Managing Epidemics and Natural calamities management in India .

An epidemic is a sudden increase in the number of cases of a disease above what is normally expected in the population of a specific area. A pandemic is declared when an epidemic has spread to several countries or continents, usually affecting large number of people.

During the last five years, Pandemic Influenza A H1N1( swine flu) is the only disease that has been declared as a Pandemic by WHO.

Health is a State Subject. However, Ministry of Health has crisis management plan that was updated last on 24.07.2013 and circulated to all concerned. This plan provides for Crisis Management Group and Technical Advisory Committee. Emergency Medical Relief (EMR) Cell in Directorate General of Health Services coordinates all Public Health Emergency activities of national and international concern. Integrated Disease Surveillance Programme (IDSP) has nationwide surveillance for providing early warning signs. National Centre for Disease Control is the identified agency for investigating outbreaks. Laboratories under IDSP network and Indian Council of Medical Research have been identified for testing clinical samples. Ministry of Health also provides support to the States in terms of guidelines and operating procedures.

Integrated Disease Surveillance Project (IDSP) was launched with World Bank assistance in November 2004 to detect and respond to disease outbreaks quickly. The project was extended for 2 years in March 2010. From April 2010 to March 2012, World Bank funds were available for Central Surveillance Unit (CSU) at NCDC & 9 identified states (Uttarakhand, Rajasthan, Punjab, Maharashtra, Gujarat, Tamil Nadu, Karnataka, Andhra Pradesh and West Bengal) and the rest 26 states/UTs were funded from domestic budget. The Programme continues during 12th Plan under NRHM with outlay of Rs. 640 Crore from domestic budget only.

• Surveillance units have been established in all states/districts (SSU/DSU). Central Surveillance Unit (CSU) established and integrated in the National Centre for Disease Control, Delhi.

• Training of State/District Surveillance Teams and Rapid Response Teams (RRT) has been completed for all 35 States/UTs.

• IT network connecting 776 sites in States/District HQ and premier institutes has been established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing and outbreak discussion.

• Under the project weekly disease surveillance data on epidemic prone disease are being collected from reporting units such as sub centres, primary health centres, community health centres, hospitals including  government and private sector hospitals and medical colleges.  The data are being collected on ‘S’ syndromic; ‘P’ probable; & ‘L’ laboratory formats using standard case definitions. Presently, more than 90% districts report such weekly data through e-mail/portal (www.idsp.nic.in). The weekly data are analyzed by SSU/DSU for disease trends. Whenever there is rising trend of illnesses, it is investigated by the RRT to diagnose and control the outbreak.

IDSP is one of the best IT enabled project in India, have a look at the disease outbreak in last week: Click here

Government has approved a scheme for “Establishment of a network of laboratories for managing epidemics and natural calamities” to strengthen diagnostic capabilities of existing microbiology and virology laboratories in the country. The three tier network includes (i) Regional Level Bio Safety Level (BSL) -3 laboratories (ii) State Level BSL-2 Plus Laboratories (iii) Medical College BSL-2 Laboratories. An amount of Rs 639.48 crores has been approved for establishing 160 laboratories in the in this network all over the country.