PGI study flags rise in chest infections due to lesser-known bacterium in north India

Pertussis, commonly known as whooping cough, is a highly contagious respiratory illness that has historically been a major cause of childhood mortality

A team at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, has reported a significant rise in infections caused by a lesser-known bacterium that mimics whooping cough in north India, officials said on Thursday.

Pertussis, commonly known as whooping cough, is a highly contagious respiratory illness that has historically been a major cause of childhood mortality, with fatality rates reaching 10 per cent in the early 20th century, a PGIMER statement noted.

The study, titled 'Emergence of Bordetella holmesii–Associated Pertussis-Like Illness, Northern India, 2019–2023', was published in the Emerging Infectious Diseases journal (of the Centers for Disease Control and Prevention, USA) and analysed 935 suspected pertussis cases.

Researchers discovered that nearly 37 per cent of infections were caused by Bordetella holmesii (bacterium), surpassing the number of infections from Bordetella pertussis, which used to be relatively more common.

The most significant increase was recorded in 2023, predominantly among children aged 5-10 years in northern India, the statement said.

According to the data obtained under the ongoing surveillance programme at the PGIMER since 2015, the prevalence of B pertussis declined from 15-20 per cent to just 2-5 per cent, while infections from B holmesii rose markedly.

This shift signals an evolving pattern in the etiology of pertussis-like respiratory illness in the region, the statement said.

This long-term research was spearheaded by Dr Vikas Gautam's laboratory at PGIMER, in collaboration with Dr Prabhu Patil of the CSIR-IMTECH, Chandigarh, it said.

In Asia, pertussis continues to pose a significant public health burden, particularly in India and China, primarily affecting young infants and children, the PGIMER statement noted.

After a brief decline during the COVID-19 pandemic, the number of cases has sharply rebounded. India recently reported approximately 13.6 million cases, while China's incidence rose from 0.13 per 1,00,000 in 2013 to 2.15 per 1,00,000 in 2019, exceeding 58,990 reported cases by early 2024, it said.

The PGIMER team's findings underscore the institute's pivotal role in identifying emerging pathogens and follow the scientific team's earlier identification of stenotrophomonas sepilia, a new bacterium responsible for sepsis, it added.

https://www.tribuneindia.com/news/health/pgi-study-flags-rise-in-chest-infections-due-to-lesser-known-bacterium-in-north-india/

Chest X-rays inadequate to detect asymptomatic TB among household contacts: The Lancet

Lancet study reveals chest X-rays miss 40% of asymptomatic TB cases, with 82% of infected household contacts showing no symptoms, challenging current screening methods.

TB Detection Crisis: Why Chest X-Rays Miss 40% of Silent Infections

Study screened 979 household contacts in South African communities using universal testing

5.2% of contacts had pulmonary TB with 82.4% showing no symptoms

Chest X-rays detected only 56.1% of asymptomatic tuberculosis cases

Combined symptom and X-ray screening reached just 64% sensitivity, below WHO standards

Commonly used chest X-rays, based on symptoms, are inadequate to detect asymptomatic tuberculosis (TB) infection among household contacts, according to a study published in the journal The Lancet Global Health.

"More than 80 per cent of confirmed people with tuberculosis among household contacts were asymptomatic; chest radiograph screening missed more than 40 per cent of these - Dr Simon C Mendelsohn"

Researchers from the University of Cape Town, South Africa, conducted systematic screening with universal sputum microbiological testing of 979 household contacts of people with pulmonary tuberculosis in three South African communities.

They compared tuberculosis symptom (any duration) and chest radiograph (any abnormality indicative of active tuberculosis) screening approaches against a microbiological reference standard.

The team confirmed pulmonary tuberculosis in 5·2 per cent of household contacts, and 82·4 per cent of these reported no symptoms. Alarmingly, the chest radiographs were not able to detect 40 per cent of the cases.

"More than 80 per cent of confirmed people with tuberculosis among household contacts were asymptomatic; chest radiograph screening missed more than 40 per cent of these," said corresponding author Dr Simon C Mendelsohn, South African Tuberculosis Vaccine Initiative, at the varsity.

"Community prevalence surveys reliant on symptom-based and chest radiograph-based approaches might substantially underestimate the prevalence of asymptomatic tuberculosis in endemic countries," he added.

According to the World Health Organization (WHO), approximately 2·7 million (25 per cent) of the estimated 10·8 million people with tuberculosis worldwide went undiagnosed or untreated in 2023.

While finding and treating these so-called missing millions is crucial, the challenge is that a majority of these remain asymptomatic.

