Mothers' exposure to toxic linked to autistic-like behaviours in kids

Researchers have found that children of the pre-school age-group, whose mothers were exposed to select toxicants, including metals, pesticides during gestation, are more likely to show autistic-like behaviour.

In this study, published in the American Journal of Epidemiology, the team measured the levels of 25 chemicals in blood and urine samples collected from 1,861 Canadian women during the first trimester of pregnancy.

A follow up survey was conducted with 478 participants, using the Social Responsiveness Scale (SRS) tool for assessing autistic-like behaviours in pre- school children.

The researchers found that higher maternal concentrations of cadmium, lead, and some phthalates in blood or urine samples was associated with increased SRS scores, and these associations were particularly strong among children with a higher degree of autistic-like behaviours.

"The relationships we discovered between these toxicants and SRS scores would not have been detected through the use of a means-based method of statistical analysis (such as linear regression)," said lead author Josh Alampi from Simon Fraser University.

Interestingly, the study also noted that increased maternal concentrations of manganese, trans-Nonachlor, many organophosphate pesticide metabolites, and mono-ethyl phthalate (MEP) were most strongly associated with lower SRS scores.

The researcher note that this study primarily "highlights the relationships between select environmental toxicants and increased SRS scores. Further studies are needed to fully assess the links and impacts of these environmental chemicals on brain development during pregnancy."

https://www.dailypioneer.com/2021/pioneer-health/mothers--exposure-to-toxic-linked-to-autistic-like-behaviours-in-kids.html

Researchers look for drugs to keep HIV dormant

Researchers during a recent study found a way to look for chemicals that can keep the virus

suppressed into its dormant state.

 

The human immunodeficiency virus infects the cells that can either exploit them to start

making more copies of itself or remain dormant, a phenomenon called latency. Researchers

during a recent study found a way to look for chemicals that can keep the virus suppressed

into its dormant state.

 

The findings of the study were published in a new paper, Proceedings of the National

Academy of Sciences. "The current drug treatments block healthy cells from becoming

infected by the virus," said Yiyang Lu, a PhD student in the Dar lab at the University of

Illinois Urbana-Champaign. "The latent reservoir poses a bigger problem because it can start

producing the virus at any time. Consequently, patients have to remain on antiretroviral

therapy all their lives to prevent a viral rebound."

 

So far, there are two types of drug treatment strategies: shock-and-kill, where reactivated

cells are killed due to HIV, and a second drug cocktail prevents other cells from being

infected, or block-and-lock, which forces the virus into a deep latent state so that it does not

reactivate again. The problem with the first approach is that there are always some leftover

reservoirs that do not get activated. The problem with the second approach, which the

researchers are trying to solve, is that there aren't many drugs that have been discovered.

Double mutant variant of Sars-CoV-2 detected in India: What it could mean

Covid antibodies may last from days to years, depending on infection severity

Since the transition from latency occurs randomly, measuring the fluctuations in gene

expression can provide more coverage than the average gene expression. "Commercial drug

screens usually look at mean gene expression. Instead, we used a drug screen that looks at

fluctuations in gene expression. Our screen allowed us to therefore find more compounds that

could have been overlooked," Lu said.

 

"We implemented a time-series drug screening approach that are less commonly used in other

labs," said Roy Dar, an assistant professor of bioengineering at Illinois and faculty member of

the Carl R. Woese Institute for Genomic Biology. The researchers used a T- cell population,

which is a reservoir for HIV, that had been infected by the virus. They imaged the cells in 15-

minute intervals for 48 hours and tested over 1800 compounds. They looked at noise maps to

identify which drugs can modulate gene expression.

 

Using the screen, they were able to find five new latency-promoting chemicals, raising the

possibility that similar screens can be successfully adapted to study other systems that exhibit

variability in gene expression, such as cancer. They are currently working on understanding

how the five novel drugs suppress viral reactivation. "We want to test if these drugs have off target effects in terms of how many other genes they affect in the host cells," Dar said. "We

also want to test these drugs in patient samples to see whether these drugs suppress HIV in

them."

https://www.hindustantimes.com/lifestyle/health/researchers-look-for-drugs-to-keep-hivdormant-

101616570142378.html

Undiagnosed genital tuberculosis seen in over 10 per cent couples seeking IVF: Doctors

According to Dr Amita Shah, genital TB is "mostly found in women when they face issues of infertility and go for treatment".

