulnerable population, which can be used as

template to prepare IEC at State after

translating in regional language. (Figure 4)

Way forward

Creating awareness among general

population (vulnerable community),

health-care providers and policy makers

regarding impacts of heat wave on human

health.

Strengthening capacity of health-care

system by capacity building, strengthening

health preparedness and response by

performing situational analysis at

national/state/district/below district levels

and strengthening research capacity to fill

the evidence gap.

Contributed by: Drs. Akshay Kumar & Aakash Shrivastava

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AES Outbreak in Muzaffarpur, Bihar, June - July 2019

Acute encephalopathy syndrome (AES) is

characterized by sudden onset of seizures and altered

sensorium. Seasonal outbreaks of AES have been

reported from Muzaffarpur, Bihar since 1995. This

syndrome is a public health challenge in India. IDSP

reported clustering of cases and deaths due to AES

from Muzaffarpur, Bihar on 10 June 2019. The first

team of NCDC officials were deputed to investigate

on 11 June 2019. NCDC Epidemic Intelligence

Services Officers joined the investigation on 15th

June 2019.

Objectives

1. To describe the clinical and epidemiological

profile of AES cases

2. To identify risk factors for deaths due to AES

Methodology

In 2019, NCDC EIS Officers investigated this

syndrome through hospital-based clinical and

epidemiological surveillance established at the Shri

Krishna Medical College Hospital (SKMCH) and the

Krishnadevi Deviprasad Kejriwal Maternity

Hospital (KDKMH), the chief tertiary care medical

centers in Muzaffarpur district, India.

Case definitions

We reviewed records of all admitted patients with

suspected AES diagnosis from May 1 through June

30, 2019 in pediatric wards of these hospitals. From

those, we identified probable AES cases following

case definition: seizures or altered sensorium in a

child ≤15 years admitted to SKMCH or KDKMH

from 1st May to 2nd July, 2019. Additionally, we

also identified and enrolled incident cases admitted

to the pediatric wards SKMCH and KDKMH using

following case definition: new onset seizures of less

than 7 days duration (excluding simple febrile

seizures) or altered sensorium in a child ≤15 years of

not more than 7-day duration, admitted to SKMCH

or KDKMH from 1st May to 2nd July.

Data collection

For identified cases, we conducted

1. In-depth record review and data abstraction from

case-sheets available with the medical records

departments,

2. Prospective data collection using a structured

clinical epidemiological data collection tool, and

In a purposive sample of cases, we administered

modified clinical-epidemiological questionnaire.

Data analysis: We prepared a database in

Microsoft excel and Epi info 7. We cleaned the

data and calculated proportions, means, median

and interquartile range to summarize the data.

We prepared incidence maps and epi- curve. We

compared cases on the basis of their outcome

(survived vs. died).

Results: A total 561 cases met our case

definitions, and case fatality rate was 20%

(115/561). Of total, 17 cases with missing or

having invalid basic demographic data were

dropped; data of 544 cases was used for further

analysis. The median age was 4 years (range:

0.25-14 years, N=541) , and 59% (320/544)

were females.

Median temperature was 98.8°F (IQR: 98-

100°F, n=376) at admission. In 75% (389/518)

cases, blood glucose of <70mg/dl was found at

admission. Out of 464 cases with complete

clinical treatment record, anti-epileptic was

given to 97% (452/464) and 10% dextrose to

64% (297/464) cases on arrival to tertiary

facility. Median duration of hospital stay was 2

days. (IQR: <1-3days).

In 115 deceased cases, 31.3%

were referred from primary health facility. The

median time from admission to death was 18

hours (IQR, 6-37 hours) for 35 deaths.

Muzaffarpur district reported the highest age

specific (<15years) incidence of AES cases

(219.8/10 lac). Age specific incidence (<15

years) was highest from block Sahebganj (70.7

per lakh), Kanti (52 per lac) and Minapur (48.7

per lac).Cases started increasing from June 1st

week with a peak around 15 June 2019.

(Figure.3)

Results of prospectively enrolled AES cases at

SKMCH or KDKMH

A total of 94 AES cases were enrolled for risk

factor interviews using a standard questionnaire

tool. Head of household of more than half of

cases were wage workers. Nearly half belonged

to middle socioeconomic status as per NFHS

scale (47.2%, 43/91). In 62% (58/93) cases,

seizures were reported as first symptom at home.

