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DENGUE
Dengue is a viral disease that is transmitted through the bites of female ital mosquitoes. There are four serotypes of dengue virus and all the four are prevalent in India. During 1996, an outbreak of Dengue was recorded in Delhi. For control and containment of Dengue, the following major activities are in operation.
Broad guidelines for action plans and calendar of activities for prevention and control of Dengue have been provided to states. All other States/UTs have been advised to take appropriate action for control and containment of Dengue/Dengue Haemorrhagic fever.
Leprosy is a Chronic, infectious disease of human beings that primarily affects the skin, mucous membranes, and nerves. The disease is caused by a rod-shaped bacillus, Mycobacterium leprae, which is similar to the bacillus that causes tuberculosis. The leprosy bacillus was identified in 1874 by the Norwegian physician Gerhard Henrik Armauer Hansen.Leprosy is scourge of mankind. It is unique in many aspects. The public health importance of leprosy lies in the capacity of the disease to produce deformities as well as psychological and social disabilities.
The National leprosy Control Program had been in operation since 1955. The main objective that time was to control leprosy through domiciliary Dapsone Monotherapy. It was redesignated as National Leprosy Eradication Program in 1983 with an aim to achieve arrest of the disease activity. After the World Health Assembly Resolution in the year 1991, the objective of the program was defined to achieve the elimination of leprosy in the country by the end of century thereby reducing the case load to 1 or less per 10,000 population. After World Bank assistance, the whole country has been brought under MDT which is being implemented through 490 DLSs.
Tuberculosis (TB) is a chronic or acute bacterial infection that primarily attacks the lungs, but which may also affect the kidneys, bones, lymph nodes, and brain. The disease is caused by Mycobacterium tuberculosis, a rod-shaped bacterium 2 to 4 micrometers in length. Symptoms of TB include coughing, chest pain, shortness of breath, loss of appetite, weight loss, fever, chills, and fatigue. In 1995 the World Health Organization (WHO) declared TB to be a global emergency, the first such designation ever made by that organization.
In India, 1.4 crore people are estimated to be suffering from active tuberculosis of whom 30 to 35 lakh are highly infections. About 5 lakh die to the disease every year. An estimated 20 to 25 lakh cases are added every year.
The program is in operation since 1962 and is integrated with the General Health Services. The National TB Control Program has been accorded high priority by the government with inclusion of NTP in the 20 point program. The main features of program include
The National Tuberculosis Institute, Bangalore collects, compiles and analyses the quarterly reports and disseminates the same to the district, the State and the Central TB Division.
The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease. Multidrug-resistant tuberculosis (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the two most powerful anti-TB drugs.
The primary causes of multidrug resistance are mismanagement of TB treatment and person-to-person spread. Most people with tuberculosis are cured by a strictly followed, six-month drug regimen that is provided to patients with support and supervision. Inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs, and premature treatment interruption can cause drug resistance, which can then be transmitted, especially in crowded settings such as prisons and hospitals.
In some countries, it is becoming increasingly difficult to treat MDR-TB. Treatment options are limited and expensive, recommended medicines are not always available, and patients experience many adverse effects from the drugs. In some cases even more severe drug-resistant tuberculosis may develop. Extensively drug-resistant TB, XDR-TB, is a form of multi-drug resistant tuberculosis that responds to even fewer available medicines. It has been reported in 92 countries worldwide.
Solutions to control drug-resistant TB are to:
India switches to daily TB cure plan
Tuberculosis patients across India will now be put on daily treatment instead of the previously practiced intermittent treatment regimen.The government has finally made the path-breaking shift from the old system of administering alternate day therapy to TB patients to a system where a new drug dose combination would be administered to affected people daily. The intermittent therapy was started in 1992 when India rolled out DOTS therapy.
Need for switch:
The daily dose regimen was much needed to prevent India’s rising multi-drug resistant burden, a fast emerging challenge. Even today, one in every four TB patients in the world is from India, which accounts for the highest TB burden in the world.India was also the only country in the world still practicing the intermittent (alternate day) TB therapy, and the WHO had been nudging the country for years to make the critical transition.
