An illness, dubbed the ‘mystery illness’ as none could understand why it erupted, gripped Eluru town in West Godavari district, Andhra Pradesh, in early December 2020. It affected nearly 600 people and claimed the life of one, 45-year-old Sridhar from Vidyanagar. The impact was restricted geographically to a few colonies in Eluru. The two days following the first report of the illness, a special sanitation drive was undertaken in the town.
The mysterious disease had people suddenly falling unconscious after suffering from symptoms of fits and nausea. The outbreak started in the One-Town area of Eluru. The affected people belonged to areas like Ashok Nagar and Arundhatipet in Eluru town, an agriculturally-rich town, where a case of contamination of drinking water had been reported 10 days before.
The disease was not found to be contagious and affected people of all age groups. Most of the patients were in the 20 to 30 age group, while 45 children were below the age of 12. The symptoms were a single episode of epilepsy that continued between 3–5 minutes but did not repeat, dizziness, forgetfulness, anxiety, nausea and vomiting, headache, and back pain. The Eluru Government Hospital noted that some of them had bone dislocations and muscular pains.
The first indications of the epidemic came in the middle of November 2020. Some 20 cases had been reported till December 4, but they were only a few and were treated in private hospitals.
Tests
Tests conducted on the blood samples in All India Institute of Medical Sciences (AIIMS), Delhi, revealed the presence of heavy metals nickel and lead in the patients, which is suspected to have entered their bodies through consumption of water or milk. The Indian Institute of Chemical Technology (IICT), Hyderabad experts found no trace of heavy metals—lead, nickel or arsenic or pesticide residues in 21 drinking water samples. However, endosulfan (an organochlorine insecticide) and dichloro-diphenyl-trichloro-ethane (DDT) (another harmful pesticide) were found in blood samples. No trace of organophosphates were present. Hyderabad’s National Institute of Nutrition (NIN) reported pesticide residue in tomato and brinjal samples. Tests by the Centre for Cellular and Molecular Biology (CCMB) in Hyderabad and the National Institute of Virology (NIV) in Pune found no evidence of bacterial or viral infection. National Environmental Engineering Research Institute (NEERI) also tested underground water and surface water samples, and found all metals to be within permissible limits, except for mercury. Tests on air quality by NEERI in Hyderabad found pollution within permissible limits. However, tests showed levels of mercury to be higher in underground water samples than those from surface sources.
After the Event
The Andhra Pradesh government constituted a multi-disciplinary, 2-member expert panel from institutions such as AIIMS, CCMB, IICT, NIN, NIV, NEERI and others to investigate the illness.
The first report, by the expert group, submitted to the A.P. government and contents announced by the Chief Minister, Y. S. Jaganmohan Reddy pointed to pesticide residues like organochlorines, and heavy metal contamination—traces of nickel and lead—in blood samples, as the main reasons. However, it was not clear how the pesticide residues or heavy metal contamination reached the food chain and the human bodies. It was noted that chlorination was being done properly and the content of chlorine in the water was at permissible levels.
Effects of Lead and Nickel
Lead
The body absorbs higher levels of lead when it is breathed in.
Sources Lead can get into the body via lead paint, chocolate/toffees and toffee wrappers, jewelry and other lead items of regular use, soil, industries associated with battery manufacturing, pipe fitting, firing ranges, demolition, glass production, smelting operations, imported glazed pottery, and other sources.
Drinking water may have lead in it as the Environmental Protection Agency (EPA) has allowed maximum level for lead in drinking water systems 15µg/l. The largest source of lead in drinking water occurs through leaching from lead-containing pipes, taps, and solder, which can be found in plumbing of older buildings.
Effects Within our bodies, lead is absorbed and stored in bones, blood, and tissues. With age, our bones demineralise and larger releases of lead from the bone tissue follow.
Exposure to very high levels of lead over a short period of time can result in abdominal pain, constipation, headache, loss of appetite, memory loss, and pain or tingling in the hands and feet. As these symptoms may occur slowly or may be caused by other things, lead poisoning can be easily overlooked. Exposure to high levels may cause anemia, weakness, and kidney and brain damage. Lead is a neurotoxin and affects the nervous system. Very high lead exposure can cause death. Prolonged exposure can also result in high blood pressure, heart diseases, and reduced fertility. It is probably cancer-causing as well.
Pregnant women who are exposed to lead expose their unborn child to lead which can damage a child’s nervous system, affecting behaviour and intelligence. Lead exposure can cause miscarriage, stillbirths, and infertility (in both men and women). Generally, lead affects children more than it does adults.
Nickel
Small doses of nickel in the body is normal.