In 67% cases (62/93) symptoms started in the

morning hours (3-8am). Of the cases, 96.7%

(90/93) had seizures as

Outbreak Section

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Figure 3. Distribution of AES cases and deaths by date of admission

Muzaffarpur, Bihar May- July 2019 (N=538)

presenting symptom at the tertiary health facility. In

more than 90% cases, seizures were generalized

tonic clonic type.

In 44% (25/57) cases, stunting was observed. Of

cases, 62% (43/69) were underweight and 43%

(10/23) were less than 2SD for BMI for age.

The median time delay from onset of symptom to

reaching tertiary health facility was 3 hours (<1 hr –

90 hrs). 46% of cases were referred from primary

health facilities.30% cases were stabilized at primary

health facilities before referring.

Out of 68 cases, 86.7% (59/68) gave history of litchi

consumption in past seven days. Of these 59 cases,

95% (54/57) gave history of litchi consumption in

past 24 hours.

Of 88 cases, 54.5% (48/88) gave history of missing

one meal in past 24 hrs. 65.5% cases had taken their

last meal equal to or more than 10 hours prior to

symptom onset of 60 eligible cases, 45% (27/60)

were enrolled in anganwadi. Only 8% (7/83)

caregivers reported visit by a frontline worker in the

4thweek prior to date of symptom onset.

enquired about other illnesses in the index child,

44% (18/41) reported generalized weakness and

malaise. 53% (27/51) reported muscle cramps.

Those who survived have poor anthropometric

measures as compared to deceased group. A higher

proportion of case-patients in survived group were

reported to have been stabilized at Primary Health

Facility (PHF) than deceased (33.3 vs 23.1, p >0.05).

Conclusions:

This was an outbreak of acute encephalopathy

syndrome with hypoglycemia and associated

high mortality in Muzaffarpur district, Bihar.

Young under-weight children from 3 blocks of

Muzaffarpur were at high risk of illness in a

setting of low Anganwadi enrollment of eligible

children. Skipping meal and litchi consumption

in past 24 hours was reported in more than half

of the case patients. Survival was poor in those

who did not receive management with dextrose

and antiepileptic in PHF.

Recommendations

Short term

Health messages in Muzaffarpur district should

be disseminated for:

a) Ensuring provision of meal prior to bed time

in young children

b) Prompt transfer of child to the nearest health

facility for hypoglycemia and seizure

management

c) Educating parents that litchi consumption in

young children cannot substitute meals

Management at lower level health facility

a) Ensure 24*7 availability of staff and

logistics for management of hypoglycemia

induced seizures and correction of

hypoglycemia with 10% dextrose during

outbreak period.

Preparatory activities should be carried out prior

to outbreak period (March onwards) with

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1-May 8-May 15-May 22-May 29-May 5-Jun 12-Jun 19-Jun 26-Jun 3-Jul

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Date of admission to tertiary health facility

Cases Deaths

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sensitization of district administration and health

department

b) Staff to ensure that children are referred to higher

facility only after glucose level correction

Long term

Increase uptake of various government nutrition

programme through ICDS and School mid-day

meal scheme

Glimpses of Field Investigation

Contributed by: Drs. Vaisakh.T.P, Rajeev Kumar, Abhishek Mishra, Binoy.S.Babu, Purvi Patel, Tanzin

Dikid, Rajesh Yadav, Mohan Papanna, Anoop Velayudhan, S.K. Jain, S.K. Singh

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Capacity Building of NCDC officials on Laboratory Biosafety

Centre for Arboviral and Zoonotic Diseases, NCDC

Delhi organized master training on Personal,

Protective Equipment (PPE), Triple Layer

Packaging and Spill Management for NCDC

officials on 24 September 2019. The training was

inaugurated by Dr Sujeet Kumar Singh, Director

NCDC who emphasized on the role of training for

medical and paramedical staff in laboratory and

outbreak situations in field.

A total of 33 participants from various

divisions/sections of NCDC (Epidemiology, Centre

for AIDS and Respiratory viruses, Biotechnology,

Viral Hepatitis, Malaria and Coordination,

Bacteriology and AMR, Enterovirus,

Noncommunicable diseases, Biochemistry, IDSP

division) participated in this training.

