Monsoon fever can be deceptive and dangerous

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

Any medication should be taken only in consultation with a specialist

New Delhi, 30 July 2018: The number of those with fever and other associated conditions increases during monsoons in India, indicate statistics. However, in this season, any episode of fever should not be taken lightly as there may be many diseases responsible, the commonest being viral, malaria, dengue, or Chikungunya. Awareness need to be created on identifying the warning signals and getting expert help at the earliest to avoid comorbidities.

With the monsoon, varsharitu starts in India. In Ayurveda, it is the time for aggravation of Vata or the movement functions in the body. While this is a time to rejoice, it is also imperative to take certain precautions, especially in children, failing which they can become susceptible to a host of diseases and infections.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “While one should not ignore persistent fever during monsoons, it is also important to not indulge in self-diagnosis. Fever can be an indication of various conditions and monsoon fever, in particular, can be deceptive. Viral fever is associated with cough, redness of the eyes or nasal discharge. Dengue is accompanied by fever with rash and pain in eye movement. Chikungunya is a triad of fever, rash, and joint pain. Typically, the joint pain increases on compression of the joint. Malarial fever comes with chills and rigors and will have a normal phase in between two episodes of fever. Fever in jaundice disappears after the onset of the condition. Lastly, typhoid fever is often continuous with a relatively low pulse rate and with toxic feeling.”

Many of the diseases in this season occur due to water stagnation and resultant breeding of mosquitoes. Contamination of drinking water is also common. It is important to drink clean and pure water to prevent diarrhea and gastrointestinal infections.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “There is no need to consume antibiotics unless there is a feeling of toxemia. Antibiotics in cases of sore throat are only required if associated with pain in the throat while swallowing food or red angry–looking tonsils. Except for paracetamol or nimesulide, other anti-fever medicines should not be used indiscriminately as they can reduce a person’s platelet count. Most diseases in this season are self-limiting and can take 4 to 7 days to resolve. The basic precaution involves proper hydration, especially on the days when fever is subsiding.”

Some tips from HCFI

  • Eat light food as the GI system of the body cannot digest heavy food.
  • Do not eat leafy vegetables without washing or boiling as they may be contaminated with eggs of round worms. Beware of eating snacks at some outside stall.
  • Beware of electrical deaths in this season as the coolers without earthing can leak electricity.
  • Do not walk barefooted as most worms can come out and cause the infection. Do not keep wet clothes and leather without proper drying them as they may attract fungus.
  • With each shower of rain, the BP may fluctuate so medications must be revisited.
  • Do not play in stagnant water as rat urine mixed with rain water may produce lactosyrosis (fever with jaundice)
  • Do not let water accumulate in the house or surrounding areas. Drink only boiled or safe water as there are more chances of diarrhea, jaundice, and typhoid in this season.

Malaria may become treatable with the approval of tafenoquine

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

Treatment is the second step; the first is prevention from the disease and stopping transmission

New Delhi, 24th July 2018: The USFDA has given its approval for a new drug called Krintafel (tafenoquine) to treat P. vivax malaria relapse, which accounts for 34% of the estimated 13 million cases in India.

The drug has been developed by a not-for-profit research and industry partnership and is the first new treatment for the disease in more than 60 years. It is most likely to get fast-tracked approvals for use globally. It is a single-dose, ‘radical cure’ treatment (when given with chloroquine) for ages 16 years and older that kills dormant infection in the liver to prevent relapse.

India had an estimated 1.31 million malaria cases and 23,990 deaths in India, where more than half of the population (698 million) is at risk of infection, according to the World Malaria Report 2017 by WHO. India accounted for 6% of all malaria cases in the world, 6% of the deaths, and 51% of the global P. vivax cases.

