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Dengue in news again

After India, it’s Pakistan that is now grappling with dengue. As of November 22, a total of 5,235 patients with symptoms similar to dengue fever had been admitted to different hospitals across Pakistan. To date 48 deaths have occurred from dengue fever in Pakistan.

Meanwhile, in India, the Petitions Committee of the Delhi Assembly has held the Municipal Corporation of Delhi and the Delhi Jal Board responsible for the outbreaks of dengue and vector-borne diseases in the capital. The report states that the corporation's failure to effectively de-silt open drainages has worked as breeding grounds for mosquitoes and insects that have given rise to diseases such as dengue, chikangunya and malaria. The government body has not yet reacted to the filed petition.

While Pakistan and India continue to be fraught with dengue worries, some developments in the sphere of dengue vaccine and diagnosis may offer relief in the future. The Pediatric Dengue Vaccine Initiative (PDVI), a program of the International Vaccine Institute (IVI) has decided to work in collaboration with Hawaii Biotech to develop a dengue vaccine for the global prevention of dengue fever. According to Harold Margolis, Director of the PDVI, the primary objective behind this joint venture is to ensure rapid introduction to dengue vaccines into the immunization programs in all affected areas as soon as a vaccine becomes available.

Bio-Rad India, subsidiary of Bio-Rad Laboratories USA, launched India’s first early dengue detection kit called Platelia Dengue NS1 Ag. The common test employed to detect dengue involved identifying the presence antibodies which are produced four to six days after the appearance of the first symptoms. However, this new kit is a time saving device as it checks for virus NS1 antigen which can be traced in the blood stream as soon as the first symptoms of dengue appear.

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Ayurveda expands its horizon

Ayurveda, the ancient Indian method of treatment, is gaining a foothold across the globe. Indian herbs like 'tulsi' (Holy Basil), 'gulab' (Rose), honey, 'zaffran' (Saffron) and 'rajnigandha' (Tuberose) are finding a place in the clinics of cosmetic surgeons at Britain’s Harley Street. The ayurvedic therapies are gaining momentum with people’s acceptance of holistic healing systems and alternative treatments. Similarly, in Australia, the European Union, New Zealand and USA, ayurvedic organic skincare is growing rapidly.

In another development, turmeric, a yellow colored spice, which is also an ayurvedic medicine, has shown promising prospects of preventing rheumatoid arthritis and osteoporosis, according to a recent US study. Janet L Funk, Managing Director at the University of Arizona College of Medicine and Barbara N Timmermann, PhD then-director of the Arizona Center for Phytomedicine Research conducted an experiment by preparing their own extracts of rhizome and comparing them with a turmeric root, essential oils and an oil-depleted extract containing the three major curcuminoids found in the rhizome. The results of the test proved turmeric root contained chemical composition similar to their developed rhizome that possessed capabilities to inhibit the onset of rheumatoid arthritis. The study also suggested turmeric to be beneficial in treating inflammatory disorders such as asthma, multiple sclerosis, inflammatory bowel disease and joint inflammation.

Meanwhile, in a strategic move, the traditional Indian ayurvedic firms are all set to tap the USD 120 billion global herbal market. Initiating this move is Coimbatore-based Arya Vaidya Pharmacy (AVP) that plans to launch a chyawanaprash, a popular health tonic used for boosting energy, immunity and memory, in biscuit form. Following the new trend is another leading ayurvedic treatment center in Kerala, Kottakkal Aryavaidyasala, which is developing a technique to manufacture a capsule containing medicinal powders as a complete health supplement for the modern man.

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Polio worries in India and Kenya but not in SA

In India, polio has become a cause for concern with four new cases being reported in the capital New Delhi. This has raised this year’s polio toll to 416 cases. The rise in cases has led to questions regarding the efficacy of polio vaccines distributed by the government. However, Principal Secretary (Health) D S Negi has insisted that these cases are due to the affected victims having contracted the virus whilst traveling to states like Uttar Pradesh and Bihar. In these states, the lack of public initiative towards the pulse polio vaccination program has let the virus run wild. But New Delhi’s Chief Minister Sheila Dikshit acknowledged the urgency of the issue and that the approach to the polio campaign “needs to be reworked”.

Polio has raised its head in Kenya too for the first time in 22 years. A three-year-old girl living in a refugee camp has been diagnosed as having polio. While health officials admit the possibility of the virus having originated in Somalia, where the girl came from, they are taking steps to prevent it from becoming a major epidemic. Beginning in the first week of November, government, UNICEF and WHO officials will start a large-scale immunization program for children under the age of five.

While India and Kenya are fighting polio, South Africa is celebrating its success in getting rid of polio. The African Region Certificate Commission (ARCC), a sub committee of the Global Certification Commission (GCC) has certified South Africa as polio–free. The last confirmed wild polio case had been in 1989. However, the ARCC urged the government to put in place measures that would help it to respond immediately if a case is reported.

