SHAPU scourge

The Nepal-specific eye disease, Seasonal Hyperacute Panuveitis (SHAPU), has affected 40 patients, mostly children, in the past few weeks. Almost half of them have lost their eyesight due to it. This unique disease, which can damage eyes within hours, was first recorded in 1975 in Kaski district and has been reported every alternate two years--odd year in Gregorian calendar and even in Nepali calendar--from September to December infecting only one eye, usually the right one. It is doubly dangerous in that it looks like the infected person is suffering from conjunctivitis and can be mistaken for that.



SHAPU can be treated through antibiotics or antiviral drugs if caught in the initial stage. But if it is not diagnosed immediately, it has to be operated within 48 hours beyond which the eye can become dysfunctional. The distinguishing symptom of this disease at the initial stage is that there is no sticky secretion as in conjunctivitis. The eye then gradually loses sight, patients have difficulty opening the infected eye in the presence of light, and a white spot appears in the black part of the eye due to accumulation of pus which has to be removed surgically to save the infected eye.



It is a matter of shame that the cause of this blinding disease has not been identified even after more than three decades of being first seen in Nepal. The fact that it is unique to Nepal has been a big handicap as we cannot fall back on international research. But the very fact that it is Nepal-specific should also have spurred the concerned authorities into getting to the root of this disease years ago. Ophthalmologists believe this disease is triggered by contact with white tussock moth and say that children get infected after playing with it. Many of the past cases have shown the strong link with the moth of this species as tiny hairs belonging to it were found inside the eye in some instances. They say this nocturnal moth--which does not fly and can only crawl, and is seen around bright lights--is responsible for this disease but cannot explain its biennial nature.



Though the frequency of the cases went down during October after peaking in September, as in previous years, the upcoming festival of lights would be something to look out for because bright lights attract such moths and can claim new victims. Parents should hence be careful and not allow children to play with moths and immediately consult eye hospitals if conjunctivitis-like infection without secretion of sticky substance occurs. We also urge concerned authorities to do adequate research on this disease and be prepared by the time it revisits in 2011, going by its biennial nature.

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