The trainees were oriented on different types and

use of PPE followed by demonstration on

Donning and Doffing of various types of PPE,

Triple layer packaging and blood and body fluid

spill management. This was followed by hands

on by the participants from various divisions

with a facilitator from Zoonosis division

supervising them.

Dr Naveen Gupta (HOD), Dr Monil Singhai

(DD), Dr Shubha Garg (AD) and Ms Yosman

(ARO) were the facilitators and master trainers

for this training. The training concluded with

vote of thanks and certificate distribution by

HOD Centre for Arboviral and Zoonotic

Diseases.

Glimpses of Training

Contributed by: Drs. Naveen Gupta, Monil Singhai, Shubha Garg

NCDC News

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NCDC conducts Expert Group Meeting for

preparation of Computer Injury Prevention

and Awareness Guidelines

Millions of people are becoming victim of Computer

Related Injuries as they are unaware of the scientific

methods of working with computers. With regards to

this, a communication received from PMO (Prime

Minister’s Office) was examined in the Ministry of

Health and Family Welfare and with the approval of

DG (Director General), Dte.GHS (Directorate

General of Health Services), NCDC (National

Centre for Disease Control), Delhi was nominated to

develop National guidelines for Computer Injury

Awareness and Prevention in collaboration with

other agencies concerned.

In this regard, the Centre for Non Communicable

Diseases (NCD), NCDC, Delhi, organized an Expert

Group Meeting on 27th August, 2019 at NCDC,

Delhi with experts from VMMC (Vardhman

Mahavir Medical College) & Safdarjung Hospital,

Delhi, MEITY (Ministry of Electronics and

Information Technology), ICMR – NIOH (Indian

Council of Medical Research – National Institute of

Occupation Health), Ahmedabad, IHBAS (Institute

of Human Behaviour and Allied Sciences), Delhi, V.

V. Giri National Labour Institute, Noida, MHRD –

DoSEL (Ministry of Human Resource Development,

Department of School Education & Literacy) and

NCDC, Delhi.

Dr. Anshu Sharma, Additional Director and Head,

NCD Division extended a warm welcome to all the

experts. Dr. Sujeet Kumar Singh, Director, NCDC

explained the objectives and TOR (Terms of

reference) of the Expert Group Meeting. The

meeting was chaired by Shri P. K. Bali, Deputy

Secretary, MHRD – DoSEL and Dr. Kamalesh

Sarkar, Director, ICMR-NIOH, Ahmedabad was the

co-chair. There was discussion on the draft

guidelines prepared and all experts gave their views

and suggestions. Some of the issues highlighted in

the discussion were: lack of clarity in labour laws

regarding computer related injuries, lack of

standards pertaining to safe use of computers, lack

of integration among various stakeholders, lack of

typing skills in school curriculum, lack of education

/ training about correct / safe use of computers in

educational institutions. The meeting ended with a

demonstration regarding proper use of computers by

Dr. H. M. Arun Kumar, Ph. D. researcher on

computer injury prevention.

Contributed by: Drs. Anshu Sharma, Rinku Sharma, Navin Verma, Manoj Kumar

Singh and Suman Shekhar

Experts deliberate on Computer Injury Prevention and Awareness

Containment of Kyasanur Forest Disease:

NCDC organizes National Consultation in

Bengaluru

A multi-stakeholder National Consultation on

Kyasanur Forest Disease (KFD) was organized

by NCDC in collaboration with WHO on 20-21

August, 2019 at Bengaluru. This national

consultation held over two days was first of its

kind which brought together eminent experts

institutions such as Animal Husbandry,

Environment sector, Wildlife and Forest,

Entomology, NCDC, ICMR, NIVEDI, key

research organizations and officials of the five

affected states i.e. Karnataka, Kerala, Tamil

Nadu, Maharashtra and Goa together and

provided an opportunity to deliberate upon KFD

on one platform.

Objectives of the Consultation:

To understand and discuss the epidemiology

and ecology of risks factors associated with

KFD.

To review the existing laboratory capacity,

ongoing entomological surveillance and

public health interventions such as KFD

vaccinations in endemic states.

To discuss the current gaps in knowledge and

areas for future research for responding to this

emerging pathogen.