Expressing concern at the rising cases of genital tuberculosis, a leading cause of infertility in both men and women, doctors warn that as much as “10 per cent of the couples seeking fertility assistance have the disease and are unaware of it”.

 

“Genital tuberculosis is treatable in an early stage but can damage fallopian tubes in women and cause azoospermia (complete absence of sperm in semen) in men if diagnosis or treatment is delayed. The number of couples coming with genital TB have increased by over 10 per cent in the past 5 years. Medicines for tuberculosis can eradicate the bacterial infection but cannot revert the damage it has done, which is why such couples seek fertility services, depending on the seriousness of the impairment,” said Dr Gauri Agarwal, founder-director, Seeds of Innocence.

According to Dr Agarwal, embryo transfer has been the most successful IVF treatment for women who have genital TB while men can undergo minor procedures such as testicular sperm aspiration (TESA), in which sperm cells and tissue are extracted from the testicle using a small needle and the sperm is separated from the tissue to fertilise eggs.

 

Notably, tuberculosis in the reproductive organs is just one of the forms of TB and is caused when the person contracts the mycobacterium tuberculosis bacteria which is then transported by the blood to other organs. In women, genital TB can affect fallopian tubes and uterus, its endometrium lining and cause adhesion of the uterine wall, known as Asherman’s syndrome. In men, it can cause inability to ejaculate, low sperm motility and inability of the pituitary gland to produce sufficient hormones.

According to Dr Amita Shah, medical director and head of obstetrics and gynaecology, Miracles Mediclinic; Apollo Cradle Hospital, Gurugram, genital TB is “mostly found in women when they face issues of infertility and go for treatment”.

 

“Although in most of the cases, it may not cause any symptoms or signs at all but some of the prevalent symptoms are weight loss, fatigue and mild fever, no menstrual bleeding or abnormally heavy bleeding and infrequent menstrual periods. The infection is always hard to diagnose because of the unawareness about the same and it is a silent invader of the genital tract. In some cases, bacteria might damage the reproductive organs. The chances of pregnancy in women suffering from genital tuberculosis are very poor even after completing the full treatment, though IVF can help in conceiving. Genital tuberculosis can be asymptomatic or may present atypical symptoms or even mimic other clinical conditions that make the situation even more challenging. Therefore it is necessary that we consider the possibility of TB in patients who have symptoms of infertility, chronic pelvic pain and menstrual dysfunction. This is very important for those women who fall unto the high risk category for TB infection,” said Dr Shah.

 

According to the Indian Council of Medical Research (ICMR), half of the women in India seeking IVF procedure have been reported to have genital TB and the prevalence has increased by more than 10 per cent between 2011 and 2015.

 

“This is a very alarming statistics as India has about a quarter of the global TB burden and genital TB can be a silent infection. Lack of awareness about the disease and missing symptoms are key hindrances to control this health condition,” she mentioned.

 

So, what can women do?

“Women must watch out for symptoms such as irregular menstrual cycle, swelling in the genital area, vaginal discharge with blood, bleeding or pain after intercourse that may indicate an infection. Adopting safe sexual practices and getting a Bacille Calmette-Guerin (BCG) vaccine can help prevent acquiring an infection in both men and women. Besides, one must ensure well-ventilated rooms, natural light, and good hygiene practices to prevent infection,” added Dr Agarwal.

https://indianexpress.com/article/lifestyle/health/world-tb-day-genital-tuberculosis-symptoms-treatment-ivf-couples-doctors-7242481/

Stroke: A major health challenge

Govt-aided policies and programmes, including PPP, are needed to effectively manage stroke

