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WHO Releases First-Ever List of Essential Diagnostic Tests to Improve Diagnosis and Treatment Outcomes

The list is a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.

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WHO Launches First List of Essential Diagnostics
GENEVA (Switzerland): The World Health Organization (WHO) on Tuesday published its first essential diagnostics list (EDL), cataloguing the 113 most critical categories of diagnostics for common and priority diseases.

The step was taken to address the problem of people’s inability to access diagnostic services, thus failing to receive the correct treatment.

An accurate diagnosis is the first step to getting effective treatment,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

WHO first announced it would develop the list in June 2017 after an expert committee recommended that the agency craft a list of essential in vitro diagnostics (IVDs) for priority diseases including tuberculosis, malaria, HIV and hepatitis B and C.

Of the 113 types of diagnostics selected for the list, 58 are intended to diagnose a wide range of common conditions, both communicable and noncommunicable.

The remaining 55 diagnostics are intended to diagnose or monitor priority diseases.

The list itself provides information about each test category, including the tests’ intended use, format, and the appropriate setting the test is suited for.

The list also includes information on applicable WHO guidelines for the various types of diagnostics and notes whether there are WHO prequalified products available within a particular category.

“Our aim is to provide a tool that can be useful to all countries, to test and treat better, but also to use health funds more efficiently by concentrating on the truly essential tests,” said Mariângela Simão, WHO assistant director-general for access to medicines, vaccines and pharmaceuticals.

The list is similar to WHO’s essential medicines list (EML), which has been updated every two years since 1977 and is used as a reference by health authorities around the world to guide procurement decisions for critical drugs.

Going forward, WHO says it will update the EDL on an annual basis based on input from its expert group and expects the list to expand significantly with the inclusion of diagnostics for other focus areas, such as antimicrobial resistance, emerging pathogens and neglected tropical diseases.

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HEALTHCARE

Kerala Nipah Virus Cases: Situation is Under Control, No Need to Panic

Health Minister J P Nadda has urged citizens not to believe in rumours posted on social media and not to spread panic. 

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NEW DELHI: The Union Minister for Health & Family Welfare J P Nadda has reviewed the situation arising out of reported cases and deaths due to Nipah Virus in Kerala with Secretary (HFW) Preeti Sudan and DG (ICMR) Dr.Balram Bhargava and has directed for all support to be extended to Kerala in its prevention and management.

Following directions of the Union Health Minister, a multi-disciplinary Central team from National Centre for Disease Control (NCDC) is presently in Kerala constantly reviewing the situation.

The Central team includes Dr.Sujeet K Sing, Director, NCDC; Dr. S K Jain, Head Epidemiology, NCDC; Dr. P Ravindran, Director, Emergency Medical Relief (EMR);Dr Naveen Gupta, Head Zoonosis, NCDC; Dr Ashutosh Biswas, Prof Internal Medicine, AIIMS; Dr. Deepak Bhattacharya, Pulmonologist, Safdarjung Hospital along with two clinicians and one expert from Ministry of Animal Husbandry.

The NCDC team visited the house in Perambra from where the initial death was reported.  The team found many bats housed in the well from where the family was drawing water.

Some bats have been caught and have been sent for lab examination to confirm whether they are the cause of the disease or not. 60 different samples have been collected from the spot and sent for examination.

There are two confirmed cases with a history of contact with the index case. They were admitted to the Calicut Medical College Hospital and died due to Nipah virus.

The Ministry has mobilized a public health team from NCDC Branch Kozhikode to assess the extent of the problem, for risk assessment and risk management.  They are assisting the State Level Team already deployed at the epicentre.

So far, seven patients have been admitted to Baby Memorial Hospital and in the Govt. Medical College at Kozhikode and at the Amrutha Medical College, Ernakulam.

Nadda has urged citizens not to believe in rumours posted on social media and not to spread panic.

The field team has advised hospitals to follow intracranial pressure (ICP) guidelines, use personal protective equipment (PPE) for healthcare workers and sample collection; assist in enhancing active fever surveillance in the community; strengthen contact tracing in close contacts of cases, relatives, health care workers; ensure isolation facilities, ventilator support and hospital infection control practices; and coordinate with animal sector and enhance surveillance for unusual illness and deaths in animals.

The Ministry has ensured availability of diagnostic kits, personal protective equipment and risk communication materials. High-quality personal protection equipment has been provided to health care personnel.

A total of nine individuals are currently under treatment. Isolation wards have been opened in many hospitals in Kozhikode.

Hospitals in public and private sector have been provided with personal protective equipment. Appropriate steps to contain this virus have been taken among domestic animals such as pigs.

Since all the contacts are under observation and steps to avoid exposure through animal vectors have been taken there is no reason for people to panic.

This appears to be a localised occurrence.

With early and efficient containment measures undertaken jointly by the Ministry of Health & Family Welfare and Government of Kerala, the outbreak is unlikely to spread.