The inaugural session of the national

consultation was graced by Sh Jawaid Akhtar,

Principal Secretary (Health), Govt. of

Karnataka, Dr. Prabhakar TS, DHS, Govt. of

Karnataka, Dr. Parimal Roy, Director, NIVEDI,

Dr. D.T. Mourya, Former Director, NIV, Dr.

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Eminent experts from various institutions, key

research organizations deliberated for two days on

global perspective of tick borne diseases, overview

of KFD in India; its epidemiology & risk factors,

outbreak investigation, existing laboratory facilities

and opportunity for up scaling and strengthening;

clinical perspective of KFD, animal health

perspective and vaccination coverage and efficacy,

scope and gaps in epidemiological, entomological

research aspects of KFD, biosafety and biosecurity

procedures in KFD, ecological aspects and risk

mapping of KFD and engaging community health

workers in tick bite prevention followed by group

work for multi-disciplinary research on KFD.

Key recommendations of the consultation on

strengthening of human surveillance component,

laboratory surveillance establishment and its

strengthening, clinical management,

pharmacological interventions, entomological

surveillance, Wildlife interventions and capacity

building of personnel in laboratories and

entomologists, veterinarians, joint outbreak

investigations keeping in view One Health approach

will help the affected states in containment of the

disease.

Contributed by: Faculty of Epidemiology and

Zoonotic Programme Division, NCDC

NCDC conducts Team Building Workshop

Conflicts at workplace arise due to varied interests,

opinions, thought processes and are sometimes

inevitable. If left unresolved, they may disrupt the

productivity of an organization/Division. In this

regard, the Centre for Non Communicable Diseases

(NCDs), NCDC, Delhi did a behavioural training

need assessment by circulating an assessment

tool among NCDC officers and areas for

capacity building were identified. In accordance

with the same, NCD division organized a

workshop on “Team Building” for the officers of

NCDC on 11th September 2019 with a vision

that this workshop will help to manage

workplace conflict and improve the office

communication, workplace environment, etc.

which in turn will help to enhance the overall

productivity as a team.

The workshop was conducted by behavioural

scientist, trainer and management consultant,

Prof. Dr. Naveen Gupta, Director, HIMCS

(Hindustan Institute of Management and

Computer Studies), Mathura, UP. The aim of

this workshop was to focus on understanding the

common causes of conflicts and to resolve them

by using various management strategies like

betterment of communication, practicing several

aspects in moral and spiritual disciplines. Dr.

Anshu Sharma, Additional Director and Head,

NCD Division welcomed all the participants and

Dr. Sujeet Kumar Singh, Director, NCDC

inaugurated the workshop. The workshop was

attended by 35 officers of various divisions of

NCDC.

Interactive sessions were conducted on

understanding of self and improving

relationship, group dynamics and interpersonal

conflicts, and discovery of self for creating team

culture. The workshop ended with discussion

with all participants on team building,

improving interpersonal skills, behaviour

management and conflict management.

Contributed by: Drs. Anshu Sharma, Rinku Sharma,

Navin Verma, Manoj Kumar Singh and Sh. Suman Shekhar

Participants of two day National Consultation on KFD at Bengaluru

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NCDC observes World Rabies Day

Working towards implementation of 'One

Health' in its true spirit, this year Division of

Zoonotic Diseases Program, NCDC, advocated

for collaborative observation of World Rabies

Day with Delhi Governments School Health

Programme, Municipal cooperation , NGOs,

Resident Welfare Associations, Medical

Colleges, Veterinary Universities and Private

Medical Organizations and Private Veterinary

Organizations.

Plethora of activities conducted to mark

World Rabies Day

Public talk on prevention and control of

Rabies was organised for primary school

children, teachers and general public by

NCDC officials and consultants.

Free Canine Rabies Vaccination and

Sterilization drives of dogs was conducted

within the NCDC Campus by North

Municipal Corporation of Delhi

Department of Veterinary Services of

South Municipal cooperation of Delhi

and East Municipal cooperation of

Delhi conducted Free Canine Rabies

Vaccination drives in southern and

eastern zones of Delhi

A short educational video competition

was organised for students of Medical,

Veterinary, Dental, Nursing and

Pharmacy colleges by Indian

Association of Preventive and Social

Medicine (IAPSM) and National Rabies

Control Programme (NRCP)

Audio and Visual spots of Anti-Rabies

Campaigns published on the NCDC

website were distributed by the State

Nodal Officers of NRCP for advocating

about Rabies and were played at bus

stops, railway stations, and movie

theatres.