It is an Infectious virus disease of the central nervous system, sometimes resulting in paralysis. The greatest incidence of the disease, also known as infantile paralysis, is in children between the ages of five and ten years. The disease was described in 1840 by the German orthopedist Jacob von Heine. In its clinical form it is more prevalent in temperate zones.
India introduced the oral polio vaccine in 1985 in the Universal Immunisation Programme in the backdrop of over 200,000 cases of polio annually (as per estimates of the Indian Academy of Pediatrics). In 1995, the first national polio immunization campaign was held; since then two national and multiple sub-national campaigns are rolled out every year for children up to 5 years of age.
An independent panel of 11 health experts from the Southeast Asia Regional Certification Commission for Polio Eradication met for two days to review data from the countries before reaching the decision that all 11 countries of the region are now polio-free and have met the requirements for certification.
India as well as WHO's southeast Asia region was certified polio-free in February 2014 by an independent commission under the WHO (World Health Organization) certification process.Polio eradication is one of the biggest public health successes of India. From being one of the top three countries reporting polio, there hasn't been a single polio case in the country for the last three years.
Several conditions must be satisfied before a region can be certified polio-free — at least three years of zero confirmed cases due to indigenous wild poliovirus; excellent laboratory-based surveillance for poliovirus; demonstrated capacity to detect, report, and respond to imported cases of poliomyelitis; and assurance of safe containment of polioviruses in laboratories (introduced since 2000).
The National Program for Control of Blindness was launched in the year 1976 as a 100% Centrally Sponsored Program. Various activities of the program include establishment of Regional Institutes of Ophthalmology upgradation of Medical colleges and district hospitals and block level Primary Health Centres, development of mobile units, and recruitment of required ophthalmic manpower in eye care units for provision of various ophthalmic services.
The program also extends assistance to voluntary organisations for providing eye care services including cataract operations and eye banking.
Voluntary organisations are playing an important role in this program. With the success achieved and experience gained through the pilot districts, District Blindness Control Societies (DBCS) have been established throughout the country under the chairperson of the District Collector/District Program Managers is being carried out for 2 weeks.
AIDS (Acquired immunodeficiency syndrome) is the serious health problem that threatens the entire human population. It is a fast spreading and incurable disease and is defined as most severe form of continuous illness and is caused by HIV (Human immunodeficiency virus).AIDS was first reported in 1981 in U.S.A. HIV was discovered in 1984 by American & French Scientist independently. AIDS is believed to have originated in central Africa, where monkeys may have originally harboured the virus. It may have passed from monkey host into human population in Africa during 1960s. It is heartening to know that only 10% of the people, who get AIDS virus infection, actually develop full blown AIDS. Some people carry AIDS virus but have apparently normal immunity.
A person infected with HIV gradually loses immune function along with certain immune cells, called CD4 T-lymphocytes or CD4 T-cells, causing the infected person to become vulnerable to pneumonia, fungus infections, and other common ailments.
Infection with HIV does not necessarily mean that a person has AIDS, although people who are HIV-positive are often mistakenly said to have AIDS. In fact, a person can remain HIV-positive for more than ten years without developing any of the clinical illnesses that define and constitute a diagnosis of AIDS. In 2007 an estimated 2.31 million people were living with HIV or AIDS in India.
The tests which confirm presence of antibody to HIV are ELISA (Enzyme linked immunoserbent assay), Western Blot assay, Indirect immunofluoresence assay, RIPA (Radio immunoprecipetator assay)
Antiviral drugs that attack HIV exploit vulnerable spots in the viral replication cycle. One target is the process of Reverse Transcription—that is, the conversion of the viral ribonucleic acid (RNA) into deoxyribonucleic acid (DNA)—that HIV must undergo to be infectious.
Reverse transcription is a process unique to retroviruses and is performed by the viral enzyme reverse transcriptase (RT). One class of anti-HIV drugs, known as nucleosides, are all RT inhibitors. Five nucleosides are currently licensed by the United States Food and Drug Administration (FDA): AZT (zidovudine), ddi (didanosine), ddC (zalcitabine), d4T (stavudine), and 3TC (lamivudine).
