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Panic over kala-azar in Vaishali villages

HAJIPUR: Dreaded disease kala-azar claimed the lives of 51 patients, both in rural and urban areas in Vaishali district, in the year 1999.

It is to be recalled that the number of deaths due to kala-azar in two villages of Bidupur block in 1996 was 196 and in 1997 36. In the year 1998, 16 died of kala-azar while 61 died in 1999.

Talking to TOINS, the chief malaria and kala-azar officer, Dr D P Mandal said that altogether 671 persons were affected by the menace of kala-azar in different parts of Vaishali district in 1999 and out of them 51 had died.

Even today, Dhabauli village under Bidupur block of the district has been a witness to the devastations caused by this disease. There is not a single family in the village, of which one or two members have not died of kala-azar.

It is to be noted that bleaching powder is supposed to have already been sprayed in the town areas for wiping the kala-azar. But a number of people replied in the negative when asked whether bleaching powder was sprayed or not.

Talking to TOINS, many citizens opined that things were considerably better when Anjani Kumar was the DM. But once he was transferred and other DMs took over, the efforts got diluted. Expressing serious concern, a town resident Brajanand Pandey said that this year DDT or bleaching powder were not used anywhere in the town or rural areas, thereby leading to a proliferation of the sandfly, the carrier of kala-azar.

A thorough probe is a must in order to first detect the patients of kala-azar and second, to punish the administration as well as the concerned health officials for their alleged inaction.

It is doubtful that "bleaching powder" is an effective insecticide vs. sandflies.

For more background on Kala-Azar, read Robert Desowitz' excellent book The Malaria Capers. Below are a couple of quotes from that book about kala azar.

"However, the great unexpected additional bounty of the antimalaria spray program was its effect on kala azar. Considering the natural history of _Phlebotomus argentipes_ it is only natural that DDT would be as effective, or more so, against the sandfly as against the mosquito. _Phlebotomus argentipes_ is a domestic creature...The sandfly is not a strong flyer...And they rested on the walls inside the house, usually not above six feet from the floor." - pg. 64.

"When the spraymen came to kill the malaria-transmitting anopheline mosquitoes, the kala azar-transmitting phlebotomine sandflies got a dose of DDT, too. The DDT was especially effective against them because they tended to rest on the wall mroe often for longer perooids and at more accessible heights than the anophelines. They were also (and still are) exquisitely sensitive to DDT, being killed by concentrations that would be too low to affect the mosquito." - pg. 65.

"By the mid-1950s there were virtually no new cases of kala azar. By 1965 it was a forgotten disease. In 1970 kala azar returned-it was 1940 all over again." - pg. 65.

"Without the containment of DDT the sanfly population proliferated to its former great numbers. In 1969 or 1970 - no one is certain of the exact date - the inevitable came to pass. In the village of Vaishali, people began dying of kala azar." - pg. 66.

Desowitz, Robert. 1991. The Malaria Capers. W.W. Norton. 288 pp. ISBN 0-393-03013-X

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