Stroke is the third leading cause of death in India and the sixth major cause of Disability Adjusted Life Years (DALYs). The incidences of stroke have doubled in the past five decades and roughly 87 per cent of these are ischemic strokes — where a clot disrupts blood supply to a part of the brain — while 13 per cent are haemorrhagic strokes when an artery ruptures to cause a bleed in the brain. With around 17 lakh new stroke cases occurring in India annually, the projected economic loss attributable to it is estimated to be Rs 2.34 lakh crore. That’s over three times the total allocation for the healthcare sector for the Financial Year 2020-21! Yet, the problem is not drawing the attention it needs from the Government even as its prevalence has increased by over 50 per cent from 1990-2019 in India, according to the Global Burden of Diseases Study, 2019.

The number of cases has been on the rise not just in India but across the globe, especially in the developing countries. It is the second leading cause of death and fourth leading cause of disability worldwide, causing functional impairments, with 20 per cent of survivors requiring institutional care even after three months and 15-30 per cent being permanently disabled. Other than the economic loss and disabilities, the high incidence and prevalence of stroke has a massive impact on societal well-being as well. According to conventional treatment protocols, patients need to be treated within a little over four hours from the time of onset. A delay in seeking the right treatment can lead to lifelong disability and may even be fatal in some cases. One of the bigger challenges that exist in our country is accessibility, affordability and availability of the optimal, timely care needed to patients who suffer stroke. These constraints are due to the enormous geographic, economic and social challenges across the length and breadth of the Indian subcontinent. A prompt affirmative action from policymakers is imperative for ensuring corrective measures to overcome these hurdles. Given the resource constraints in terms of infrastructure, transport, awareness besides other limitations, the chances of getting a stroke affected patient to a certified facility in time is difficult. In fact, studies estimate that the average time taken by a patient to reach a hospital is above seven hours in urban areas while in rural areas it is 34 hours. The delay in treatment increases the chances of permanent disability or even the death of a patient. Advanced therapies such as mechanical thrombectomy can play a crucial role in such cases because it has been shown to be effective in some patient upto 24 hours post symptom onset. However, the question remains, when will the Government take cognisance of the available technology and extend support to make it accessible and affordable for all? Currently, the most frequently used treatment available is Intravenous Tissue Plasminogen Activator (IV-tPA) injection which may be helpful if the patient is able to get to the nearest hospital within a little over four hours. Mechanical thrombectomy, on the other hand, can be effective upto 24 hours after symptom onset and in combination with IV-tPA has shown to be upto 60 per cent effective in the long-term.

Paucity of trained healthcare professionals and the lack of awareness is one of the major reasons for mechanical thrombectomy not finding its due place. The Government-aided policies and programmes, including public-private partnerships, may be needed to effectively manage stroke, rehabilitate patients and alleviate the concerns of the patients and their caregivers. Undoubtedly, there is a need to have a comprehensive integrated approach to address this public health crisis.

https://www.dailypioneer.com/2021/columnists/stroke--a-major-health-challenge.html

India’s Premas Biotech, Israel’s Oramed jointly develop oral vaccine for COVID-19

However the findings of the joint venture have not been reported in a scientific publication
yet.
An Indian-Israeli collaboration has reportedly developed an oral vaccine, one that can be
swallowed like a pill instead of being injected as is the norm, for COVID-19. A preliminary
test in animals showed that the vaccine produced the expected antibodies that confer
protection. However the findings have not been reported in a scientific publication yet and
can’t be independently verified.
 
The product is also far from being tested in human trials, though company promoters say
depending on how tests pan out, the vaccine candidate could be ready for human trials in the
next three months.
 
Premas Biotech, a Gurugram-based biotechnology firm and Oramed Pharmaceuticals, a
Jerusalem headquartered company, have a long standing collaboration on developing new
drug delivery techniques.
 
The nascent COVID-19 vaccine candidate is a “protein-based VLP (Virus Like Particle)
vaccine candidate” that generates “triple protection” against the SARS CoV-2 virus, that is, it
is able to target the spike, membrane, and envelope proteins of the coronavirus. These three
proteins are critical to the structure of the coronavirus and give it form as well as the ability to
replicate inside the body. Typically vaccines are supposed to coax the immune systems into
producing antibodies neutralising these antigenic proteins.
 
