At least 211 people, mostly children, have died in an outbreak of Japanese encephalitis in an impoverished region of northern Indian and the death toll is likely to soar, officials said Saturday.

"Most of the deaths have occurred in the Gorakhpur district of Uttar Pradesh state since the monsoon struck the region in July," regional health officer U.K. Srivastava told AFP by telephone from Gorakhpur.
The deaths of five more children on Friday pushed the toll to 211, with hundreds sick, some two to a bed, in hospitals in Gorakhpur, a deeply neglected area of 14 million people, he said.
"A total of 1,299 patients had been admitted in hospitals until Friday in Gorakhpur," which is the epicentre of the outbreak, and "more encephalitis patients are coming into our hospitals," Srivastava told AFP.
"We fear the total number of encephalitis cases will go up to at least 3,500 and the death rate will be at a ratio of around 20 percent," Srivastava said.
Japanese encephalitis causes brain inflammation and can result in brain damage. Symptoms include headaches, seizures and fever.
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Unusually heavy monsoon rains coupled with overflowing rivers coursing through Gorakhpur are making it tougher for health workers battling encephalitis.
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V.S. Nigam, in charge of Uttar Pradesh's encephalitis prevention programme, said a mammoth project to contain the disease ended with 35 million children vaccinated in the state's 34 districts.
But as soon children are vaccinated against Japanese encephalitis, they fall sick with acute encephalitis syndrome "because when one virus is suppressed by vaccines, others become dominant," he said from the state capital Lucknow.
"It's a large challenge," Nigam said, adding state health experts would meet national virologists next week in New Delhi for talks on way to prevent future outbreaks.
The regional chapter of the Voluntary Health Association, India's largest non-governmental organisation, which works alongside the UN Children's Fund, blamed the annual tragedy on the state's random immunisation programmes.
"A high alert is sounded only after an encephalitis epidemic flares," association executive director J.P. Sharma said.
"Preventive steps should be taken well ahead of the monsoon as vaccines need an incubation period to make human beings immune to the virus," Sharma told AFP.
Source-AFP