25 lives are already lost after another malaria outbreak struck the vulnerable population in this recently flood hit zone in Bihar. There are another 1500 reported cases and possibly nearly 50,000 cases of undetected malaria already in these highly populated villages situated about 200 miles away from Patna the capital city of the Bihar state.

There are 5 children among the 25 dead and about 560 serum sample positive cases among the affected population. The possible cause of the death is the cerebral malaria a severe form of the disease seen in patients affected by Plasmodium falciparum parasite through the mosquito bite.

Cerebral malaria causes death within 72 hours in many cases if not detected and treated early. If detected early and if the treatment is started early the disease responds favourably to the antimalarial drugs.

The recommended drugs for the treatment of cerebral malaria include intravenous or intramuscular quinine, intramuscular quinidine, or intramuscular artemisinin derivatives.

The state government is currently mobilising the mechanisms in a hurry after the villagers from this area expressed their frustration and anger by attacking a healthcare facility after two sudden deaths occuured in that particular healthcare facility.

The possible sources of the current epidemic of malaria affecting nearly 18 districts in this densely populated and thickly forested area in Bihar could have arisen out from neglected and inconsistent spraying of mosquitos over several years and a current shortage of antimalarial drugs.

There is now reportedly availability of antimalarial medicines as the central government of India have moved in to help the situation.

A similar outbreak causing up to 4 reported deaths occurred in 2004 in Godda district which is now a part of Jharkhand state and is not located very far away from Munger district. This whole zone is endemic to malaria.

There is also an element of reactivation of the malaria endemic after the recent floods in Bihar and Jharkhand states.

These above districts have the conducive/ congenial environment including terrain, rainfall, temperature and humidity for breeding of mosquitoes and vectors of malaria.

The state government of Bihar and the central government in New Delhi should work together and prevent further spread of the malaria and effectively ensure there is enough antimalarial stock available at all times to be able to deal with such similar catastrophes in future.

With the H1N1 viremia already spreading rapidly in India the government of India cannot afford to be lax and incomplacent in this matter.