“Many of my family members were sick themselves when I read reports of people dying in the district hospital due to a mysterious fever; I was really very scared. Yet I delayed in taking them to the doctor and, later, got them admitted at Novoday hospital, where I had to shell out Rs 40,000. Not only have I realised that nothing is more important than life, but I have also seen the state of our healthcare sector and will vote wisely now.”

Pramod Srivastava, a resident of Qilla area in Bareilly district

“My father came down with the mystery fever too during the time that cases were rising. I admitted him to a private hospital and he recuperated fine. It’s been three months since, but we are still scared that anyone in the family can get it.” 

Rahul Kumar, a resident of Bareilly’s Kamarchari Nagar 

These are just two stories six months after the cases first broke, claiming scores of people across four districts of Uttar Pradesh’s Bareilly division. After sweeping through Bareilly — where 140 villages were affected — and Badaun — where 160 villages were hit — and then afflicting Pilibhit and Shahjahanpur, strains of the ‘mystery fever’ were felt in Lucknow division as well.

And while health department authorities, who are still groping in the dark over the exact cause, struggled to contain the outbreak, opposition leaders engaged in government-bashing.

There is no realistic assessment of the death toll even now, but media reports put it anywhere between 100 and 700. 

How it all started?

The outbreak started in September 2018, as the monsoon was retreating; then, speculations were rife that the deaths were due to either typhoid, malaria or “some other” viral fever, encephalitis in the fray as well. That’s what State Director-General of Health Services Padmakar Singh’s “prima facie” evaluation was. “Medicines are being provided and fogging operations are being carried out to control the mosquito population,” he’d said.

It took Chief Minister Yogi Adityanath ordering an audit on September 20 for officials to take serious note of the issue. However, the official report is still not out.

Soon after the outbreak, one of the teams formed to analyse it tested water samples from different areas and found the presence of Plasmodium falciparum (PF) in some, including in those taken from Bareilly’s Majhgawan block, which witnessed a large number of deaths.

PF is one of the four protozoa that causes malaria. According to the World Health Organisation, the symptoms are fever, chills, headache, muscular pain and weakness, vomiting, cough, diarrhea, and abdominal pain. These are usually followed by organ failure, which then leads to coma and/or death.

It’s known that filth accumulation and water stagnation after monsoon leads to an increase in mosquitoes in rural areas, but what needs to be investigated now is why this mystery fever gripped Bareilly and Badaun the hardest. Also intriguing is the fact that, despite malaria and typhoid being curable, the outbreak achieved epidemic proportions.

However, in the absence of an official audit report coupled with the fact that many deaths went unreported and without autopsies, it remains an epidemic of mystery fever, not malaria.

What did the health department do?

According to Bareilly CMO Dr Vineet Kumar Shukla, more than 100 teams were formed when the mystery fever first broke out and sent to all villages for diagnosing the symptoms and providing preliminary medicines. 

“Our teams of doctors did rapid active surveillance to check this fever in different villages of Bareilly division, which was the first to report the cases. Fortunately, this year, the health department has not heard of any such deaths,” Dr Shukla said, adding that it was the media that coined the term ‘mystery fever’.

When asked why the doctors were unable to diagnose the fever and contain its spread faster, he said the deaths happened in a very short time, giving doctors little time to get to the bottom of it; they worked in the emergency ward as per emergency medical protocol to contain the epidemic.  

Dr Shukla explained that lack of awareness compounded the problem and, hence, the health department is now taking the help of the education department for this purpose. “By taking simple precautions, one can easily protect oneself from diseases; lack of awareness, however, hinders that. Hence, we are taking the help of the education department to spread important information. Our first priority is to curb the rate of vector-borne diseases; spreading awareness will play a crucial role in controlling them.”

Dr Rajendra Kumar, who heads the community health centre (CHC) in Aonla, Bareilly district, said they got a lot of mystery fever cases. “The hospital was full of patients having a fever with symptoms similar to malaria. Several died too. The surveillance teams were formed soon after analysing the seriousness of the issue and sent to every affected village,” he said, adding that the health department’s field staff was also asked to spread awareness and take precautions, like sleeping wearing full-sleeved clothes, using mosquito nets, and drinking clean water. 

“At the CHC and PHC level, we formed separate teams to check this fever and set up different wards for it.”

But reports show that several of those who took precautions for malaria, as instructed by the health department, succumbed to their illness nonetheless.

However, Dr Kumar assures that the authorities are now fully prepared to deal with such a situation should it recur.

But villagers still live in fear

To get a firsthand account, the correspondent visited Pathri village in Aonla. According to gram pradhan Gurvir Singh, “Seven people died due to the mystery fever and many villagers abandoned their homes and moved to urban areas, where they could access proper medical care. Some villagers even had to sell their land to get their kin treated.”

“Since then, residents have been living in constant fear that the outbreak will reappear.”

“Some had to sell their harvest at throwaway prices just to be able to afford treatment for their sick family members,” said another villager Narottam Singh.

Village elder Hira Lal explained, “It all happened so fast that many lost several family members in quick succession, even before anyone could get the right medical attention. That’s why we are all still scared.”

He alleged that neither government officials nor local politicians came forward to help the affected families.

The politics of a tragedy

Members of opposition parties have been taking potshots at the government for neglecting the affected villagers and are demanding that proper compensation be paid to families who lost loved ones.

Highlighting the “bad state” of healthcare services, Congress spokesperson Onkar Nath Singh alleged, “Even after so many deaths, the government hasn’t upgraded healthcare services in the affected areas, nor has any effort been made to provide financial assistance to the affected.

“Instead, all the BJP government is doing is brazenly indulging in divisive politics in the name of caste and religion.”

State unit head of Rashtriya Lok Dal Dr Masood seconded him and said, “The government has failed to protect the lives of people. By not providing timely healthcare services to the needy, the government aggravated the situation, as a result of which casualties mounted.”

Dr Masood demanded that the government provide Rs 10 lakh compensation to every family that lost its members to the fever.

Amid these accusations of neglect and indifference, the health department has maintained that the situation is under control, but there is no denying that the Opposition has got a crucial weak point — in the form of the state’s deteriorating healthcare system — to take advantage of during the upcoming general elections.

Last year, it had sought the CM’s head after oxygen shortage at Gorakhpur’s Baba Raghav Das Medical College killed several children.