31-May-2022: Update on Monkeypox
In view of the increasing reports of Monkeypox (MPX) cases in non-endemic countries, as part of a proactive and risk-based approach for management of Monkeypox and to ensure advance preparedness across the country, Union Ministry of Health and Family Welfare has issued ‘Guidelines on Management of Monkeypox Disease’, today. These are available on MoHFW’s website, https://main.mohfw.gov.in/sites/default/files/Guidelines%20for%20Management%20of%20Monkeypox%20Disease.pdf
There are no reported cases of monkey pox disease in India, as on date.
As per the Guidelines, a confirmed case is laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction (PCR) and/or sequencing. All the clinical specimens should be transported to the Apex Laboratory of ICMR-NIV (Pune) routed through the Integrated Disease Surveillance Programme (IDSP) network of the respective district/state.
The Guidelines on Management of Monkeypox Disease include epidemiology of the disease (including host, incubation period, period of communicability and mode of transmission; contact and case definitions; clinical features and its complication, diagnosis, case management, risk communication, guidance on Infection Prevention and Control (IPC) including use of personal protective equipment.
The guidelines stresses on surveillance and rapid identification of new cases as the key public health measures for outbreak containment, mandating need to reduce the risk of human-to-human transmission. It explains the Infection Prevention and Control (IPC) measures, IPC at home, patient isolation and ambulance transfer strategies, additional precautions that needs to be taken care of and duration of isolation procedures.
As per the Guidelines, contacts should be monitored at least daily for the onset of signs/symptoms for a period of 21 days (as per case definition) from the last contact with a patient or their contaminated materials during the infectious period.
Raising awareness of risk factors under risk communication and preventive measures, the Guidelines further explain in detail about raising awareness and educating people about the measures for Monkeypox virus like avoiding contact with any material of the sick person, isolation of infected patient from others, practicing good hand hygiene and using appropriate personal protective equipment (PPE) when caring for patients.
Monkeypox has been reported as endemic in several other central and western African countries such as: Cameroon, Central African Republic, Cote d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. However, cases have been also reported in certain non-endemic countries e.g. USA, United Kingdom, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Israel, Switzerland etc.
Union Ministry of Health & Family Welfare continues to maintain a close watch over the evolving situation.
10-May-2019: Singapore reports first case of rare monkeypox virus
Monkeypox, a virus similar to the human smallpox which was eradicated in 1980, does not spread easily from person to person, but can in rare cases be fatal.
Singapore has reported its first case of the rare monkeypox virus brought in by a Nigerian man who authorities said may have been infected by bushmeat he ate at a wedding. Bushmeat, which can be chimpanzee, gorilla, antelope, birds or rodent, is a staple of some African diets.
Human monkeypox infections have only been documented three times outside of Africa, in the United States, the United Kingdom and Israel, according to the U.S.-based Centers for Disease Control and Prevention.
Singapore's Ministry of Health (MOH) said in a statement that the infected patient was a 38-year-old Nigerian who arrived in Singapore in late April. While risk of spread is low, MOH is taking precautions.
Monkeypox typically lasts for two to four weeks, starting as a fever and headache and progressing through to small bumps called pustules that spread over the body.
Sporadic human cases of monkeypox have been reported in west and central Africa since the 1970s, and in 2003, the first cases outside of Africa were reported in the United States. Last September, Britain reported its first cases all linked to travel in Nigeria.
25-Mar-2022: Government Steps to Curb Type-1 Diabetes
For maintaining Diabetes record, there is a registry maintained by the Indian Council of Medical Research called as the Young Diabetes Registry (YDR) since year 2006. The YDR registry recruits patients with young onset diabetes, diagnosed on or before 25 years of age. The registry operates at 205 centres from 10 cities across India. According to the YDR registry data out of 20351 young diabetes patients recruited, 13368 (65.6%) were type 1 diabetes. According to the 10th International Diabetes Federation Atlas 2021, the number of children with type 1 diabetes in India is 22,94,000 in the age group of 0 - 19 years.