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Dengue becomes an Asian woe

India is struggling with dengue and the disease is fast assuming epidemic proportions. Three weeks after the first death was reported, spread of the mosquito-borne disease continued unchecked with 72 new cases taking the total number of affected people to 1,111 in Delhi and its surrounding areas. Across India, 3,803 people have been affected and 52 have died of the deadly viral fever. In fact, such is the scare of the situation going out of control that a special ward has been created at the All India Institute of Medical Sciences. In an effort to get a grip on the situation, Delhi health services also carried out a review meeting to discuss the situation. The discussion was on the colonies that have been identified as dengue-prone and the measures being taken to control the growth of mosquitoes in the area.

Meanwhile, in neighbouring Nepal, the Ministry of Health and Population (MoHP) will be starting programs to check the spread of dengue. The Epidemiology and Disease Control Division (EDCD) is starting a surveillance system in districts bordering India that have a high risk of catching the disease. In case of detection of the virus, patients would be given rapid diagnostic tests after fever for six days.

And further ahead, in China, an alert has been issued against dengue. South China is currently in its peak season for dengue outbreaks, and large-scale efforts are being made to eradicate mosquitoes by cleaning up the environment. China reported 502 dengue cases in September alone, though no one has died from the disease.

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Polio compounds health worries for India

Dengue and Chikungunya are not the only worrying lines creasing India’s health scene at the moment. Polio, a disease that spreads through faecal contamination, has also been in the news recently.

With 352 cases reported in 2006, India seems to be in the grip of this disease. And what is alarming is that a number of these cases are from areas that were free of the virus. The highest incidence has been reported from the northern state of Uttar Pradesh where there have been 312 cases. Its neighbouring state Bihar is in second position with 20 cases. Meanwhile, southern Indian states have managed to resist the virus as a result of 80 to 90 per cent immunization. In Maharashtra, where two polio cases have been reported, health officials are conducting complete routine immunization among twenty million children less than five years of age. The next round of the Pulse Polio vaccination drive sponsored by the federal government will be carried out in early November. It shall cover 100 million children across the states of Delhi, Bihar, Haryana, Punjab, Bihar, Rajasthan, Gujarat, Maharashtra, Jharkhand, West Bengal, Assam and Tripura.

Meanwhile, UNICEF is implementing a special immunization program in the entire northeastern region of India over a period of five months. Even though no polio case has been reported in the region, UNICEF has found that there is risk in the wake of the polio outbreak in neighbouring Bangladesh. UNICEF shall also work closely with the federal health ministry to carry out a special immunization drive in 11 more mainland states.

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After Chikungunya, it’s the dengue scare in India

These are testing times for the Indian government and its healthcare system. While the country is still grappling with Chikungunya, another mosquito-borne disease, dengue has tightened its grip over Delhi, the country’s capital.

The number of people suffering from dengue in Delhi has surpassed 700 with 30 fresh cases being reported yesterday. So far 17 people in Delhi have died of dengue. The total number of people suffering from Dengue and total deaths due to dengue all over India are 2,900 and 43 respectively. The All India Institute of Medical Sciences (AIIMS) has decided to start a dengue helpline from Friday to educate people about how to arrest the dengue outbreak. Considering the severity of dengue in Delhi, the health ministry is preparing a list of hospitals in Delhi where people with fever and symptoms of dengue get a free diagnostic check-up.

Alarmed by the dengue outbreak, the government has decided to change its mosquito surveillance system to better predict the size and intensity of future outbreaks of vector-borne disease, like dengue and malaria. While the government has maintained a stand that it is not an epidemic but a ‘public health problem’ it has also decided to prepare a contingency plan for dealing with the outbreak.

Dengue and other mosquito-borne diseases continue to be a public health concern in the Asian region. This year four people have already died of dengue in Singapore. While the National Environment Agency (NEA) has reported that the number of dengue cases has reduced by 76 per cent this year, The Straits Times has reported that 2,432 cases were recorded compared to 20,229 during the same period last year.

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Tuberculosis adds to Indian health worries

The spread of tuberculosis is beginning to ring alarm bells across India. In order to gauge the efficacy of its TB control strategy i.e. the Directly Observed Treatment Shortcourse program, which seeks to improve detection of tuberculosis and combat increasing resistance to antibiotics, India will commence a survey of 300,000 children. Per World Health Organization (WHO) statistics India reports about 1.8 million new cases of the disease each year, higher than any other country.

Another fear is that of the spread of extremely drug-resistant TB, which is being frequently encountered in India and whose presence has been known from the time anti-TB drugs were introduced for the treatment of TB. Though nationwide data on drug resistance is not available, a study carried out by the Tuberculosis Research Centre, Chennai and the Bangalore based National Tuberculosis Institute in eight districts found that 12 per cent of patients on an average were resistant to at least one of the drugs used for treating TB.

