<p>Sleepy hamlets amidst forests around Kargal village in Shivamogga district have suddenly become the centre of attention, more than Jog Falls that cascades just a few miles away from this place.</p>.<p>It has turned out to be the epicentre of recently broken out monkey disease, causing death of more than 15 people. Several hundreds are still suffering and it is now spreading to adjacent hilly districts as well. This winter turned out to be too troublesome for thousands of rural families here, who are forced to return to their faraway homes in this peak harvesting season from here.</p>.<p>The monkey disease is a tick-borne viral haemorrhagic fever, endemic to certain pockets in Western Ghats districts of Karnataka. It is called Kyasanur Forest Disease (KFD), as it was detected for the first time in the 1950s near the Kyasanur forest of Shivamogga district.</p>.<p>A RNA (ribonucleic acid) virus that causes this, is now found to be existing in many parts of the hilly and coastal districts. The disease gets noticed only when monkeys start dying in forests due to this viral infection. Varieties of animals are found to be the reservoir hosts for this virus, including porcupines, rats, squirrels and mice. They remain dormant for long period and there would be no incidence of disease then.</p>.<p>Like many pathogenic viruses, they get virulent form once in a few years and then disease breaks out suddenly as it is happening now. Haemaphysalis spinigera, a forest floor tick acts as vector for the disease transmission. Forest dwellers get infected by these ticks and disease starts spreading. This is what is exactly happening now in these forest districts. High fever and headaches followed by haemorrhagic symptoms such as bleeding from the nasal cavity and throat, as well as gastrointestinal bleeding, get manifest in patients.</p>.<p>Only those have prior vaccination may escape this. Otherwise, the sufferers from this Malanad belt need to rush to either Shivamogga or Manipal for getting it diagnosed, as diagnostic facilities like RT-PCR and ELISA tests are available only there. Symptomatic treatments must only save them as there is no drug developed yet for this viral disease. </p>.<p>It is being reported every summer in one or the other pockets of Western Ghats though not as severe as this time. Joida, for instance, a highly wooded taluk in Uttara Kannada district, is one such traditional hotspot of this disease. It had seen similar outbreak once in mid 1990s. This author had the opportunity to join health volunteers, those engaged then in helping disease affected families.</p>.<p>The scenes of trees cut and forest being burnt were common there, obviously to accommodate the ‘developmental aspirations’ like hydel dam built across nearby Kali river, teak plantations promoted by the forest department, expansion of farming, forest encroachment etc. All those opened up forest pockets were being occupied by an exotic weed belonging Chromolanea species. The forest dwellers were sensitive enough to recognise that the ticks which spread KFD, finding good hosts in those weeds! It is now realised that deforestation would facilitate the infection in two ways.</p>.<p>While host weeds help ticks’ multiplication, lack of food in forests forces the wildlife like monkeys to emerge out and come in contact with people. The epidemiological studies have now confirmed that increasing incidence of the disease in recent years is attributed to the large scale loss of natural forests. The fact that it is now spreading beyond Ghats to Kerala and Goa, only indicate that this endemic disease seems to be turning an epidemic.</p>.<p>Even during that summer tragedy in Joida, people were trying their own ways of avoiding disease. Farmers had stopped let their livestock out for grazing, to keep them away from ticks. Kunabi tribal there used to give ash-bath for their cattle and buffaloes to make them tick free. Kerosene used to be applied on hands and legs while going out to repel out the ticks. Cumin decoction was added in their daily recipe.</p>.<p>A report comprising all these insights was submitted then to state health department and Pune based National Institute of Virology, hoping it would help the cause in some way. Decades have passed by now, but knowledge on KFD management does not seem to have progressed much beyond that.</p>.<p>Field experience shows that disease recedes back only with heavy summer showers or monsoon rain. The current outbreak may also continue till coming May or June. The government needs to address this challenge in multiple ways.</p>.<p class="CrossHead"><strong>Healthcare to all</strong></p>.<p>Ensuring healthcare to all in affected region by providing sufficient vaccine dosages and tick repellent volatile oil, must certainly take the priority. The Virus Diagnostic Laboratory (VDL) in Shivamogga needs to be strengthened with fulltime physicians, skilled technicians and other necessary supporting infrastructure like diagnostic tools, so that it serves people effectively.</p>.<p>Besides, there is an urgent need to take up further in-depth research on this disease, involving epidemiological, pathological, diagnostics and remedial aspects. The issue of decreasing effectiveness of vaccines also needs investigations. It is better to impress upon Union Health Ministry to take up a comprehensive research project that looks into all these, through the Indian Council of Medical Research (ICMR). Investigators can procure adequate samples like blood, ticks and other field clues and evidences in this peak of disease onset, if the project is initiated immediately. </p>.<p>Wish our developmental policies recognise sooner that public health is a function of well managed natural capital too. Vaccines and drugs alone cannot win the war like this. We can’t keep monkeying around, when it comes to protecting sensitive ecosystems of Western Ghats. The KFD could perhaps be prevented effectively in the long run only by ensuring such environmental prudence.</p>.<p>(The writer is a conservation biologist and Director, Centre for Conservation Biology & Sustainable Development, Sirsi)</p>