A sub study from the ICMR-YDR registry also estimated the annual incidence of type 1 diabetes from the cities of Delhi and Chennai. According to this study, the average annual incidence of type 1 diabetes (below 20 years) is 4.9 cases/1,00,000 populations.
Even though Health being a state subject, the Department of Health & Family Welfare provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM), based on the proposals received from the States/UTs. Diabetes is an integral part of the NPCDCS. Under the program, all age-groups, including children, are covered.
Under Free Drugs Service Initiative of NHM, financial support is provided to States/UTs for provision of free essential medicines including insulin for poor and needy people including children. Furthermore, quality generic medicines including insulin are made available at affordable prices to all, under ‘Jan Aushadhi Scheme’, in collaboration with the State Governments.
Government Hospitals provide free of cost treatment. The treatment for in-patient care is also available under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PMJAY) for 10.74 crore families eligible under AB-PMJAY as per Socio Economic Caste Census (SECC) database 2011.
4-Jul-2020: Genetics could help diagnose type-1 diabetes in Indians
Researchers at the KEM Hospital and Research Centre, Pune; CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad; and the University of Exeter in the UK have found that a genetic risk score is effective in diagnosing type-1 diabetes in Indians. The outcome of their research has been published in Scientific Reports.
Now, what is this genetic risk score? Developed by the University of Exeter, the genetic risk score takes into account detailed genetic information that are known to increase the chance of developing type-1 diabetes. The score may be used at the time of diabetes diagnosis to help decide if someone has type-1 diabetes.
Will the European genetic risk score be effective in diagnosing type-1 diabetes in Indians? This was the question that naturally arises as the bulk of the research in this field has been conducted in European populations. To answer this question, the research team studied people with diabetes from Pune, India, using the genetic risk score. The team analysed 262 people with type-1 diabetes, 352 people with type-2 diabetes, and 334 people without diabetes. All were of Indian (Indo-European) ancestry. The research outcomes compared well with those in Europeans as revealed in the Wellcome Trust Case Control Consortium Study.
It is widely believed that only children and adolescents get type-1 diabetes and obese and older (typically after 45 years of age) get type-2 diabetes. However, recent findings have shown that type-1 diabetes can occur later in life, while type-2 diabetes is on the rise among younger and thinner Indians. Distinguishing the two types of diabetes, has therefore, become more complex. The two types follow different treatment regime with type-1 diabetes needing lifelong insulin injections but type-2 diabetes often being managed with diet or tablet treatment. Misclassification of the type of diabetes may lead to sub-standard diabetes care and possible complications. In this context, this particular study gains importance as it helps in diagnosing diabetes from its type-1 and type 2 variants correctly.
Although based on European data, the researchers found that the test is effective in diagnosing the right type of diabetes in Indians, even in its current form. They have also found genetic differences between the populations, indicating that the test could be further improved to enhance outcomes for Indian populations.
“Diagnosing the right diabetes type is an increasingly difficult challenge for clinicians, as we now know that type 1 diabetes can occur at any age. This task is even harder in India, as more cases of type 2 diabetes occur in people with low BMI. We now know that our genetic risk score is an effective tool for Indians, and can help get people on the treatment they need to avoid life-threatening complications such as diabetic ketoacidosis and to achieve the best health outcomes”, said Dr Richard Oram, of the University of Exeter Medical School.
Dr Chittaranjan Yajnik of the KEM Hospital and Research Centre, Pune agrees with Dr Oram. He said that the escalating epidemic of diabetes in young Indians makes it imperative that we diagnose the type of diabetes correctly to avoid mistreatment and its long-term biological, social, and economic implications. The new genetic tool will be a great help in this. It will help decide the contribution of failing pancreatic B-cells against reduced action of insulin due to excess fat and smaller muscle mass in the body of Indians (‘thin-fat Indians’). He further said, “We look forward to using this test in diabetic patients from different parts of India where the physical characteristics of diabetic patients differ from the standard description”.
The authors also found that the study can be used to predict the onset of type 1 diabetes in Indians.