Glimpses of activities conducted to mark World Rabies Day

Contributed by- Drs Simmi Tiwari, Ajit Shewale, Tushar Nale,

Monal Daptardar, Prashant Tiwari

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State TOT on IDSP Module of Integrated

Health Information Platform (IHIP)

Integrated Disease Surveillance Programme

(IDSP) has been organizing State TOT Trainings

on IDSP Module of Integrated Health Information

Platform (IHIP) for state IDSP officials since June

2018 which has continued in the various States. The

officials from IDSP are deployed as master trainers

for conduction of same. IHIP was designed &

developed with assistance from WHO, in order to

have holistic picture of consolidated data reported

under different National Health Programmes with

“One-Health Approach” and IDSP module of IHIP

launched in 7 States -Karnataka, Andhra Pradesh,

Himachal Pradesh, Odisha, Uttar Pradesh,

Telangana , Kerala and would be rolled out in

entire county.

In the 3rd quarter of 2019 (July-September), IHIP

trainings were conducted in following States-

Uttarakhand (17-18 July, 14/14 districts

participated),

Haryana (23-24 July, 5/22 districts

participated),

Manipur (24-26 July, 16/16 districts

participated),

Goa (29 July 2019, 2/2 districts participated),

Arunachal Pradesh (29-30 July, 19/26 districts

participated),

Maharashtra (2-10 Aug, 36/36 districts

participated). These trainings are being conducted with hands-on-

mode in well-equipped computer lab having good

internet connectivity. WHO country office is also

assisting TOT trainings by deploying resource

personnel and also providing user credentials of

Training portal to the participants for

demonstration & testing purpose.

Discussion & Hands-on-Trainings of IDSP Module of IHIP at Haryana

Contributed by: Drs Suhas Dhandore,

Himanshu Chauhan

Regional Meeting for Preparedness of

Zoonotic Diseases

A regional meeting for preparedness of zoonotic

diseases was organized at State Institute of Health

and Family Welfare (SIHFW) Jaipur in joint

collaboration of NCDC, SMS Medial College

Jaipur and IDSP Rajasthan. A total of 100

participants (medical and veterinary

professionals) participated in this meeting. In this meeting the participants were trained

about the zoonotic diseases prevalent in state and

inter sectoral measures taken by Animal

Husbandry department for prevention and control

of diseases. The increasing and emerging trend of

zoonotic diseases was highlighted and emphasis

was given on collaborative approaches between

human health and Animal Husbandry Department

to contain these diseases. Director NCDC gave an

overview of inter sectoral coordination for

prevention and control of zoonotic disease in state

and country and stressed upon strengthening of

Infectious Diseases Hospital in the state. NCDC

representative elaborated on zoonotic diseases that

are of public health importance, Zoonotic disease

surveillance and Zoonotic disease distribution in

the state.

Participants were also educated on collection of

sample and its transportation for High Risk

Pathogens, (CCHF, Zika, Nipah Virus), lab

diagnosis of CCHF and preventive and control

measures taken in Gujarat for CCHF virus. It was

further emphasized to strengthen entomological

surveillance for any unforeseen vector borne

disease emergencies. The joint efforts of the State

in constitution of zoonotic committee at state and

district level and periodic organization of meetings

was well appreciated.

Participants during Regional Meeting Preparedness Of

Zoonotic Diseases

Contributed by- Drs Simmi Tiwari, Ajit Shewale, Tushar Nale, Monal Daptardar, Prashant Tiwari

13 | P a g e

India celebrates World Population Day

World Population Day is celebrated every year on 11

July, to focus attention on the importance of

population issues worldwide. This day was first

celebrated in 1989 when the world population

reached five billion.

This year's World Population Day calls for global

attention to the unfinished business of the 1994

International Conference on Population and

Development when 179 governments recognized

that reproductive health and gender equality are

essential for achieving sustainable development.

