Number of people affected by Nipah fever on the rise in Kerala

Health Care, Heart Care Foundation of India, Medicine Comments Off

One must be aware of all aspects of the infection and take measures to avoid contracting the virus

New Delhi, 21st May 2018: The state of Kerala has reported an outbreak of a new viral infection, the death toll due to which has already reached nine. This virus-induced fever is being attributed to the Nipah virus (NiV), which causes high fatality rate and spreads mainly through bats, pigs and other animals. NiV was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998, with pigs as the intermediate hosts.

NiV infection is a newly-emerging zoonosis (a disease which can be transmitted to humans from animals) that causes severe disease in both animals and humans. The natural host of the virus are fruit bats of the Pteropodidae Family, Pteropus genus.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “With the outbreak of this disease, we have yet another war to fight. The NiV jump the species barrier and infect a secondary animal host. Apart from avoiding direct contact with infected animals, it is also imperative to not consume fruits that have fallen on to the ground. What makes the situation tougher is that there is no vaccine or medicine for the disease. The only form of treatment is supportive medicines and palliative care. When the infection occurs in humans, it has a range of clinical presentations, from asymptomatic infection to acute respiratory syndrome and fatal encephalitis.”

The incubation period for the virus ranges from 5 to 14 days after which the symptoms start becoming visible. The common symptoms include fever, head ache, fainting and nausea. In some cases, a person may experience choking, stomach pain, vomiting, fatigue and blurred vision.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “Once the symptoms begin, there is an increased likelihood of the person going into a coma just two days after. There are also high chances of contracting encephalitis that affects the brain. The first line of defence is to avoid exposure and quarantining those who have already contracted the virus.”

Some preventive measures from HCFI.

Ensure that the food you eat is not contaminated by bats or their feces. Avoid consuming fruits bitten by bats.
Avoid drinking toddy that is brewed in open containers near palm trees.
Prevent contact with anyone who has contracted the disease. Sanitize and wash your hands thoroughly of you happen to visit someone with NiV.
Clothes, utensils and items typically used in the toilet or bathroom, like buckets and mugs, should be cleaned separately and maintained hygienically.
It is important to cover the face while transporting the dead body of anyone who dies after contracting Nipah fever. Refrain from hugging or kissing the dead person and take precautions while bathing the body before cremation or burial.

Notification of adverse drug reactions should be made mandatory

Health Care Comments Off

Adverse drug reaction (ADR) reporting or pharmacovigilance is an integral part of quality patient care as ADRs not only impair quality of life for the patient, they also increase treatment costs as they increase the likelihood of hospitalization. At times, they may be potentially life-threatening. The World Health Organisation (WHO) has defined pharmacovigilance as “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems”.

A database of ADRs will help the clinician to identify any clinical event occurring as a result of a drug being administered and manage it in time. This was the very objective of the Pharmacovigilance Programme of India (PvPI) i.e. to generate data about ADRs across the country by promoting ADR reporting. PvPI is run by the Indian Pharmacopoeia Commission (IPC) as its National Coordination Centre (NCC) under the aegis of the Health Ministry.

Like all programs, several challenges undermine its effectiveness. Under reporting is one such challenge.

PvPI encourages reporting of all types of suspected adverse reactions with all pharmaceutical products irrespective of whether they are known or unknown, serious or non-serious and frequent or rare.

ADRs should be reported without delay as a contribution to the safety profile of a drug, which is still evolving. If this information is given to the competent authorities, hitherto unknown risks can be identified and tackled.

At IJCP, we receive several case reports describing adverse effects of drugs, which are not mentioned in the PvPI database. In view of this, we propose that no case report linked to a drug side effect should be published or presented in a conference unless it is notified in PvPI. We have adopted this as part of our publishing policy.

The Heart Care Foundation of India (HCFI) has also written to IPC in this regard with the suggestion that notification of ADRs to PvPi should be made mandatory before a case report is published in any journal or is presented at a conference or any clinical meeting.

This will help in strengthening the PvPI program.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA