5 Points on Hepatitis B Virus in India

1. Morbidity and Mortality Statistics: Despite the introduction of hepatitis B vaccine in the Universal Immunisation Programme in 2002 and scaling-up nationwide in 2011, about one million people in India become chronically infected with the virus every year. According to the Health Ministry, as on February 2019, an estimated 40 million people in India were infected. Hepatitis B infection at a young age turns chronic, causing over 1,00,000 premature deaths annually from liver cirrhosis or liver cancer.
2. Vaccination Coverage Increased; Disease Uncontrolled: According to the WHO, the coverage of hepatitis B third dose had reached 86% in 2015. However, despite the high vaccination coverage, disease prevalence in children aged less than five years has not dropped below 1%.
3. First 24 Hour Period Crucial: One of the reasons for this is the sub-optimal coverage of birth dose in all infants within 24 hours of birth. Even seven years after the Health Ministry approved the birth dose in 2008, its coverage remained low — 45% in 2015 and 60% in 2016 — according to a 2019 Health Ministry report.
4. Awareness and Training of Health Workers: One of the reasons for the low coverage is the fear of wastage of vaccine when a 10-dose vial is used. Unfortunately, health-care workers are very often unaware of the WHO recommendation that allows hepatitis B open-vial policy. Opened vials of hepatitis B vaccine can be kept for a maximum duration of 28 days for use in other children if the vaccine meets certain conditions.
5. Conclusion: Awareness and Achievement: There is also a need to increase public awareness about the merits of the birth dose. On September 3, 2019, Bangladesh, Bhutan, Nepal and Thailand became the first four countries in the World Health Organization’s southeast Asia region to have successfully controlled hepatitis B. India must follow suit.

5 Points on India's CVD Burden

1. CVD Burden in India: In low-income countries, including India, however, CVD is still the top killer, with death three times more frequent than that due to cancer.
2. Poor Quality Healthcare: Higher mortality in poorer countries was likely due to other factors, including ‘lower quality and less health care’. Access to affordable, quality health care is still a dream in many pockets in India.
3. High OoP Expenditure Deters Treatment: A great amount of out-of-pocket expenditure (according to Health Ministry data for 2014-15, nearly 62.6 % of India’s total health expenditure) often frustrates continuation of treatment, or adherence to drug regimens.
4. Prominent Causes of High CVD Mortality: It is significant that the single largest risk factor is a low education level. It is no doubt part of the job description of the National Programme to modify this risk factor. However, governments will have to muscle up to tackle a rather startling finding — ambient air pollution and indoor air pollution have an impact on CVD and mortality. Household air pollution is the third top risk factor in low-income countries, according to the study.
5. Solution: National and State schemes running on mission mode, including the National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke will have to step up efforts to target people at risk with life-saving interventions. While some States have shown limited successes with government-sponsored health insurance schemes, the Centre’s Ayushman Bharat Yojana will have to take much of the burden of hospitalisation for complications of non-communicable diseases.

GK: Understanding Norovirus that hit Winter Olympics (S&T)

PyeongChang 2018, the ongoing XXIII Olympic Winter Games at the South Korean city of Pyeongchang, has been hit by an extraordinary outbreak of disease. A Norovirus infection is sweeping through the Games Village and surrounding areas, cutting down people with severe attacks of diarrhoea and vomiting, and spreading panic among athletes and residents.

So, what is Norovirus?

It is a bug similar to the diarrhoea-inducing rotavirus for which India has recently included a vaccine in its universal immunisation programme. While rotavirus primarily affects children, Norovirus infects people across age groups. Disease outbreaks typically occur aboard cruise ships, in nursing homes, dormitories, and other closed spaces (such as the Games quarters). 

How do you get the infection?

Norovirus is highly contagious, and can be transmitted through contaminated food, water, and surfaces. The primary route is oral-faecal. One may get infected multiple times as the virus has different strains. Norovirus is resistant to many disinfectants and heat up to 60°C. Therefore, merely steaming food or chlorinating water does not kill the virus. The virus can also survive many common hand sanitisers.

How common is Norovirus infection?

It is the most common pathogen implicated in outbreaks of gastrointestinal disease (inflammation of the stomach and intestines), according to the World Health Organisation.

How can the infection be prevented and treated?

The basic precaution is also the most obvious — repeatedly washing hands with soap after using the lavatory or changing diapers. It is important to wash hands scrupulously before eating or preparing food. During outbreaks, surfaces must disinfected with a solution of hypochlorite at 5,000 parts per million. Diagnosis is done by real-time reverse transcription polymerase chain reaction. No vaccines are available for the disease.

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Source:

http://indianexpress.com/article/explained/whats-the-mystery-bug-stalking-the-winter-olympics-in-korea-5065923/