adminMorning Health Talk :
May 21st, 2018 :
New Disease: Nipah Virus Encephalitis
The cause of death of two people, ostensibly suffering from fever, in Kozhikode has been confirmed to be due to the Nipah virus (NiV), spread by fruit bats and which caused severe disease in both animals and humans. The virus has been confirmed by the National Institute of Virology, Pune.
Transmission of Nipah virus takes place through direct contact with infected bats or from other NiV-infected people and people have been also cautioned that they should not consume fruits that have fallen to the ground.
Nipah virus caused an outbreak in pigs and humans in Malaysia and Singapore between 1998 and 1999, and has caused recurrent human outbreaks in Bangladesh and West Bengal, India since 2001.
Nipah virus was initially discovered when it caused an outbreak of viral encephalitis among pig farmers in Malaysia. The virus was named after a village in Malaysia, where the infected patient lived. Since then, there have been several outbreaks of acute Nipah encephalitis in various districts in Bangladesh, in the neighboring district of Siliguri in India, and in the Southern Philippines
The natural host is believed to be fruit bats of the Pteropus species, four of which have been demonstrated to have serologic evidence of infection with this virus. The virus has also been isolated from fetal tissue and uterine fluids of these bats
Nipah and Hendra viruses are two related zoonotic pathogens that have emerged in the Asia-Pacific region. Both are RNA viruses that belong to the Paramyxoviridae family.
The viruses jump the species barrier and infect a secondary animal host (eg, pigs or horses), and transmit infections to humans. In addition, the Nipah virus may be able to spread from human to human.
Nipah virus primarily causes an encephalitic syndrome with a high mortality rate. The characteristic MRI abnormalities are multiple, small (less than 5 mm), asymmetric focal lesions in the subcortical and deep white matter without surrounding edema.
The incubation period ranges from 7 to 40 days. The initial presentation is non-specific, characterized by the sudden onset of fever, headache, myalgia, nausea and vomiting. Meningismus is seen in approximately one-third of patients although marked nuchal rigidity and photophobia are uncommon. Patients infected with Hendra virus have presented with fever and influenza like illnesses, or with meningoencephalitis.
The diagnosis of Nipah virus can be established using an enzyme-linked immunoassay (ELISA). Supportive care is the mainstay of treatment and infected patients may require intensive care monitoring.
In the Malaysian outbreak, anti-thrombotic agents, aspirin and pentoxyfylline, were administered in some patients based upon the recognition that arterial thrombosis may play an important role in the CNS disease.
Ribavirin, a nucleoside analogue, was also given empirically as it has a broad spectrum of activity against RNA and DNA viruses. In the Malaysian outbreak, 140 treated patients were compared to 54 control patients who did not receive ribavirin. Fewer treated patients died (32 percent versus 54 percent) . However, treated patients were identified later in the outbreak so it is possible that they were given better general medical care compared to untreated patients seen earlier. Subsequent animal models found that ribavirin, as well as chloroquine, were ineffective.
Public Health
- World health leaders met on Friday to discuss the Ebola outbreak in the Democratic Republic of the Congo (DRC) and concluded that for the time being, while the outbreak is serious, it is not a public health emergency of international concern.
- A team of researchers at Baylor College of Medicine has taken a closer look at the effect of mosquito saliva alone and found that it can trigger an unexpected variety of immune responses in an animal model ( ‘humanized mice’) of the human immune system. These results offer an opportunity to develop effective strategies to prevent mosquito-based transmission of disease. The study appears in the journal PLOS Neglected Tropical Diseases.
- Tavishi Perara is the first Indian ‘child without a father’s name’ thanks to Madras high court’s direction to authorities to keep the column blank.
- On March 2, 2015, in response to questions in the Rajya Sabha, ICMR gave a list of 15 papers from ICMR-funded projects. These projects claimed that they found evidence for adverse biological effects.
- A paper in Current Science (December 27, 2017) claimed that mobile phone radiation induced sedation in cockroaches and caused changes in enzyme systems, protein content, total free amino acids. (The Hindu)
DENGwar
- The dengue virus is spread by the Aedes aegypti mosquito that can breed in fresh water collected at construction sites or in overhead tanks during the dry season apart from stagnant water in monsoon.
Once a week, impose fines on individuals and institutions who dump open containers on their premises making it a breeding ground for Aedes aegypti, another team to conduct fogging and spray bleaching powder and the third team to conduct awareness campaigns against the vector-borne disease.
Legal
- Irish News: The chairman of the Dáil’s Public Accounts Committee (PAC) has called for “traumatic” and “major” medical negligence claims to be dealt with through mediation in the wake of the cervical screening scandal.
- An application has been submitted to the Registrar Pakistan Medical & Dental Council (PMDC) by the family of a serving Supreme Court judge detailing how the daughter of an SC Justice -a young medical student- became permanently disabled owing to criminal professional negligence of “senior” doctors and staff of Islamabad’s most well-known private hospital. (thenews)
Clinical
- Common bugs that can be transmitted during intercourse or oral sex could end up in the placenta and increase a woman’s risk of going into labour before 37 weeks. (Applied and Environmental Microbiology)
Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI
HealthySoch
