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The COVID -19 pandemic which has affected 209 countries/ territories, infected more than a million persons and claimed more than 50 thousands human lives worldwide (till 4 th April, 2020). It is caused by SARS-CoV-2 a novel virus genetically similar to SARS virus and reported first in Wuhan, China. In India, the first case was reported in January and until 5 th April, 2020 it has spread to 29 States/UTs, affected more than 3 thousand. The fate of this disease in India is to be determined by three elements of epidemiology, i.e. agent, host and environment. The agent is novel, but it has been reported that there are two strains of SARS-CoV-2 under circulation out of which one is more aggressive and spread quickly. As the susceptibility to the virus is there in Indian population, like other countries but its presentation in hosts which range from asymptomatic to severe pneumonia would be affected by the innate immunity of hosts and small proportion of population belonging to high risk group. In addition, the weather of India may also act as an impediment to the fatalities this disease may cause. The measures taken by India first to restrict the entry of this agent in community and further to interrupt its transmission are exemplary. However, still there is need to be future ready and plan strategically, learning from success and failure of other countries. In order to tackle this pandemic, there is need to strengthen the existing medical infrastructure to take care of advance stage of COVID-19 patients and quality epidemiological investigation of COVID -19 cases at the community level.

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Introduction: Acute Encephalitis Syndrome (AES) is a disease characterized by fever and mental confusion, disorientation, delirium, or coma. It could be due to various causes such as viruses, bacteria, fungus, parasites, spirochetes, chemical and toxins. Objective: Epidemiological investigation of acute encephalitis syndrome occurred in Muzaffarpur, Bihar in 2011. Methods: This epidemiological investigation was done by a team consisting of experts from various disciplines. The team visited Muzaffarpur, from 14 th to 20 th July 2011 and reviewed the situation of deaths among children due to AES, as directed by the Authorities. Results: A total of 147 cases of fever with altered sensorium were admitted between 11 th June to 18 th July 2011 in a private hospital and a Medical College Hospital of Muzaffarpur. Out of these, 54 patients died indicating case fatality rate of 36.73%. Evidences suggest that there were increased chances of contacts between cases and wild rats during the period of occurrence of outbreak. Etiological agent could not be identified by laboratory tests. Conclusion: Clinico-epidemiological and environmental evidence supports the diagnosis of Acute Encephalitis Syndrome which has significant mortality, affecting predominantly rural population with poor sanitation and presence of wild rats.

The novel disease COVID-19 has reached to 33 States/ Union Territories (UT) of India causing more than 49,000 infections and 1600 deaths till 6 th May, 2020. Various measures have been undertaken to control and arrest the spread of this disease in country which include invocation of Epidemic Act, 1897, social distancing, nationwide lockdown, enhanced active and passive surveillance. COVID-19 containment strategy for single large area with multiple foci and cluster is being implemented. The real war is being fought by the silent warriors, i.e. Public Health workforce of India at community level, to arrest the local transmission of COVID-19 following mapping & micro-planning as given in National guidelines. As the quality implementation of these field activities is essential to control this disease, several Central Rapid Response Teams (CRRT) were constituted to visit States/ UTs to provide assistance in effective implementation of same. The present article is compilation of best public health practices observed by CRRT, Haryana, State, which were followed to conduct surveillance, monitoring, awareness generation, coordination etc. at community level, with objective to enable its replication by other States/ UTs.

India being predominantly a rural country, striving hard to provide quality healthcare services to more than 890 million people who lives there. The importance given to rural health care by Govt. of India is visible through the implementation of dedicated submission under NHM, i.e., NRHM. However, there are still several rural health challenges, i.e., specific needs, belief/ superstition, scarcity of human resources in rural areas, lack of quality research/ coordination and collaboration between various sectors. The possible solutions to these challenges lie in strengthening research in rural health epidemiology, agricultural health, enhancing use of Information Technology & Telemedicine, designing specific clinical services, field practices, applying the biostatistics & mathematical modelling in decision making and mentoring the human resources in specific need of rural health. This article is an attempt to elucidate various rural health challenges and need for development of National Institute of Rural Health in India, to address the challenges of rural health and conduct before mentioned activities as an apex body.

Background: Despite the achievement of elimination of leprosy in 2005 at the national level, India still has more than a dozen states reporting a Grade II Disability (G2D) rate of > 2 per million populations, and over two-fifth of districts are high or moderate endemic. It is necessary to understand the factors leading to continued endemicity and disability in these districts to plan strategies and achieve the envisaged targets of NLEP. Method: To identify individual, environmental, socio-demographic, and health system-related factors responsible for leprosy and disability occurrence in a high endemic district of Bihar, case-control design was adopted. A total of 896 individuals (448 cases and 448 controls - excluding family members; matched with age and gender) were interviewed with pre-designed, pre-tested schedules. Blocks were stratified based on the proportion of G2D among new cases detected (NCD) in the year 2019 to draw samples in proportion to NCD. Descriptive, stratified, bivariate and multinomial logistic regression was done to find the association among factors. Results: Factors found significant for leprosy occurrence were Scheduled Caste (SC) category, education less than 8th class, unemployment, living in the household without windows/ light/ safe water supply, kutcha type, family income less than INR 8000, and history of leprosy patients in family/ friends. Further age more than 14 years, ST category, reporting delay of 6-12 months, remoteness of health facility, financial constraints etc. were found significant for disability occurrence. Conclusion: Further exploration in this area and designing strategies considering these factors may help in controlling this chronic disease in endemic areas and preventing related disability.