National AIDS Control Program (including blood safety): The first AIDS case in India was detected in 1986. India is home to the world’s third highest population of people with HIV, which stood at nearly 2.4 million in 2011. Since then HIV infection has been reported from almost all States and Union Territories of the country. Government of India launched a National AIDS Control Program in 1987. The Ministry of Health and Family Welfare has set up a National AIDS Control Organization as a separate wing to implement the program.
NACO is the country’s premier agency charged with crafting and executing the anti-HIV/AIDS strategy, NACP. One million people are treated under the programme. Consolidating the gains made till now, the NACP-IV aims to further strengthen the epidemic response in India through a cautious and well-defined integration process over its next five-year period. Phase IV of the National AIDS Control Programme (NACP) was launched in February 2014.
The overall objective of the project is to arrest the spread of HIV/AIDS infection in the country with a view to reducing morbidity and mortality, minimize from HIV/AIDS infection. The project consists of the following components:
But the emerging pattern of geographical distribution is not uniform. Though the dominant mode of transmission of HIV infection in the country still remains heterosexual contact, the pattern of transmission on the North Eastern States seems to be predom inantly through sharing of infected needles by injecting drug users.
FOOT-AND-MOUTH (FMD) disease, which is ravaging cattle herds in Britain and other countries in Europe, is beginning to cast to cast its shadow over India.
FMD is a disease caused by a virus belonging to the genus Apthov irus of the family Picornaviradae. In India, the virus is endemic, with four basic types and numerous variants. Due to various reasons, a slaughtering policy cannot be adopted in India, and the disease has to be controlled by regular vaccination, supported by early diagnosis, proper disposal of infected animals and restricting animal movement. The disease (also called hoof-and-mouth disease) affects cloven-hoofed animals, i.e., cattle and pigs rarely humans. It manifests itself as a sudden rise in temperature, followed by an eruption of blisters in the mouth, on areas of tender skin, such as the udder in females, and on the feet; blisters may also appear in the nostrils. There may also be salivation and frequent smacking of the lips. Eating becomes painful. Because soft tissues under the hoof become inflamed, the animal becomes lame and may eventually shed its hooves. Livestock raised for meat may lose weight, and dairy cattle and goats give less milk. Often, the disease kills young animals and causes pregnant females to abort.
The UK, together with other European countries, holds some 30 million doses of vaccines of all the main types of virus. In an emergency, the strategy is either to mass vaccinate or to “ring-fence” outbreaks, i.e., to vaccinate all animals in the area surrounding an outbreak. At present, the strategy is “ring-fencing” by slaughtering, with all the logistic problems of disposing of the carcasses.
Vaccination confers immunity for short periods. Periodic outbreak and variations among the circulating viruses necessitate rapid and sensitive diagnostic tests.
Collecting samples for diagnosis involves physical handling of the animal, which means increasing the risk of spreading the virus. To get over this difficulty, a simple method has been developed by Dr V.V.S. Suryanaryana and his colleagues at the Indian Veterinary Research Institute, Hebbel, and Bangalore.
The test uses samples of the air collected from the vicinity of animals kept in sheds. Claimed to be the first of its kind, the test may be employed to test for the presence of the virus in the contaminated area.
It Is A Respiratory Infection Caused By Type A Or Type B Influenza Virus, Which Usually Enter The Human Body Through Mucous Membrane In The Mouth, Nose Or Eyes.Also called as Avian influenza is caused by the avian virus H5NI, a subtype of influenza virus.This virus can infect several animals but the birds are especially affected species because it makes them sick and they die ultimately.Wild birds are the natural host of avian virus and hence the name bird flu other avian influenza is coined.The virus coined was first isolated from birds in South Africa in 1961.The virus circulates among the birds worldwide. It is very contagious among birds and can be deadly to them.
The virus doesn’t typically infect human beings.H5NI strain may be more widely established in bird populations. Wild migratory ducks are the natural reservoirs of the strain. These ducks usually withstand the virus but the chickens have very little resistance. When chickens are infected, the virus spreads to the entire flock.
Infected birds shed virus in saliva, nasal secretions and faces, when human breathe in these conditions, and they get infected.The virus does not spread through meat or eggs.Most of the cases of infection are reported from chicken.