Sources Nickel is an element that is naturally found in the earth’s crust, so a certain amount of it is found in water, soil, air, and food. Most of the nickel in our body comes from foods that contain this trace element. Hazardous industries produce nickel and it is inhaled by those working in these industries. It may be inhaled via tobacco smoke.
Effects Nickel has a role in the functioning of enzymes and metabolism of certain proteins. It contributes to production of hormones, lipids, and cell membranes. Nickel is also used by the body to convert glucose into energy. A low level of the element in the body is associated with kidney and liver diseases. Its increased level has harmful effects.
Drinking water which has a large amount of nickel, about 250 of its particles per million, can cause problems with the kidneys and blood cells, but this is rare. The inhalation of smoke or dust that contains nickel compounds can occur if you work in hazardous industries. This can lead to decrease in lung function, bronchitis, and an increased risk of lung cancer. The ingestion of too much nickel in the body can cause gastrointestinal disorders, increased red blood cell levels, renal stress, chronic bronchitis, decreased lung function, and in some cases lung cancer.
Why Eluru
Eluru, the headquarters of West Godavari district, one of the 13 districts in Andhra Pradesh, is bound by Krishna district on the west, East Godavari district on the east, Telangana on the north and the sea in the south. It has a population of 4 million people. Intensive agriculture, aquaculture, and the agri-processing industry, over the decades, has seen an abundant use of agrochemicals and pesticides in the coastal districts. The Krishna, East, and West Godavari districts are fertile and well-irrigated lands.
For decades, the Krishna-Godavari districts, called the ‘Rice Bowl’ of India, have had abundant cultivation, such as of fine varieties of paddy in the delta. They have had abundant water, so such cultivation was possible and Eluru town flourished. With large-scale availability of pesticides and chemicals, the urge to increase productivity and profits made both farmers and industrial manufacturers use them. But soon, the pesticides began to show their effects. Guntur began to be called the ‘Pesticide Capital’, with all major brands of pesticide-producers having their operations there. Another two years and the use of pesticides, both branded and many local variants, rose to excessive levels. Seeking profits, the traditional farming practices were changed with some taking up aquaculture, prawn culture, etc., which would be more commercially viable. There are more than two dozen large aquaculture units, which are engaged in the aquaculture export business in Eluru. Roughly 10,000 tonnes of fish and prawn catch is processed, packaged, and exported to various countries. So, while business and economy flourished, other things suffered including the environment.
It is known that the large-scale use of pesticides and chemicals for agriculture and aquaculture and the discharge of the wastes into water bodies has been a common practice in the region for decades. Use of banned and environmentally harmful ones too, like DDT (banned in some countries), has been noted.
Reports and Views After the ‘mystery illness’ attack, experts from Eluru Nagarjuna University in Guntur said that as Eluru lies in the lower region of the Krishna-Godavari Delta region, the fertilisers-chemicals that are applied in the upland region, particularly Krishna district and Khammam district, get down to Eluru and are washed all over the place. The pesticide effect is visible on the famous Kolleru lake. The once-expansive wetland, located about 15 km from Eluru, stretched to about 245 sq km in the past but now has become highly polluted and shrunk in size. The Siberian cranes do not make their regular visits anymore. Aquaculture (over a 1000 fish ponds) occupies nearly 40 per cent area. In addition, the construction has also taken a toll.
In a letter to the Chief Minister, K. Veeraiah, professor and dean, Faculty of Natural Sciences, and Department of Zoology and Aquaculture, has pointed out that the present illness could be due to the influx of heavy metals from the opencast mining at Sathupalli in neighbouring Khammam district. The recent heavy rains and floods in the region in August-September 2020 could have washed these mining wastes into the river Thammileru which runs through Khammam, Krishna, and West Godavari districts. Most of the mining wastes contain heavy metals like lead, nickel, copper, mercury, and cadmium. The reports on the illness have already revealed some of these residues in samples. Heavy metals are long lasting in the environment and even in the organisms. And pesticide residues, especially organochlorine, organophosphate, and carbamate are quite common in the region and foods. Studies in 1996 had reported about the presence of organochlorine pesticide residues.
The eruption of the illness should come as a stern warning, for the problem of pesticide pollution and heavy metal poisoning in the environment is not limited to Andhra Pradesh alone. It is a problem across the country.
It is suggested that regular testing of food samples, water, plant and fish should be done to see if the pollutants have entered the food chain. Cracking down on dumping grounds of pesticides and other pollutants is another needed step. Farmers should be informed about the use of harmful chemicals. There is the need to withdraw harmful pesticides and encourage farmers to opt for organic alternatives.