The challenge with making an oral vaccine is that gastric juices would rapidly degrade any
protective layers enclosing the antigen making them useless. Oravax claims to have solved
that problem but how, is part of their proprietary secret sauce.
 
Oravax, the company developing the vaccine, is a joint venture between Premas and Oramed.
The latter specialises in making oral drug delivery systems and Premas has a technology
platform called D-Crypt that is used to make a variety of “difficult to express” proteins in
sizeable quantities efficiently.
 
“The vaccine candidate is also safe, efficacious and well-tolerated at normal to high doses,
and generated high titres of neutralising antibodies. The VLP is manufactured using Premas’
proprietary D-Crypt™ platform, which is highly scalable and can be manufactured on large
scales,” Oravax said in a statement.
 
Prabuddha Kundu, Co-founder and Managing Director, Premas Biotech, told The Hindu that
an oral vaccine would significantly ease mass administration. “It would be like taking a
vitamin pill and what I can disclose now is that we are more than 100% sure that the
technology works and is promising. In a month we should have a scientific publication
reporting our results.”
 
Oramed and Premas have an oral insulin drug candidate employing similar technologies
underlying the vaccine candidate, and is currently in phase 3 human trials in the United
States.
 
So far India has only two vaccines publicly available for the pandemic though several others,
employing a variety of approaches, are in different stages of clinical trials.
https://www.thehindu.com/sci-tech/health/premas-biotech-oramed-report-early-success-withoral-
covid-19-vaccine/article34125280.ece?homepage=true
 

All you need to know about head injuries

Injuries can be as mild as bumps and bruises, or even a cut on the head, or more traumatic in nature, such as a brain injury in an accident that can lead to fractured skull bones, internal bleeding, and even brain damage, says a doctor.

Head injuries are life-threatening and are one of the common causes of mortality and disability in people. The injuries can occur owing to a fall or an accident when you get hit by any object on the head or while playing a sport.

The injuries can range from mild to severe. So the injuries can be as mild as a bump, bruise, or even a cut on the head. But, one can sustain a traumatic brain injury in an accident that can lead to fractured skull bones, internal bleeding, and even brain damage. Depressed skull fractures, epidural hematoma, and subdural hematoma are other types of serious head injuries that will require your timely attention, said Dr Prashant Borade, head- critical care unit, Global Hospitals, Mumbai.

 

The symptoms

It may vary from person-to-person depending on the severity of the head injury. Those having a mild head injury may exhibit symptoms such as headache, sensitivity to light and sound, dizziness, nausea, vomiting, tiredness, change in sleeping patterns, balancing and vision problems, and cognitive issues. If your injury is moderate to severe, then symptoms that you may represent are slurred speech, unconsciousness, inability in walking, a weakness that may occur in one side of the body, sweating, convulsions, seizures, fluid coming out of the ear, coma, deep cut on the scalp, being in a vegetative state, or even changes in behaviour like irritation.

 

The diagnosis and treatment

Your doctor will take an X-ray, CT scan, or an MRI to determine the injury and the location. Then, depending on your age, the type, and the location of your injury, you will be advised to undergo a treatment suitable for you. This may include hospital admission, surgery, stitches in case of severe injuries and rest, applying ice, and observation if the injury is minimal. Do not delay in seeking treatment if the injury is serious as doing so can even lead to loss of life.