It assumes endemic character because virus keeps on changing as has been evidenced from the gene sequences of different countries.Because these viruses do not commonly infect human beings, there is little or no protection available against them.The antiviral that have been made earlier are rendered useless due to changing nature of the virus.
Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia.
According to the World Health Organization (WHO), during the SARS outbreak of 2003, a total of 8,422 people worldwide became sick with SARS; of these, 916 died.
Symptoms of Sarsbegins with a high fever (temperature greater than 100.4°F [>38.0°C]). Other symptoms may include headache, an overall feeling of discomfort, and body aches mild respiratory symptoms.SARS patients may develop a dry cough. Most patients develop pneumonia.
Sars Spreadsby close person-to-person contact. Most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.
In May 2013, India has successfully developed indigenous rotavirus vaccine named Rotavac which will help in preventing deaths caused due to rotavirus diarrhea. Globally, approximately 4.5 lakhs children die each year due to this and India alone accounts for 22% of all (Source: Lancet study).
The Phase-III clinical trial has been successful in terms of efficacy and safety and it now awaits the approval of Drugs Controller General of India. First phase III efficacy trial conducted in India for any vaccine Expected by 2014, It will be much cheaper than the two other such vaccines currently in the market. It was developed under PPP (public-private partnership) as part of Indo-U.S. Vaccine Action Program - collaboration of Department of Biotechnology, India and Bharat Biotech (Hyderabad) with help of Bill & Melinda Gates Foundation and other funding agencies.
Currently Rotavac is administered as part of Universal Immunisation Programme (UIP) of Government (oral vaccine for infants; dose at 6, 10 and 14 week)
Rotavirus spreads easily through food and water and also associated with gut infection. The main cause of diarrhoeal diseases in infants under 11 months; causes severe diarrhea, accompanied by vomiting and fever; most deaths are from dehydration in children. It is second leading killer of young children globally, after pneumonia
Brazil has manufactured and put to use a unique biological weapon "Franken-skeeter" to contain the deadly infectious diseases spread by mosquitoes.
The novel deterrent is a swarm of genetically modified mosquitoes, largest ever in the world, that have been engineered to wipe out their own species.
It first has been unleashed on a farming town namely Jacobina (Bahia) that has been plagued for years by dengue fever.Dengue fever is a mosquito-borne tropical disease and a leading cause of illness and fatality in Brazil.As per a report by WHO, the world has suffered a 30-fold increase in dengue cases during the last 50 years.
It has been equipped with a gene designed to devastate the non-GM Aedes aegypti population and reduce dengue’s spread.The mosquitoes contain a lethal gene but are kept alive in the laboratory with the help of the antibiotic called 'tetracycline'. Once they reach larval stage, the males are preserved (as they don’t bite) while the females are eliminated.Such males are released to mate with wild females in order to pass on their lethal gene to their offspring. This result in a disaster for the newborns as in the absence of tetracycline they end up dead.
MERS-CoV is the acronym for Middle East Respiratory Syndrome Coronavirus, the virus that causes MERS.
It likely came from an animal source. In addition to humans, MERS-CoV has been found in camels in Qatar, Oman, Egypt and Saudi Arabia, and a bat in Saudi Arabia. Camels in several other countries have also tested positive for antibodies to MERS-CoV, indicating that the camels were previously infected with MERS-CoV or a closely related virus. It may be that people became infected after contact with camels, although more information is needed to figure out the possible role that camels, bats, and other animals may play in the transmission of MERS-CoV.
MERS-CoV has spread from ill people to others through close contact, such as caring for or living with an infected person. Infected people have spread MERS-CoV to others in healthcare settings, such as hospitals. Researchers studying MERS have not seen any ongoing spreading of MERS-CoV in the community.
All reported cases have been linked to countries in and near the Arabian Peninsula. Most infected people either lived in the Arabian Peninsula or recently traveled from the Arabian Peninsula before they became ill. A few people became infected with MERS-CoV after having close contact with an infected person who had recently traveled from the Arabian Peninsula.