"More than half of all tuberculosis found in community prevalence surveys has been classified as asymptomatic, occurring in people who do not have, recognise, or report typical tuberculosis symptoms such as cough, fever, night sweats, and loss of weight," the team said in the paper.

In the study, asymptomatic tuberculosis in household contacts had low bacterial load, and were also associated with low serum C-reactive protein concentrations that were indistinguishable from those of healthy controls. However, these were distinct from symptomatic tuberculosis in a comparator group of clinic attendees.

Sensitivity of chest radiograph screening for asymptomatic tuberculosis was only 56·1 per cent; sensitivity of combined symptom and chest radiograph screening for all tuberculosis was marginally higher at 64·0 per cent.

"Our findings from household contacts suggest that symptom-based and chest radiograph-based approaches are inadequate for community tuberculosis screening and do not meet the WHO target product profile for a tuberculosis screening test (minimum 90 per cent sensitivity, 70 per cent specificity). National tuberculosis prevalence surveys that omit universal sputum microbiological testing might substantially underestimate the prevalence of asymptomatic tuberculosis in high-burden countries," Mendelsohn said.

Chest X-Rays Inadequate for Asymptomatic TB Detection Study

A groundbreaking study in The Lancet reveals that traditional chest X-rays are failing to detect a significant portion of tuberculosis cases. Researchers found that over 80% of infected household contacts showed no symptoms at all. Even more alarming, standard X-ray screening missed 40% of these asymptomatic infections. This suggests current screening methods are substantially underestimating TB prevalence in high-burden countries.

https://www.newkerala.com/news/o/chest-x-rays-inadequate-detect-asymptomatic-tb-among-household-contacts-520

Stem cell therapy may help reduce heart failure after a heart attac

New study shows stem cell infusion within days of heart attack significantly lowers heart failure risk and improves heart function over three years.

Heart Attack Breakthrough: How Stem Cell Therapy Prevents Heart Failure

Stem cell therapy reduced heart failure rates by over 50% compared to standard care

Treatment involved injecting stem cells directly into coronary arteries within 3-7 days

Patients showed significant improvement in heart function within six months

Study followed 396 first-time heart attack patients across three Iranian hospitals

Patients with weak heart function who receive stem cell therapy shortly after a heart attack are less likely to suffer heart failure, according to a study.

"The results suggest that this technique may serve as a valuable adjunctive procedure after myocardial infarction - International Research Team"

Heart failure can occur after a heart attack when the heart muscle is extensively damaged, weakening its ability to pump blood effectively.

This can be a sudden complication (acute heart failure) or a long-term one. Symptoms include trouble breathing, fatigue, swelling in the legs, and an irregular heartbeat.

The clinical trial, published by the BMJ, suggests stem cell therapy may be a valuable add-on procedure for this particular group of patients after a heart attack to prevent subsequent heart failure and reduce the risk of future adverse events.

An international team of researchers, including those from Queen Mary University of London in the UK, set out to assess the impact of delivering stem cells directly into coronary arteries (known as intracoronary infusion) after a heart attack on the development of heart failure over three years.

“The results suggest that this technique may serve as a valuable adjunctive procedure after myocardial infarction to prevent the development of heart failure and reduce the risk of future adverse events," the team said.

The trial included 396 patients (average age 57-59 years) with no previous heart conditions at three teaching hospitals in Iran. They had all experienced a first heart attack (myocardial infarction).

Of these, 136 patients in the intervention group received an intracoronary infusion of allogenic Wharton's jelly-derived mesenchymal stem cells within 3-7 days of their heart attack in addition to standard care.

The remaining 260 control group patients received standard care alone.

Compared with the control group, intracoronary infusion of stem cells was associated with reduced rates of heart failure (2.77 vs. 6.48 per 100 person years), readmission to hospital for heart failure (0.92 vs. 4.20 per 100 person years), and a combined measure of cardiovascular death and readmission for heart attack or heart failure (2.8 vs. 7.16 per 100 person years).

The intervention did not have a statistically significant effect on readmission to the hospital for heart attack or death from cardiovascular disease.

However, by six months, heart function in the intervention group showed a significantly greater improvement compared with the control group, said the researcher, while also urging the need for additional trials confirming the finding.

Stem Cell Therapy Reduces Heart Failure After Heart Attacks

A groundbreaking study reveals that stem cell therapy could be a game-changer for heart attack patients. When administered shortly after a heart attack, this treatment significantly reduces the risk of developing heart failure. Patients receiving stem cells showed dramatically lower hospitalization rates for heart complications. This research offers new hope for preventing long-term heart damage and improving recovery outcomes.

https://www.newkerala.com/news/o/stem-cell-therapy-help-reduce-heart-failure-heart-attack-348