 

Tips to prevent head injuries

*Wear a helmet while travelling by motorbike.
*Make sure your children do not play on playgrounds where the surface is hard and can cause head injuries.
*You should avoid participating in sports if you are tired.
*Avoid cycling or skating on uneven surfaces.
*Replace the protective gear that is damaged.
*If you are at a pool, park, or a beach, you will have to follow the guidelines. You may end up harming yourself if you fail to do so.
*Wear a seat-belt while driving. Do not drive under the influence of alcohol as it can lead to accidents.
*Install bars in the house to reduce the fear of falls. Keep the stairs clean to avoid falls.
*Install grills on the windows to prevent falls.

https://indianexpress.com/article/lifestyle/health/head-injuries-prevention-accidents-symptoms-7237512/

Faster spread of some coronavirus variants could be due to sturdier protein, say scientists

The spike protein of the novel coronavirus, which enables it to infect human cells, is more stable in faster spreading versions of the virus, such as the ones first reported in the UK and South Africa, compared to the original form of the pathogen from Wuhan, China, says a new study.

Researchers, including those from the Boston Children's Hospital in the US assessed the structure of the coronavirus spike protein down to the atomic level, and found how it changed with the D614G mutation which is carried by the Brazil, South Africa and UK variants of the SARS-CoV-2 virus.

The results, published in the journal Science, showed that the mutation makes the spike more stable as compared with the original SARS-CoV-2 virus from Wuhan, enabling the variants to spread more quickly.

According to the scientists, the spike proteins in the original virus would bind to the ACE2 receptor on human cells, and then dramatically change shape, folding in on themselves and enabling the virus to fuse its membrane with host cells.

However, they said the spikes would sometimes prematurely change shape and fall apart before the virus could bind to cells.

While this slowed the virus down, the researchers said this shape change also made it harder for the human immune system to contain the virus.

"Because the original spike protein would dissociate, it was not good enough to induce a strong neutralizing antibody response," said study co-author Bing Chen from the Boston Children's Hospital.

In the variant forms, the scientists said the mutation stabilises the spike by blocking the premature shape change and making the spikes bind more weakly to the ACE2 receptor.

According to the researchers, since these spikes are less apt to fall apart prematurely, the virus overall is rendered more infectious.

"Say the original virus has 100 spikes. Because of the shape instability, you may have just 50 percent of them functional. In the G614 variants, you may have 90 percent that are functional, so even though they don't bind as well, the chances are greater that you will have infection," Chen explained.

Based on the findings, the scientists suggested that redesigned vaccines incorporate the code for this mutant spike protein.

They believe more stable spike shapes could make vaccines based on these virus proteins more likely to elicit protective neutralising antibodies.

https://www.dailypioneer.com/2021/pioneer-health/faster-spread-of-some-coronavirus-variants-could-be-due-to-sturdier-protein--say-scientists.html

Woman gives birth to first known baby with antibodies against coronavirus, doctors say

Pediatricians have reported the first known case of a woman, who was given the first dose of the COVID-19 vaccine during her pregnancy, giving birth to a baby with antibodies against the novel coronavirus.

According to the yet-to-be peer-reviewed study, posted in the preprint server medRxiv, the mother had received a single dose of the Moderna mRNA vaccine at 36 weeks and three days of her gestation period.

Three weeks later, she gave birth to a vigorous, healthy, full-term girl, whose blood sample taken immediately after birth revealed the presence of antibodies against the SARS-CoV-2 virus, the study noted.

"Here, we report the first known case of an infant with SARS-CoV-2 IgG antibodies detectable in cord blood after maternal vaccination," noted the co-authors, Paul Gilbert and Chad Rudnick from Florida Atlantic University in the US.

The woman, who has been breastfeeding the baby exclusively, received the second dose of the vaccine as per the normal 28-day vaccination protocol timeline, the doctors noted.

While earlier studies showed that the passage of antibodies from COVID-recovered mothers to their foetuses via the placenta was lower than expected, the current research suggests "potential for protection and infection risk reduction from SARS-CoV-2 with maternal vaccination."

However, Gilber and Rudnick note that further long-term studies are needed to quantify the antibody response in babies born to vaccinated mothers.

"Protective efficacy in newborns and ideal timing of maternal vaccination remains unknown," the pediatricians wrote in the study.