India recognizes the importance of population

stabilization as a crucial determinant of quality of

life and achievement of universal health coverage

goals. On this occasion, National Workshop on

International Conference on Population and

Development (ICPD)@ 25 years – Leveraging

Partnerships’ was organized. During the

inauguration of this workshop Hon’ble Union

Minister of Health and Family Welfare, Dr. Harsh

Vardhan emphasized that Government of India is

committed to addressing the health issues,

improving the scale and ensuring accessibility of

quality services for everyone. India has increased

focus on spacing at birth to achieve improved

maternal and child health outcomes. He also

appealed to NGOs for dedicating of one month every

year towards the cause of Population Stabilisation.

New IEC material were designed and launched this

year, focusing on improving the uptake of spacing

methods by addressing myths and misconceptions

prevailing around these methods and reviving the

category of oral contraceptive pills and improving

the uptake of Condoms and Injectable

Contraceptives.

On-going activities of Government of India for

Population Control

Interventions under Family Planning

Programme

Ensuring quality of care in Family Planning

services by establishing Quality Assurance

Committees in all state and districts.

Increasing male participation and promotion of

‘Non Scalpel Vasectomy’’.

Operating the ‘National Family Planning

Indemnity Scheme’ (NFPIS) under which clients

are insured in the eventualities of deaths,

complications and failures following

sterilization and the providers/ accredited

institutions are indemnified against

litigations in those eventualities.

Compensation scheme for sterilization

acceptors - under the scheme MoHFW

provides compensation for loss of wages to

the beneficiaries on account of undergoing

sterilisation.

Accreditation of more private/ NGO

facilities to increase the provider base for

family planning services under PPP.

Improving contraceptives supply

management up to peripheral facilities

A rational human resource development

plan is in place for provision of IUCD,

Minilap and NSV to empower the facilities

(DH, CHC, PHC, SHC) with at least one

provider each for each of the services and

Sub Centres with ANMs trained in IUCD

insertion

Emphasis on Minilap Tubectomy services

because of its logistical simplicity with less

failure rates.

Demand generation activities in the form of

display of posters, billboards and other audio

and video materials in the various facilities

Interventions under Jansankhya Sthirata

Kosh (JSK)

Prerna Strategy: - JSK has launched this

strategy for helping to push up the age of

marriage of girls and delay in first child and

spacing in second child birth.

Santushti Strategy:- Under this strategy,

private sector gynecologists and vasectomy

surgeons are encouraged to conduct

sterilization operations in Public Private

Partnership mode.

National Helpline: - JSK is also running a

call centers for providing free advice on

reproductive health, family planning,

maternal health and child health etc. Toll free

no. is 1800116555.

(Extracted from Press Information Bureau)

News From Around

14 | P a g e

Viral Hepatitis Surveillance under IDSP

Viral hepatitis is a global public health problem,

particularly in resource-poor countries. About 30%

of the disease burden due to viral hepatitis is located

in the WHO South-East Asia Region. Viral hepatitis,

caused by hepatitis viruses A and E remains a major

public health problem in India. Hepatitis A Virus

(HAV) and Hepatitis E Virus (HEV) are an

important cause of acute viral hepatitis and acute

liver failure in India.

IDSP undertakes weekly surveillance of HAV and

HEV in P (Presumptive) and L (Laboratory

Confirmed) formats and outbreaks.

The reporting of probable cases of viral hepatitis is

gradually increasing under IDSP over last three years

with gradual increase in laboratory confirmation

for HAV and HEV.

230 outbreaks of viral hepatitis have been

reported in IDSP during last three years. Kerala

had reported maximum number of outbreaks

(60) during this period followed by Jammu &

Kashmir (31), Odisha (29) and Gujarat (25).

Out of 230 hepatitis/jaundice outbreaks, 47%

were laboratory confirmed with 31% of HAV

and 16% of HEV and 1 outbreak of mixed HAV

and HEV infection. The data indicates that there

is need to strengthen laboratory confirmation of

the outbreaks.

Contributed by: Drs. Himanshu Chauhan, Pranay Verma, Sh. Prasoon Sharma, Sujata

0

100000

200000

300000

400000

500000

600000

2016 2017 2018

Probable Cases 442867 553093 591258

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Probable cases of Viral Hepatitis reported under IDSP (2016-2018)

Disease Trends

15 | P a g e

NCDC Buzz