<p>Sleepy hamlets amidst forests around Kargal village in Shivamogga district have suddenly become the centre of attention, more than Jog Falls that cascades just a few miles away from this place.</p>.<p>It has turned out to be the epicentre of recently broken out monkey disease, causing death of more than 15 people. Several hundreds are still suffering and it is now spreading to adjacent hilly districts as well. This winter turned out to be too troublesome for thousands of rural families here, who are forced to return to their faraway homes in this peak harvesting season from here.</p>.<p>The monkey disease is a tick-borne viral haemorrhagic fever, endemic to certain pockets in Western Ghats districts of Karnataka. It is called Kyasanur Forest Disease (KFD), as it was detected for the first time in the 1950s near the Kyasanur forest of Shivamogga district.</p>.<p>A RNA (ribonucleic acid) virus that causes this, is now found to be existing in many parts of the hilly and coastal districts. The disease gets noticed only when monkeys start dying in forests due to this viral infection. Varieties of animals are found to be the reservoir hosts for this virus, including porcupines, rats, squirrels and mice. They remain dormant for long period and there would be no incidence of disease then.</p>.<p>Like many pathogenic viruses, they get virulent form once in a few years and then disease breaks out suddenly as it is happening now. Haemaphysalis spinigera, a forest floor tick acts as vector for the disease transmission. Forest dwellers get infected by these ticks and disease starts spreading. This is what is exactly happening now in these forest districts. High fever and headaches followed by haemorrhagic symptoms such as bleeding from the nasal cavity and throat, as well as gastrointestinal bleeding, get manifest in patients.</p>.<p>Only those have prior vaccination may escape this. Otherwise, the sufferers from this Malanad belt need to rush to either Shivamogga or Manipal for getting it diagnosed, as diagnostic facilities like RT-PCR and ELISA tests are available only there. Symptomatic treatments must only save them as there is no drug developed yet for this viral disease. </p>.<p>It is being reported every summer in one or the other pockets of Western Ghats though not as severe as this time. Joida, for instance, a highly wooded taluk in Uttara Kannada district, is one such traditional hotspot of this disease. It had seen similar outbreak once in mid 1990s. This author had the opportunity to join health volunteers, those engaged then in helping disease affected families.</p>.<p>The scenes of trees cut and forest being burnt were common there, obviously to accommodate the ‘developmental aspirations’ like hydel dam built across nearby Kali river, teak plantations promoted by the forest department, expansion of farming, forest encroachment etc. All those opened up forest pockets were being occupied by an exotic weed belonging Chromolanea species. The forest dwellers were sensitive enough to recognise that the ticks which spread KFD, finding good hosts in those weeds! It is now realised that deforestation would facilitate the infection in two ways.</p>.<p>While host weeds help ticks’ multiplication, lack of food in forests forces the wildlife like monkeys to emerge out and come in contact with people. The epidemiological studies have now confirmed that increasing incidence of the disease in recent years is attributed to the large scale loss of natural forests. The fact that it is now spreading beyond Ghats to Kerala and Goa, only indicate that this endemic disease seems to be turning an epidemic.</p>.<p>Even during that summer tragedy in Joida, people were trying their own ways of avoiding disease. Farmers had stopped let their livestock out for grazing, to keep them away from ticks. Kunabi tribal there used to give ash-bath for their cattle and buffaloes to make them tick free. Kerosene used to be applied on hands and legs while going out to repel out the ticks. Cumin decoction was added in their daily recipe.</p>.<p>A report comprising all these insights was submitted then to state health department and Pune based National Institute of Virology, hoping it would help the cause in some way. Decades have passed by now, but knowledge on KFD management does not seem to have progressed much beyond that.</p>.<p>Field experience shows that disease recedes back only with heavy summer showers or monsoon rain. The current outbreak may also continue till coming May or June. The government needs to address this challenge in multiple ways.</p>.<p class="CrossHead"><strong>Healthcare to all</strong></p>.<p>Ensuring healthcare to all in affected region by providing sufficient vaccine dosages and tick repellent volatile oil, must certainly take the priority. The Virus Diagnostic Laboratory (VDL) in Shivamogga needs to be strengthened with fulltime physicians, skilled technicians and other necessary supporting infrastructure like diagnostic tools, so that it serves people effectively.</p>.<p>Besides, there is an urgent need to take up further in-depth research on this disease, involving epidemiological, pathological, diagnostics and remedial aspects. The issue of decreasing effectiveness of vaccines also needs investigations. It is better to impress upon Union Health Ministry to take up a comprehensive research project that looks into all these, through the Indian Council of Medical Research (ICMR). Investigators can procure adequate samples like blood, ticks and other field clues and evidences in this peak of disease onset, if the project is initiated immediately. </p>.<p>Wish our developmental policies recognise sooner that public health is a function of well managed natural capital too. Vaccines and drugs alone cannot win the war like this. We can’t keep monkeying around, when it comes to protecting sensitive ecosystems of Western Ghats. The KFD could perhaps be prevented effectively in the long run only by ensuring such environmental prudence.</p>.<p>(The writer is a conservation biologist and Director, Centre for Conservation Biology & Sustainable Development, Sirsi)</p>