"We urge other investigators to create pregnancy and breastfeeding registries as well as conduct efficacy and safety studies of the COVID-19 vaccines in pregnant and breastfeeding woman and their offspring," they added.

https://www.dailypioneer.com/2021/pioneer-health/woman-gives-birth-to-first-known-baby-with-antibodies-against-coronavirus--doctors-say.html

Polio lessons for COVID vaccination

Communication drives that reach out to all sections can help ease vaccine hesitancy

India covid vaccinationAnother meta-analysis study by the British Medical Journal found that

only 68.4 per cent of the population is willing to receive the COVID-19 vaccination globally.

That is a low figure considering vaccines can eradicate diseases and save lives.

More than a year ago, the SARS-COV-2 virus sent the world into a bubble. We were caught

by surprise and there was little or no preparation to meet this challenge. Health systems were

ravaged, and countless people lost their lives. In hindsight, this could have been prevented had

we been prepared.

 

A year later, while the virus is still circulating in our communities, we know much more about

it, thanks to one of the biggest health information campaigns in human history. The world is

slowly but gradually bouncing back, and science has given us another chance. Cases are on the

decline. However, sporadic outbreaks have led governments around the world to continue to

enforce fundamental public health measures.

 

At the same time, the focus has shifted to the development of vaccines. The race has fast tracked

efforts. Scientists have developed vaccines in record time and more than 250 vaccine

candidates are in different stages of development globally. India, too, has already approved and

rolled out Covishield and Covaxin for emergency use and many more are on the horizon. And

here is where we have hit a bump, expectedly so. Vaccine hesitancy – notorious words

commonly associated with inoculation drives — has been cited by WHO as one of the top 10

global health challenges.

 

Opinion |People’s confidence is a must for a successful roll out of the Covid-19 vaccine

There is no denying that immunisation is one of the most successful and cost-effective means

to help children grow into healthy adults. But with any large-scale immunisation programme,

hesitation and fear usually follows. A World Economic Forum survey released in November

2020 indicated a growing reluctance among people to receive a vaccine, despite progress made

by numerous pharmaceutical companies and international organisations. Another meta analysis

study by the British Medical Journal found that only 68.4 per cent of the population is

willing to receive the COVID-19 vaccination globally. That is a low figure considering

vaccines can eradicate diseases and save lives. So, what makes it difficult and how can we

tackle this lack of confidence among people?

 

The answers can be found in comparing the immunisation coverage of other diseases. As per

estimates released byWHO and UNICEF on immunisation—nearly one in 10 infants did not

receive any vaccination in 2016. This means that infants missed the first dose of

DTP/Pentavalent vaccine putting them at serious risk of these potentially fatal diseases.

 

Another survey byWHO in 2014 revealed that among the 1 lakh parents (of children who were

not vaccinated) interviewed, 33 per cent had no idea about the vaccination, and another 30 per

cent only knew about the Adverse Events Following Immunisation (AEFI).

Sachin Vaze scandal leaves one lesson: Dump 'encounter specialists'

BJP has turned the heterogeneity of Hindu culture into its strength

The government wants to build highways for growth. It might not work

Given the severity of the pandemic, with 2.5 million deaths reported worldwide, vaccines are

the only effective solution that can be deployed against COVID-19. India’s vaccine rollout has

kicked off to a good start with more than 2.5 crore vaccine doses being administered as of

March 15. However, the country has been witnessing hesitancy from unexpected quarters –

doctors and health-workers. Such a development can have further implications on the vaccine

coverage of the larger population, especially when there are less takers among the ones who

save lives. The apprehension it seems has been attributed to lack of vaccine efficacy data,

questions on safety, quick clinical trials, and reported deaths among the elderly and sick

population.

 

To combat this misinformation, the Indian government has stepped up efforts to quash wrong

claims and has conducted regular press conferences. The Union Minister of Health and Family

Welfare, Harsh Vardhan, has led the initiative. Messages such as “Let us put a STOP to these

falsehoods” and “Truth is powerful and shall prevail” have been disseminated to ensure its

acceptance and uptake in a timely, accurate and transparent fashion. Eminent physicians from

well-known private and public hospitals have also taken vaccine shots to boost public

confidence. Pharmaceutical companies have released factsheets addressing concerns and an

extensive communications campaign is being undertaken on social media platforms to ensure

the right information reaches people. In addition to this, development partners have been roped

in to spread awareness about the COVID-19 vaccines. All vaccines are almost 100 per cent

effective in preventing COVID-related deaths, severe symptoms and complications – that’s the

message the needs to go through.

