The clean up drive began at three in the morning on August 30, recalls Birendra Singh Savita, 50, a barber in Firozabad’s Sudama Nagar neighbourhood. Chief minister Adityanath was scheduled to meet him 12 hours later.

“I’ve lived here for 20 years,” Savita told Newslaundry. “And I’ve never seen a clean up drive like that. They properly cleaned the drains and even took away the garbage.”

On August 28, Savita’s six-year-old grandson, Vir, died hours after contracting a fever. His death summary prepared by an Agra hospital noted “severe respiratory distress”, “gasping condition”, “high grade fever” and an oxygen saturation level of 40 percent.

In the neighbouring lane, Krishna, 6, passed away under similar circumstances on August 26. So did another six-year-old, Lucky Sharma, who lived in the adjoining colony, on August 31. A couple of streets away, Mohit, 16, died on August 20.

At least four other children in Sudama Nagar – Tanu, 4, Hema, 12, Rakhi, 7, and Nikhil, 8 – have similar stories.

In a document presented to the chief minister on Monday, the Firozabad administration identified these deaths – more than 40 so far, with at least 34 children – as “dengue/viral”. The administration noted that 225 people in the district have tested positive for “suspected dengue”, of which 75 are children.

News reports have described the fever as a "mystery illness", and the local administration here is scrambling to identify it through a death audit and sample testing in Lucknow. Yesterday, Hindustan Times reported that medical teams have identified at least two dozen cases of scrub typhus in Mathura, though it is unclear if it is related to the epidemic in Firozabad.

Update on September 2: A health official working with the Uttar Pradesh government told Newslaundry that of 49 samples sent to King George's Medical University, Lucknow, 46 have tested positive for dengue. Two samples tested positive for scrub typhus. Dr Sangeeta Aneja, dean at the Autonomous State Medical College in Firozabad, told Newslaundry that in ELISA tests – which detect immune responses in the body – conducted on 27 samples, 22 tested positive for dengue.

A public health expert surveying Firozabad’s affected localities for the past week told Newslaundry that the debilitating state of sanitation in the city is the primary reason for the epidemic. “The drains are wide, dirty and uncovered,” the expert said. “It has rained heavily this year and most of them are clogged with garbage. I’ve seen children play beside these and that’s how the fever is spreading.”

Manish Asija, a Bharatiya Janata Party MLA in Firozabad, also blamed "waterlogging, lack of sanitation and hygiene” for the epidemic.

Fever, diarrhoea, haemorrhage

Fever, headache and diarrhoea were common symptoms across five families that Newslaundry met in Sudama Nagar. Mohit, who passed away on August 20, even had bleeding gums – a complication attributed to hemorrhagic dengue.

“He fell ill on August 19, shortly after he returned from selling rakhis,” said his father Bablu, who shines shoes for a living. “A doctor at the Autonomous State Medical College told us that he had dengue.”

Around midnight, when Mohit’s health began to decline, the hospital asked Bablu to shift him to a hospital in Agra, 40 kilometres away. But the 16-year-old passed away in the ambulance enroute. “My wife, Seema, and daughter, Kareena, have also been ill for 10 days now, with similar symptoms,” Bablu rued. “I earn about Rs 200 a day, but spent Rs 10,000 on my son’s medical needs. How do I take them to a hospital?”

An open drain outside Bablu’s house, covered by a scourge of mosquitoes and flies, leads to the house of Reshma, 50, where at least seven people – six children and one adult – have been gripped by fever. A second drain, at least 10 times bigger, flows 10 metres away, skirting Sudama Nagar for a kilometre.

Virat, 8, and Tanya, 10, lay on a cot arranged just beside the drain. “They’re my grandchildren. The boy has been ill for four days and the girl for eight,” Reshma told Newslaundry. “I got some medicines last week from a local clinic but the fever returned. I don’t have the money to take them to the medical college.”

Unlike Bablu, Pushpendra does not know what afflicted his son, Krishna. The symptoms were similar – the six-year-old suffered rectal bleeding – but the doctors at a local nursing home and a government hospital could not pinpoint to a particular disease.

“At the government-run SN hospital, I was asked to get platelets for my son at 3 am,” Pushpendra recalled. “I struggled at that hour to somehow procure it, and it took me four hours. At 7 am, just when I collected platelets from a blood bank, the doctor called me and said Krishna had died.”

Pushpendra, a daily wager who works at a garage, earns Rs 5,000 a month. He spent three times his monthly income at the nursing home alone. On August 30, Adityanath visited his house. “He spoke to me for two minutes about what happened to Krishna,” Pushpendra said. “Then he went away, without any assurance or help.”

‘There is no hygiene here’

Sudama Nagar residents complain that the municipality barely looks after their locality. Pooja, Reshma’s neighbour, said that the cleaning staff shows up once in four days. “They sweep the streets, but no work happens on the drains,” she said. “They take out the garbage from it and keep it on the road. It rots for a day or two and, if we’re lucky, they then take it away. Else it’s washed into the drains again.”

Pushpendra told Newslaundry that he was rebuffed when he and his neighbours confronted the cleaning staff. “About the drains, they asked me to clean it myself,” he said. “This place used to be sanitised during the lockdown, but even that has stopped now.”

“There is no hygiene here,” said Birendra, Vir’s grandfather. “We are forced to pay Rs 30 every month to the municipality staffers even if they do nothing. If we don’t, they threaten us with a fine of Rs 5,000.”

A noted preventive measure for dengue is fogging drives – a programme alien to residents here. “I’ve never seen an anti-dengue fogging drive here,” said resident Prakash Sharma, 42, whose nephew Lucky succumbed to dengue on August 31. “Drains are cleaned once a week, but they leave behind the garbage which only makes the neighbourhood filthier.”

Another cause of concern for residents is the empty plots that brim with garbage, sewer and dung. From afar, they often look like green patches of earth. Nearer, the green turns out to be the algae growing in stagnant water.

Newslaundry identified at least five such plots in Sudama Nagar.

‘The only cleaning ever happened before Yogi’s visit’

On the cue of local bureaucrats, Birendra had prepared for Adityanath’s visit on August 30. But the chief minister never came. “I think it’s because the road from Pushpendra’s house to mine passes from a plot full of garbage,” he said.

The plot, right behind Birendra’s house, is now covered with a white material. “The municipality officers cleaned the areas thoroughly hours before the CM’s visit,” said Ajay Prakash, a local. “It was the only sanitation drive that ever happened here. They even took dogs and cows away. But even so, they did not have time to clean the plots. So they covered it with soil and lime.”

When it rained here on Tuesday, the lime predictably washed away, once again exposing the waste beneath collected beside small pools of water. “They did not turn up for cleaning today,” Birendra shrugged.

In its once-in-a-generation clean up, the Firozabad municipality also built a cemented path over an open drain outside Birendra’s house that Adityanath was supposed to cross.

After the CM’s visit, the medical college sent an ambulance to transport ill residents of Sudama Nagar to the town’s main government hospital. Vishnu Dev Sharma, 55 and in good health, was pulled into the vehicle arbitrarily and taken to the institution. “A nurse there gave me a few medicines for cold and fever. Then they asked me to leave,” an upset Sharma told Newslaundry. “I had to spend money on an auto to get back home.”

Birendra, recovering from his grandson’s loss, was later visited by delegations from the Samajwadi Party and Congress. But it did not console him. “The government is dysfunctional and does not exist for the poor,” he said. “No one hears us out. When the elections come, we will not vote, no matter who turns up.”

This piece was updated on September 2 with details on how out of 49 samples tested, 46 tested positive for dengue.