Most people confirmed to have MERS-CoV infection have had severe acute respiratory illness with symptoms of: fever, cough, shortness of breath
Some people also had gastrointestinal symptoms including diarrhea and nausea/vomiting. For many people with MERS, more severe complications followed, such as pneumonia and kidney failure. About 30% of people with MERS died. Most of the people who died had an underlying medical condition. Some infected people had mild symptoms (such as cold-like symptoms) or no symptoms at all; they recovered.
Ebola first appeared in 1976 in 2 simultaneous outbreaks, in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.
Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
Nipah Virus
Nipah Virus is an infectious zoonotic disease that was first witnessed in Malaysia and Singapore in 1998 and 1999. It first appeared in Domestic Pigs and has been found among several species of domestic animals including dogs, cats, goats, horses and sheep. The infection is also known to infect human beings.
The organism which causes Nipah Virus encephalitis is an RNA virus of the family: Paramyxoviridae, genus: Henipavirus. It is closely related to Hendra Virus.
The disease spreads through fruit bats or 'flying foxes' of the genus Pteropus, who are natural reservoir hosts of Nipah and Hendra Viruses. The virus is present in Bat Urine and may also be present in bat faeces, saliva and birthing fluids. Presumably, the first incidence of Nipah Virus infection occurred when pigs in Malaysians farms came in contact with bats who had lost their habitats due to deforestation.
Symptoms and Treatment: Typically Human infection presents as an encephalitic syndrome marked by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death. There is no specific treatment for Nipah Virus. The Primary treatment for Human cases is intensive support care.
Prevention of NIPAH Infection: While there is no vaccine available for infection, preventive measures can be a key to control the spread. With fruits bats being the primary cause of infection, the farm animals should be prevented from eating fruit contaminated by bats. Physical barriers can be put in place in order to prevent bats from accessing and contaminating palm sap.
Medical officials who are looking after the patients with suspected or confirmed NiV should take basic precautions like washing hands, using a gown, cap mask and wearing gloves. For laboratory personnel, Nipah virus is classified internationally as a biosecurity level (BSL) 4 agent.
Kala Azar
A chronic and potentially fatal parasitic disease of the viscera (the internal organs, particularly the liver, spleen, bone marrow and lymph nodes) due to infection by the parasite called Leishmania donovani.
It is second-largest parasitic killer in world after Malaria. It is endemic to Indian subcontinent in 119 districts in four countries (Bangladesh, Bhutan, India and Nepal). India accounts for half the global burden of Kala-azar disease. India missed December 2017 deadline announced for elimination of Kala Azar in budget 2017-18 by Union Government.
Kala-azar can cause no or few symptoms but typically it is associated with fever, loss of appetite (anorexia), fatigue, enlargement of the liver, spleen and nodes and suppression of the bone marrow. Kala-azar also increases the risk of other secondary infections. The first oral drug found to be effective for treating kala-azar is miltefosine. However the most effective method to prevent infection is to protect from sandfly bites.
Zika virus disease (Zika) is a disease caused by the Zika virus, which is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. However, Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects. Once a person has been infected, he or she is likely to be protected from future infections.
Zika virus was first discovered in 1947 and is named after the Zika Forest in Uganda. In 1952, the first human cases of Zika were detected and since then, outbreaks of Zika have been reported in tropical Africa, Southeast Asia, and the Pacific Islands.In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infection in Brazil. On February 1, 2016, the World Health Organization (WHO) declared Zika virus a Public Health Emergency of International Concern (PHEIC). Local transmission has been reported in many other countries and territories.
Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.This can be done by using insect repellent regularly; wearing clothes (preferably light-colored) that cover as much of the body as possible; installing physical barriers such as window screens in buildings, closed doors and windows; and if needed, additional personal protection, such as sleeping under mosquito nets during the day. It is extremely important to empty, clean or cover containers regularly that can store water, such as buckets, drums, pots etc. Other mosquito breeding sites should be cleaned or removed including flower pots, used tyres and roof gutters. Communities must support the efforts of the local government to reduce the density of mosquitoes in their locality. Efforts must be made to eliminate mosquito breeding sites such as still water soon after rains and its accumulation in discarded containers and waste materials in and around houses.
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