 

opinion |There are challenges in Covid vaccination drive, but these are not intractable

Much can, in fact, be learnt from the country’s successful Polio eradication and Mission

Indradhanush initiative. In 2002, when Uttar Pradesh alone harboured 65 per cent of global

polio cases and vaccine hesitancy was at its peak, UNICEF’s induction of an army of social

mobilisers in Uttar Pradesh and Bihar states helped mitigate fears.

 

Similarly, while designing Mission Indradhanush in 2014, behaviour change communications

was put at the center stage of immunisation planning. The campaign converted a routine

immunisation into a Jan Andolan – a people’s movement. It mobilised communities to deal

with the barriers to seeking vaccines. This was achieved through a sustained coordination effort

led by the Ministry of Health with 12 different ministries.

 

India is on the right path with the recent decision to open the vaccination drive for the general

public and to speed up private sector participation. While developed countries like United

Kingdom, United States, and France are still struggling with either strict lockdowns or a health

system operating under tremendous pressure, India in contrast, has done well in focusing on

preventive measures such as an early lockdown, that also provided a window to establish robust

health systems to contain the virus and treat those with the disease. The country has seen a drop

in the number of cases – though there has been a rise in some parts of the country in the past

month — and deaths considerably. Therefore, India is in a much better situation to fast track

the vaccination drive to achieve herd immunity and prevent the second wave of infections.

 

As the third phase of vaccination closes in, it is vital that we draw inspiration from past lessons

and move to inoculate our priority population. Behaviour change communications must be

intensified. Mass media (radio, television, billboards, print material, and internet),

interpersonal channels and community mobilisation must be optimised to advertise and achieve

the desired outcomes. There is a need for active involvement of people from all strata of the

society — local community leaders, associations, private sector, celebrities, religious groups,

experts, and political leaders. It will not only keep misinformation at bay but find acceptance

among all. Let people take the lead here. With more evidence pouring in, vaccine hesitancy

among the healthcare providers is bound to evaporate soon.

 

https://indianexpress.com/article/opinion/columns/polio-lessons-covid-vaccination-publichealth-

7232853/

Covid-19 reinfection rare, but more common in 65+: Large Danish study in Lancet

Most people who have had Covid-19 are protected from catching the virus again for at least six months, but elderly patients are more prone to reinfection, according to new research.

Most people who have had Covid-19 are protected from catching it again for at least six months, but elderly patients are more prone to reinfection, according to research published in The Lancet.

SARS-CoV-2, the cause of the Covid-19 epidemic, has resulted in over 117 million cases and over 2.6 million deaths worldwide as of March 7, 2021, as estimated by the World Health Organisation. However, the degree to which infection with SARS-CoV-2 confers protection towards subsequent reinfection is not well described.

In 2020, as part of Denmark’s extensive, free-of-charge PCR-testing strategy, approximately 4 million individuals (69 percent of the population) underwent tests. Using these national PCR-test data from 2020, researchers estimated protection towards repeat infection with SARS-CoV2.

Large-scale assessment of reinfection rates in Denmark in 2020 confirms that only a small proportion of people (0.65%) returned a positive PCR test twice.

However, while prior infection gave those under the age of 65 years around 80 percent protection against reinfection, for people aged 65 and older, it gave only 47 percent protection, indicating that they are more likely to catch Covid-19 again.

The authors of the first large-scale study of its kind detected no evidence that protection against reinfection declined within a six-month follow-up period.

Their findings highlight the importance of measures to protect elderly people during the pandemic, such as enhanced social distancing and prioritisation for vaccines, even for those who have recovered from Covid-19. The analysis also suggests that people who have had the virus should still be vaccinated, as natural protection – particularly among the elderly – cannot be relied upon.