The Virus Research Diagnostic Laboratory at Manipal Hospital and the National Institute of Virology, a premier institute for research in virology, are geared up to meet any diagnostic challenges that may arise.

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After 10 Deaths, Kerala Gripped With Fear About the Spread of Nipah Virus

The disease was first reported in 2001 in India and again six years later, with the two outbreaks claiming 50 lives.

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THIRUVANANTHAPURAM (Kerala): A deadly virus carried mainly by fruit bats has killed at least 11 people in Kerala, sparking a statewide health alert on May 21.

Initial reports state three people had died from the deadly virus, but this was later revised to six, then to 11.

At least five other deaths in the state of Kerala are being investigated for possible links to the Nipah virus, which has a 70% mortality rate.

Kerala’s Chief Minister Pinarayi Vijayan has urged citizens to stay vigilant and follow instructions from the health department.

The victims all died in Calicut district, said Kerala health secretary Rajeev Sadanandan.

Samples tested in government labs confirmed the presence of the Nipah virus in three deaths, while Sadanandan said the cause of other suspicious deaths could only be confirmed through tests.

“We have sent blood and body fluid samples of all suspected cases for confirmation. It will take 24-48 hours for the results to come.”

India’s health minister rushed medical experts to the state after a local politician reported that residents were panicking in Calicut.

The team would “initiate required steps as warranted by the protocol for the disease”, J.P. Nadda said on Twitter.

The three who died included two siblings in their early twenties, the Press Trust of India reported.

A nursing assistant who had treated them also died Monday while the father of the victims was undergoing hospital treatment, PTI reported.

Neighbours told local media the siblings who died had eaten fruit picked from a compound where they were building a home.

A bat was found in the well of their home which was later sealed, PTI quoted state health minister K. K. Shylaja as saying.

Understanding Nipah:

Grey-headed flying foxes (Pteropus poliocephalus) Photo by Chi Liu

Nipah virus (NiV) infection is a newly emerging zoonosis that causes severe disease in both animals and humans.

The virus is thought to naturally infect fruit bats (of the Pteropodidae family, genus Pteropus), but it can also infect pigs and other domesticated animals, as well as humans, according to the World Health Organization (WHO).

The virus can also spread from person to person.

Nipah virus can cause an inflammation of the brain known as encephalitis, according to the CDC. Symptoms can include fever and headache, followed by drowsiness, disorientation and confusion.

People who are infected with the virus may fall into a coma within 48 hours of showing symptoms, the CDC says.

The virus can be highly lethal, with an average fatality rate of around 75%, according to the WHO.

There’s no drug to treat the illness and no vaccine to prevent it.

“We are now concentrating on precautions to prevent the spread of the disease since the treatment is limited to supportive care,” Rajeev Sadanandan, Kerala’s health secretary, told the BBC on May 21.

NiV was first identified during an outbreak of disease that took place in Kampung Sungai Nipah, Malaysia in 1998. On this occasion, pigs were the intermediate hosts.

However, in subsequent NiV outbreaks, there were no intermediate hosts.

In Bangladesh in 2004, humans became infected with NiV as a result of consuming date palm sap that had been contaminated by infected fruit bats. Human-to-human transmission has also been documented, including in a hospital setting in India.

NiV infection in humans has a range of clinical presentations, from asymptomatic infection to acute respiratory syndrome and fatal encephalitis. NiV is also capable of causing disease in pigs and other domestic animals.

There is no vaccine for either humans or animals. The primary treatment for human cases is intensive supportive care.

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‘AYUSH’ is Now a Proper English Word

The decision follows a proposal from the Ministry of AYUSH in this regards.

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NEW DELHI: The Commission for Scientific and Technical Terminology has decided to adopt the word ‘AYUSH’ in Hindi and English languages for scientific and technical purposes.

The “AYUSH” became popular as the acronym for five traditional and complementary systems of medicine, namely Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy and successfully adopted and used in all Government communications.

The decision follows a proposal from the Ministry of AYUSH in this regards.

Hailing this decision, Shripad Naik, the Union AYUSH Minister said that it would underline the essential unity of all holistic systems of healing.

He also said that this decision would add strength to the efforts of the Ministry of AYUSH to develop integrated solutions to manage the public health challenges of the Country.

As approved by the Commission, the word ‘ayush’ will have the meaning “Traditional and Non-Conventional Systems of Health Care and Healing which include Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa Rigpa, Homoeopathy etc.

Following the Commission’s recognition, the word is expected to gain currency in popular usage in a short span of time.

Despite many commonalities, the practice of the Ayush systems of healthcare in India has remained fragmented in system-specific silos. Today’s decision would, in the long term, highlight the unifying features of the different systems.  It would facilitate projects and activities of larger scope to emerge, and thereby promote faster development of these systems.

This decision will also give a boost to India’s efforts to find a place for the Indian Systems of Healthcare in the International Classification of Diseases (ICD) of the World Health Organization.

The Indian systems finding a place in ICD will lead to their international acceptance, increased rigour of research in them and their overall development.

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