Referring to the finding that nine genetic areas (called the single nucleotide polymorphisms [SNPs]) that correlated with type-1 diabetes in both Indian and European populations, Dr G R Chandak, Chief Scientist leading the study at CCMB, remarked: “It’s interesting to note that different SNPs are more abundant among Indian and European patients. This opens up the possibility that environmental factors might be interacting with these SNPs to cause the disease.”
Given the genetic diversity of the population of India, the study’s results need to be validated in other ethnic groups of the country too. Dr Rakesh K Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology (CCMB), said: “As more than 20 per cent of people with type-1 diabetes below the age of 15 years of age are in India, developing a genetic test kit to reliably detect type-1 from type-2 diabetes holds a lot of significance for the country.”
22-Nov-2019: Secretagogin may be a breakthrough for curing obesity-induced diabetes
A team of scientists from the Centre for Cellular and Molecular Biology (CCMB) have isolated a protein, secretagogin (SCGN) which plays an important role in increasing insulin action in obesity-induced diabetes. This might become a breakthrough in managing diabetes which is affecting millions of people every year. Their number in India alone is 60 million.
SCGN binds to insulin, and protects it from various stresses and increases its stability and adds to its action. Various kinds of cellular stresses can result in loss of structure and function of insulin, ultimately leading to diabetes. At present, the processes regulating insulin synthesis, maturation, secretion and signalling in diabetes are not completely understood.
Scientists at the Centre for Cellular and Molecular Biology (CCMB) have shown that injection of SCGN (found at lower levels in diabetic patients) in obese diabetic mice cleared excess insulin from circulation, and reduced fat mass. SCGN treated animals also had lower levels of harmful LDL-cholesterol and lower lipid accumulation in liver cells.
While studying calcium-binding properties of SCGN, CCMB scientists have discovered a novel function of this protein in diabetes biology.
17-Feb-2022: Non-Structural 1 protein, a potential diagnostic biomarker for Japanese encephalitis virus
Japanese Encephalitis Virus (JEV) is the leading cause of mosquito-borne encephalitis in South-East Asia and Western Pacific and is often misdiagnosed as Dengue. JEV belongs to the family Flaviviridae and genus Flavivirus and exists in a zoonotic cycle. Since there is no cure available for JEV, early detection is essential to mitigate a breakout. National Institute of Animal Biotechnology, Hyderabad developed Fluorine Doped Tin Oxide (FTO) electrode fabricated with reduced Graphene Oxide (rGO) for as an electrochemical based immunosensor for the rapid, sensitive and specific detection of the Non-Structural 1 (NS1) secretory protein, which is suitable biomarker for JEV found circulating in the blood and has been reported to elicit an immune response. Since the conventional methods for JEV diagnosis are expensive, more hazardous and time-consuming diagnostic techniques and requires an elaborate laboratory set up and trained expertise, the developed biosensor may be able to overcome these limitations. Detection of the NS1 instead of antibody has an added advantage since the antigen is present from day 1 of the infection and hence facilitates early detection. On the other hand, antibodies appear only after Day 4/5 of the infection. Docking studies were used to identify the specificity of the epitopes for different flaviviralNS1 with JEV NS1 antibody paratopes, followed by JEV NS1 sequence amplification, cloning and transformation. The NS1 protein was expressed in E. coli, characterised, and immunized in rabbits to raise the polyclonal antibodies. The NS1 Antibodies were purified from serum, characterized, and used as the bioreceptor to fabricate the electrode with reduced graphene oxide as a conductivity enhancing nanomaterial for the detection of JEV NS1 antigen (Ag). The LOD (limit of detection) was determined as 0.92 fM in buffer and 1.3 fM in spiked serum ranging from 1 fM-1 µM. This detection range is more sensitive than other sensors developed for JEV and can detect the minimal infective dose of circulating NS1 ranging anywhere from 7-284 ng/ml in clinical samples as tested in other flaviviral infections. The fabricated immunosensor was also specific towards JEV NS1Ag as compared to other flaviviral NS1Ag. Therefore, the proposed immunosensor could be a promising candidate for the development of an accurate, and rapid, diagnosis for specific and sensitive detection of JEV from clinical samples.