Speaking about this, Padma Shri Awardee Dr KK Aggarwal, President, HCFI, said, “Availability of this drug in India has the possibility to make a huge difference to the treatment of malaria as P. vivax is sensitive to treatment. For India to achieve the target of eliminating malaria by 2030, it is mandatory that the transmission of P. vivax is curbed. India still has an extremely weak malaria surveillance system. Each case of malaria has been shown to cost households at least US $2.67 (range US $0.34–7.66) in direct out-of-pocket expenses. In adults, this leads to an average of 3.4 days (range 2–6 days) of lost productivity, at a minimum additional indirect cost of US $10.85. Despite efforts at various levels, this disease still remains an acute public health challenge.”

The ‘T3’ initiative of the WHO Global Malaria Program supports malaria-endemic countries in their efforts to achieve universal coverage with diagnostic testing and anti malarial treatment, as well as in strengthening their malaria surveillance systems T3 stands for Test, Treat, and Track.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Malaria is entirely a preventable disease. It is also a treatable disease provided it is diagnosed and treated in time. The symptoms of malaria are non-specific and can be variable. Thus, it may be mistaken for other diseases such as viral infections, typhoid and the diagnosis of malaria may be missed as a result.”

Tafenoquine is a long-acting 8-aminoquinoline that, like primaquine, targets P. vivax hypnozoites. A phase IIb trial of adults in Asia and South America found that a single dose of tafenoquine in conjunction with chloroquine may be more effective at preventing P. vivax relapse than a 14-day course of primaquine with chloroquine. As with primaquine, tafenoquine can induce hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Some tips from HCFI.

  • Do not let water stagnate in your house and the surrounding areas. If any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
  • Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
  • Mosquitoes that do not produce a sound do not cause diseases.
  • Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day.

India must take urgent, proactive measures to banish malaria

Health Care, Heart Care Foundation of India Comments Off

Large-scale detection and awareness are the need of the hour

New Delhi, 26th April 2018: India has the fourth highest number of malaria cases and deaths in the world as per recent reports. Malaria exists in all Indian states and about 95% of the people are at risk. Most cases are reported from Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Arunachal Pradesh, Meghalaya, Mizoram and Tripura also have high transmission. There is an urgent need to document cases and take integrated action at the earliest.

India has set a target of being malaria-free by 2027 and eliminating the disease by 2030.However, there are many challenges before this can be achieved. What is needed is large-scale detection of cases and major awareness campaigns.

Speaking about this, Padma Shri Dr K K Aggarwal, President, Heart Care Foundation of India (HCFI), said, “Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite. It is transmitted to humans through the bite of the Anopheles mosquito. Once an infected mosquito bites a human, the parasites multiply in the host’s liver before infecting and destroying red blood cells. India still has an extremely weak malaria surveillance system. Each case of malaria has been shown to cost households at least US$ 2.67 (range US$ 0.34–7.66) in direct out-of-pocket expenses. In adults, this leads to an average of 3.4 days (range 2–6 days) of lost productivity, at a minimum additional indirect cost of US$ 10.85.Despite efforts at various levels, this disease still remains an acute public health challenge.”

Symptoms of severe malaria include the following: fever and chills; impaired consciousness, prostration, or adopting a prone position; multiple convulsions; deep breathing and respiratory distress; abnormal bleeding and signs of anemia; and clinical jaundice and evidence of vital organ dysfunction.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “India has been central to the fight against malaria since the beginning of the battle. The breakthrough discovery that malaria is transmitted by mosquitoes was made 120 years ago in Secunderabad, India. Since then, half of the world’s countries have banished malaria. It is high time that India takes urgent action to do the same.”

Some tips from HCFI for prevention.

  • Malaria mosquitoes grow in fresh water collected in the house. It is therefore important to not let water stagnate in your house and the surrounding areas. Mosquito cycle takes 7-12 days to complete. So, if any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
  • Mosquitoes can lay eggs in money plant pots or in water tanks on the terrace if they are not properly covered. If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them.
  • Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
  • Malaria mosquitoes do not make a sound. Therefore, mosquitoes that do not produce a sound do not cause diseases.
  • Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day.

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