Morning MEDtalks with Dr KK Aggarwal

Morning Health Talk :

New Delhi, June 04, 2018 ;

Clinical

• North Eastern region has been dubbed as the “cancer capital of India” on account of lifestyle, low awareness and late detection that has led to rise in number of cases of the disease. Director of Dr. Borooah Cancer Institute (BBCI) Guwahati Dr. AC Kataki lamented that the reason for the region being dubbed as “cancer capital” arose from the fact that it alone added about 39,635 cancer patients in a year.
• More than 1 billion people cross international borders each year, generally unaware of local infectious disease outbreaks. In the United States, 60 million people travel internationally most years, with 60 percent of those destinations having an active health alert. The Centers of Disease Control and Prevention (CDC) issues international Travel Alerts, but few people are actually aware of this vital information.
• Severe asthma is defined as asthma that requires use of high-dose inhaled corticosteroids along with a second controller or systemic corticosteroids, or both. It also refers to asthma that remains uncontrolled despite this treatment. Do you know that recurrent exacerbations in adult severe asthma are more common among patients with gastroesophageal reflux?

Public Health

Newcastle disease outbreak in peacocks in Haryana

Twenty-two peacocks in Bhondsi, Haryana have died in the last fortnight reportedly due to Newcastle Disease. The Indian Veterinary Research Institute, Bareilly has established the presence of the Newcastle disease virus in the infected birds following which an outbreak of Virulent Newcastle Disease among peacocks has been confirmed by authorities, reported the TOI on Saturday.

Here are 10 salient points about Newcastle disease.

• Newcastle disease is a highly contagious and fatal zoonotic viral disease of domestic poultry, cage and aviary birds and wild birds.
• It is caused by the Newcastle virus, a paramyxovirus, which is antigenically distinct from any of the human paramyxoviruses.
• It was first identified in 1926 in Java, Indonesia and in 1927, in Newcastle-upon-Tyne in England, from where it derives its name.
• Clinically, the infection in birds presents with digestive, respiratory and/or neurological signs. The incubation period is usually 5–6 days, but can vary from 2–15 days.
• Humans can acquire the infection via direct physical contact with infected birds. The virus can also be transmitted through contaminated equipment, carcasses, water, food and clothing.
• No cases of human infection have been reported yet from eating poultry products
• In humans, the infection is mild and presents as unilateral or bilateral reddening, excessive lachrymation, edema of the eyelids, conjunctivitis and sub-conjunctival haemorrhage. It may also cause influenza-like symptoms, but otherwise poses no hazard to human health.
• Laboratory workers or those living in close vicinity of the birds are mainly at risk of acquiring the infection.
• Infection can be prevented by using standard personal protective equipment.
• Virulent Newcastle disease is a notifiable disease.
• The Paramyxoviridae are a large family of single-strand, enveloped RNA viruses which causes a number of human and animal diseases. The most recognized viruses in this family are measles and mumps for human diseases and newcastle disease virus, canine distemper and rinderpest (recently eradicated) viruses for animal diseases.

The only viruses of this family handled by the Viral Special Pathogens Branch belong to the genus Henipavirus which contain 2 virus species: Hendra virus and Nipah virus. These viruses have been isolated from humans, bats, horses, and pigs.

Viral Haemorrhagic Fevers

VHFs are caused by viruses of five distinct families: Arenaviridae, Bunyaviridae, Filoviridae, Flaviviridae, and Paramyxoviridae. Each of these families share a number of features:

• They are all RNA viruses, and are all covered, or enveloped, in a fatty (lipid) coating.
• Their survival is dependent on an animal or insect host, called the natural reservoir.
• The viruses are geographically restricted to the areas where their host species live.
• Humans are not the natural reservoir for any of these viruses. Humans are infected when they come into contact with infected hosts. However, with some viruses, after the accidental transmission from the host, humans can transmit the virus to one another.
• Human cases or outbreaks of hemorrhagic fevers caused by these viruses occur sporadically and irregularly.
• The occurrence of outbreaks cannot be easily predicted.
• With a few noteworthy exceptions, there is no cure or established drug treatment for VHFs.

In rare cases, other viral and bacterial infections can cause a hemorrhagic fever; scrub typhus is a good example.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI