Meningitis is once again weaving a web of death and suffering in India's North-east having taken at least 250 lives so far The inhospitable terrain of northeast India - home to hundreds of ethnic tribes - has been plagued by killer diseases that often assume epidemic proportions. The latest scourge to ravage this otherwise also restive region is meningitis. An unprecedented onslaught of this disease which afflicts meninges i.e. the protective membranes covering the brain and spinal cord has already left more than 250 people dead in the northeastern states of Meghalaya, Tripura and Mizoram in past few weeks. Officials in Meghalaya have confirmed about 170 deaths, in Tripura the official death toll is more then 65 and in Mizoram the deadly virus is fast engulfing new areas and has left at least 15 dead till this report was filed. While the respective state administrations are still battling to control the disease, New Delhi has signalled a red alert. The situation is alarming in Meghalaya and Tripura where it has become an epidemic in all but name as bear out the mounting death toll. "The National Institute of Communicable Diseases (NICD) in New Delhi has alerted us. We have asked them to send necessary vaccines and drugs to control the disease. The worst hit is the Longtharai Valley of Dhalai district," says Tripura health service director Dr Satya Ranjan Debbarma. The preliminary probe has found out the disease to be meningococcal meningitis - a bacterial infection of the meninges, the thin lining that surrounds the brain and the spinal cord. "A variety of bacteria can cause meningitis and Neisseria meningitis is one of the most serious because of its potential to erupt in an epidemic." says Dr B Debbarma, a medical officer of the Agartala Government Medical College (AGMC) at Tripura's capital Agartala. Meanwhile, the NICD has asked these states to keep a close surveillance in remote locations, especially where the outbreak of meningococcal meningitis has been already reported. What is most serious about meningitis is that not only it is air-borne, but also even when the disease is diagnosed early and treatment starts, at least five to ten per cent of the patients die within 48 hours of onset of symptoms. The epicenters of the latest outbreak of meningitis are all remote villages where sending proper medical aid is very difficult. The recent outbreak of meningitis was not at all sudden. In fact, in the last few months the Chittagong Hill tracts (CHT) of Bangladesh bordering these three northeastern states has seen a spurt in number of meningitis cases. Therefore, there is every possibility that the virus travelled to Tripura and Meghalaya from CHT. More the 4,000 people are said to be infected by the lethal meningitis virus in northeast and the medical experts say that the infection is only escalating. "Every year northeast bears the brunt of outbreak of one or the other killer diseases that leave many dead. But this time things are really unprecedented in scale," says Syed Sajjad Ali, a journalist in the region. Of the three states, Meghalaya is the worst affected. Its most severely hit areas are East Khasi Hills, East Garo Hills, Jaintia Hills, Ri Bhoi, West Garo Hills and West Garo Hills. "The situation is alarming but it is under control and there is no reason to panic," says Meghalaya health minister's advisor, Pariong, who himself is a doctor. NICD experts have rushed to Shillong to help the state government to tackle the rapidly deteriorating situation. The outbreak of meningitis is usually seen between January and April; it spreads through droplets of respiratory or throat secretions. The most common symptoms of this silent assassin are stiff neck, high fever, headaches and vomiting. After the early troubles, Meghalaya has slowly been able to stop the virus penetrating new areas. Officials at state capital Shillong claim that situation is under control. "We have enough anti-meningococ-cal meningitis vaccines and a number of medical teams are working round-the-clock to deal with the situation," says Meghalaya health service director A Kynjing. The NICD has asked Meghalaya government to strengthen surveillance for early detection and treatment of those affected. The NICD has also taken a note of the fact that the disease has been mostly reported from slum areas where people usually live in unhygienic environs. In neighbouring Tripura the meningitis outbreak in Longthorai Valley and Chawmanu of Dhalai district has left the state's health infrastructure in a tizzy. The Tripura government has taken action to control the disease by setting up makeshift health centres in the affected areas but it came of little help as most of the affected villages are located in high terrains where one can reach only by foot. "Several medical teams are working in the affected areas and preventive medicines are being given to people in the tribal dominated areas," said R K Dhar, the director of the family welfare and preventive medicine in Tripura. Meanwhile symptoms of the disease have been reported among patients in other parts of the state including state capital Agartala. Although the death toll in Tripura is lesser than Meghalaya but the initial recklessness on the part of the state government has irked many. "It was a sorry state of affairs initially. People were dying and it was termed as mysterious fever and the state government was silent. Many lives could have been saved had they acted fast," says Sujit Dey, an activist in Agartala. Political wrestling on this issue has already also come to the fore with the opposition parties in Tripura gunning for the ruling Left Front government for not being able to handle the situation and terming it as 'non-sensitive'. Tripura health minister Tapan Chakraborty has, however, rubbished these allegations. "We have taken prompt action. A section of the media has reported exaggerated figures of death toll. We need to understand that the affected areas are remote," Tapan Chakraborty told Sahara Time. With poor tribals in the affected states running from pillar to post for medical aid it is high time centre and the state administration in northeast evolved a joint mechanism to tackle such frequent menaces.