Meanwhile in positive news, the United States and WHO signed a joint agreement on tuberculosis control in India. The US shall advance USD 4.17 million towards research and state-level implementation of India's national tuberculosis control program to the WHO. The US Ambassador to India, David C Mulford, said, “Our government supports tuberculosis control in India because of the enormous public health impact and economic burden of the disease”. Over 400,000 people die of tuberculosis in India each year, while more than 5,000 develop the disease each day, making the disease one of the leading causes of adult mortality in India. This fresh influx of funds would help in procuring drugs, carrying out research and implementing the TB control program specifically in the northern state of Haryana.

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Drug prices ease in India with new policy

It’s good news for consumers in India; the new pharma policy, which is set for Cabinet approval, will slash drug prices by almost 92 per cent.

From October 02, 2006, the new rule that caps trade margins came into effect. The new rule is expected to ultimately lead to a cut in prices of over 1,000 brands of commonly used medicines. The pharma industry has so far given a list of over 1,000 brands of ‘generic-generic’ and ‘branded generic’ drugs, whose retail and wholesale margins would be capped at 35 per cent and 15 per cent respectively. The industry has a month’s time to implement the cap on trade margins.

Two other notifications also came into effect on the same day. Now it is mandatory that drug labels be printed in English as well as in Hindi (the local language). Also consumers will now have to pay only the Maximum Retail Price (MRP) printed on the label, which will be inclusive of all taxes. Till now, taxes were levied additional to the MRP.

Making drugs affordable to the common man is a part of the government’s Common Minimum Programme. Also de-control and liberalisation led to reduction in prices in various sectors but not in the pharma sector. Trade margins in some areas of the pharma industry were unusually high. As a result, several rounds of negotiations between the industry and the government were held to resolve the issue. The new law is the fruit of these discussions.

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India on ‘Chikungunya’ alert

India and some other islands in the Indian Ocean are suffering from fever and joint pain that is being ascribed to the Chikungunya virus infection. The virus is transmitted to humans by the bite of infected mosquitoes. Symptoms include fever, chills, headache, malaise, muscle pain, joint pain, and rash. Alarmingly, there is no specific therapy or vaccine against Chikungunya.

Meanwhile, the situation is being monitored on a daily basis in Kerala, which is facing a major health risk. Chief Minister V.S. Achuthanandan has said that deaths due to Chikungunya have occurred in the State. The Health Department has taken various preventive as well as emergency measures required to contain the outbreak of Chikungunya, which has been reported from four districts. District Medical Officers have been asked to allot Rs 20,000 each to all health care institutions for purchasing medicines, IV fluids and for adopting mosquito control measures. Also, all four affected districts — Thiruvananthapuram, Alappuzha, Ernakulam and Kozhikode — have been allotted a sum for launching preventive action. Further, a project has been submitted to the Center for reviving the Virology Institute in Alappuzha. Once the institute is functional, Kerala will no longer have to depend on the lab at Pune for virology investigations. Another project has also been submitted to the Center for taking up sustained preventive measures against infectious diseases in the State.

Neighbouring Tamil Nadu is also facing a major outbreak. As many as 2,560 people have been affected by Chikungunya in the Tuticorin district in the recent months, although unofficial figures indicate a much higher number.

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Asian neighbors rev up fight against Hepatitis B

In a major relief to those suffering from Hepatitis B in India, the first homegrown Hepatitis-B Vaccine called Elovac-B has been launched by the Human Biologicals Institute (HBI). With India emerging as a global medical hub—world class health care is available here at an affordable price—this launch is yet another milestone towards cementing the country’s numero uno position in the sphere. The Andhra Pradesh Finance minister, Rosaiah said on the occasion while complimenting HBI that immunity has been made affordable with the launch of Elovac-B. “There’s a need to achieve 100 per cent immunization among children and for that the Government as well NGOs should come forward to eliminate such diseases.” The vaccine, which has been prepared by HBI at a state-of-the-art plant, offers best purity and ensures best protection. The purity of Hepatitis-B surface antigen exceeds the purity specification provided by regulatory authorities.

In neighboring China, the Ministry of Health has begun a yearlong nationwide survey of the Hepatitis B situation. The survey will run till September 2007, and involves collecting blood serum samples, conducting lab tests, filing archives and making reports for future control plans. With about 100 million people suffering from Hepatitis B in China (of these approximately 20 million are chronic patients), the situation is indeed grim. Further, the government has started a two-year program aimed at preventing the spread of Hepatitis B from mother to child in four counties of Shaanxi and Gansu provinces.

The program will be first carried out in rural areas for women of childbearing age. The USD 200,000 program aims to teach nearly 340,000 women of childbearing age and nearly 600 grassroots doctors in pilot counties how to prevent Hepatitis B.

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