As of January 2021, Covid-19 had resulted in more than 100 million cases and over 2 million deaths worldwide. Recent studies have suggested that reinfections are rare and that immunity can last at least six months, however, the degree to which catching Covid-19 confers protection against repeat infection remains poorly understood.

Dr Steen Ethelberg, from the Statens Serum Institut, Denmark, said, “Our study confirms what a number of others appeared to suggest: reinfection with Covid-19 is rare in younger, healthy people, but the elderly are at greater risk of catching it again. Since older people are also more likely to experience severe disease symptoms, and sadly die, our findings make clear how important it is to implement policies to protect the elderly during the pandemic. Given what is at stake, the results emphasise how important it is that people adhere to measures implemented to keep themselves and others safe, even if they have already had Covid-19. Our insights could also inform policies focused on wider vaccination strategies and the easing of lockdown restrictions.”

https://indianexpress.com/article/explained/covid-19-reinfection-study-lancet-7233466/

Coronavirus | ‘renal patients at high risk from COVID-19

 A rally was organised ahead of World Kidney Day from NU Hospitals in Bengaluru on

Wednesday. special arrangement 

 

When a family of three from Bengaluru, including a 53-year-old renal transplant individual,

contracted COVID-19 in August, the family only prayed that the disease should not create more

complications in the kidney recipient.

 

While two members from the family developed classical COVID-19 symptoms, including high

fever, cough, and loss of taste/smell, the person who had undergone the transplant had very

mild symptoms. Doctors said this was because of his poor immune response due to

immunosuppressants.

 

City-based nephrologists, who have noticed a high incidence of COVID-19 among people with

kidney disease and other severe chronic medical conditions, said although persons with renal

issues and those who have undergone transplant did not exhibit classical symptoms, they were

at a higher risk of more severe illness.

 

To study this aspect, a group of doctors from Manipal Hospitals documented the impact of

COVID-19 on patients with kidney disease, kidney recipients, and those on dialysis in a review

article titled ‘Coronavirus Disease 2019 and the Kidney’. The article, published in the Journal

of Internal Medicine , an official publication of the Association of Physicians of India,

Karnataka chapter, was compiled by Ravi Jangamani, Chakravarthy Thirumal, and Sankaran

Sundar from the Department of Nephrology at Manipal Hospitals in Bengaluru.

 

“Besides our own findings, we have also put together global observations regarding the impact

of the virus on the kidneys of patients,” Dr. Jangamani told The Hindu on Thursday. “Patients

with chronic kidney diseases (CKD) and immune- mediated kidney diseases should be

regarded as at risk to experience a more severe disease mediated kidney diseases should be

regarded as at risk to experience a more severe disease of immunosu- ppression drugs,” he said.

Dr. Sundar, head of international transplant services at the hospital, said that 20% to 40% of

critically ill COVID-19 patients who did not have any renal issues prior to the infection had

developed acute kidney injury.

 

“Those predisposed with renal issues were the worst hit. As most did not exhibit fever or other

classical symptoms, they did not seek timelymedical advice and went for self-medication. This

led to complications at a later stage and we have noticed high mortality in such patients,” he

said.

 

Pointing out that the pandemic had hit those on dialysis the most, Dr. Sundar said, “Dialysis

patients had a high exposure to the virus as they had no other go but to visit hospitals for the

procedure.”

 

Dr. Jangamani said that over 20% of patients who sought dialysis at Manipal Hospitals were

Infected.

 

Dialysis patients who were infected by the virus in the city had a tough time in the initial

months of the pandemic as COVID-dedicated hospitals did not have dialysis facilities.

However, things changed for the better after August when private hospitals set up dedicated

COVID-19 wards.

 

To mark World Kidney Day, Manipal Hospitals provided free vaccination to everyone

undergoing dialysis at all its centres.

https://www.thehindu.com/news/national/karnataka/coronavirus-renal-patients-at-high-riskfrom-

covid-19/article34056718.ece