How Assisted Reproductive Techniques ensure safe motherhood for those needing assistance

Amid different developments in this sphere, ART is another revolution that ensures safe motherhood to the ones with difficulty conceiving a baby

Representational image. Cassidy Rowell/Unsplash

The widespread impact of technology on the contemporary world is all-pervasive. There are rarely any aspects of human life that have remained unimpacted by the technological revolution across the globe. In this tech-enabled run, the development of the healthcare system and processes is exemplary. And amid various aspects of healthcare that are being equipped with advanced technologies and techniques, utilised for better delivery of healthcare services, maternal care under reproductive health awaits its due share.

In India, the latest Maternal Mortality Statistics estimated the MMR to be 103 per 100,000 live births. Building a continuum of care that promotes accessibility and the use of effective care during pregnancy, birth, as well as the postpartum period has become necessary to ensure that the mother and the baby are healthy. This intensive care is inevitable for bringing us closer to or achieving the Sustainable Development Goals by the UN, which aspires MMR to be not more than 70 out of 1,00,000 live births by 2030. Although India’s MMR has reduced over the years, we are still way behind the number mandated by the UN.

Amid different developments in this sphere, Assisted Reproductive Technology is another revolution that ensures safe motherhood to the ones with difficulty conceiving a baby. ART helps the couple in the identification and timely remediation of underlying conditions that might, otherwise, hamper the pregnancy and even go on to result in cases of Maternal Mortality. It ensures different pre-conception care in comparison to the natural conception by not only help in identifying the diseases that might create problems in safe pregnancy but also play an essential role to contribute in the treatment of such diseases before a woman is set on the journey of motherhood.

Under the ambit of ART, we see techniques like In vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), etc. Thus, with a chain of steps accompanied with intensive guidance and observations at every phase, ART prevents exposure to vulnerability. Women with thyroid issues, for example, may develop anaemia during pregnancy and experience a rise in blood pressure, resulting in preeclampsia. There are instances where the mothers started vomiting and getting dehydrated, resulting in stillbirth, miscarriage, or premature birth in a developing kid, putting the infant’s life in peril.

Every cycle begins with an IVF specialist’s consultation, which helps to create expectations for the procedure. Following that, the couple is subjected to a series of panel tests. This includes, among other factors, blood tests to look for polycystic ovaries, diabetes, liver damage, sexually transmitted diseases, and hormone levels like prolactin in women. Ultrasound and other image-based scans are also done. This assists in determining the reason for infertility as well as determining whether there is any medical condition that has to be treated prior to beginning the ART cycle. For example, if a woman seeking ART treatment is discovered to have uterine fibroids, they will be removed via laparoscopy or surgery; if severe diabetes that could influence pregnancy and its results are discovered, she is directed to an endocrinologist.

Once these pre-ART procedures are completed, procedural ART follows. It starts with maturing several ova or eggs inside the ovary, collecting them, fertilising with the husband’s sperm, allowing the embryo to develop for 5-6 days into a blastocyst, and implanting the embryo. Technology plays an important role. Microfluidics aids in the selection of the best sperm for fertilisation, and an electronic witnessing system assures that unrelated eggs and sperm do not combine. Artificial intelligence has also been included to automate the gamete selection procedure, removing the possibility of human error. The gametes are handled in controlled microenvironments that are identical to the human body. Pre-implantation genetic testing (PGT) examines the embryo’s genetic makeup to see whether there are any chromosome abnormalities. Such irregularities have an impact on the mother’s and child’s health, resulting in illnesses including Down syndrome, haemophilia, and thalassemia, among others, and some can even result in miscarriage.

The use of ART also eliminates the necessity for repeated embryo transfers into the uterus, which are done to boost the chances of live birth but might cause pregnancy difficulties due to the presence of several developing children. As a result, single embryo transfers, which are safer in comparison, may become the norm.

Safe Motherhood involves various pillars that are essential to ensure a healthy state of the mother during pregnancy, birth as well as the postpartum period. The pillars include family planning, antenatal care, obstetric care, postnatal care, post-abortion care and control of Sexually transmitted diseases. Governments across countries have taken various steps to ensure the same. In India, the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) and the Surakshit Matritva Aashwasan (SUMAN) are two such programmes initiated to enrich and safeguard the health of pregnant mothers and their children. On the parallel, with application of Assisted Reproductive techniques (ART) rising amongst the infertile couples, who used to seek other methods or unhealthy practices for conceiving a baby, the SDG of less than 70 MMR per 1,00,000 live births is not far at all.

The author is CEO and co-founder, Indira IVF. Views are personal.

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Conspiracy theories on US spreading monkeypox are all over China’s social media, here’s why

While Chinese state media hasn’t thus far made such an accusation – it previously hit back at the ‘lab leak hypothesis’ by suggesting the COVID-19 virus originated in the US – that hasn’t stopped social media users

Monkeypox has symptoms very similar to smallpox but is less severe. Image Courtesy: WHO

When COVID-19 first began to spread, many on social media platforms and in news outlets in the US openly wondered whether the virus leaked from a lab in Wuhan.

Now, with monkeypox spreading to over a dozen countries across the world it seems that the shoe is on the other foot.

According to Fortune, social media users in China are breathlessly speculating that the US could have deliberately spread monkeypox.

What happened?

As per the report, monkeypox has been trending on social media platform Weibo – these Chinese equivalent of Twitter – for the past three days with a hashtag on the US reporting two suspected monkeypox cases attracting more than 51 million views.

While Chinese State media hasn’t thus far made such an accusation – it previously hit back at the so-called ‘lab leak hypothesis’ by suggesting the COVID-19 virus originated in the US – that hasn’t stopped social media users.

Fortune reported that nationalist influencer Shu Chang, who has 6.41 million followers on Weibo, deliberately misconstrued a 2021 report by an NGO on biosecurity preparedness to claim “a plan by the US to leak bioengineered monkeypox virus.”

The post was liked by more than 7,500 users and received more than 660 comments, many of them in support of the post. One user said that the US was “evil beyond the imagination of humankind.”

“If the US let loose the virus to spread around the world, it’s harming the global health of people,” another Weibo user wrote, according to Insider. “The US should be reprimanded by the international community and made to pay compensation”.

Another added: “The US is known for creating viruses to harm the entire globe”.

What does the report say?

As per the Daily Mail, the report by the Nuclear Threat Initiative (NTI), which models responses to weapons of mass destruction, focusing on nuclear, cyber, biological, radiological and chemical attacks, describes a hypothetical scenario for an outbreak of monkeypox.

After the COVID-19 pandemic struck, the NTI partnered with the Munich Security Conference (MSC) to conduct a tabletop exercise aimed at reducing biological threats. The example they chose for the exercise was ‘an unusual strain of monkeypox virus’, the newspaper reported.

In the exercise, the two groups modelled the outbreak of the monkeypox strain in a fictional country called ‘Brinia’ which eventually spreads globally, measured over 18 months.

In the scenario, the initial outbreak was caused ‘by a terrorist attack using a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight.’

By the end of the exercise, the fictional pandemic resulted in more than three billion cases and 270 million fatalities worldwide, Daily Mail reported

Monkeypox, which is not usually fatal, can cause a fever, muscle aches, swollen lymph nodes, chills, exhaustion and a chickenpox-like rash on the hands and face.

The virus can be transmitted through contact with skin lesions or droplets of bodily fluid from an infected person.

The US Centers for Disease Control and Prevention (CDC) says monkeypox is spread by coming into close contact with an infected animal or person, and mainly through respiratory droplets.

After outbreaks in Europe and North America, the World Health Organization on Monday said the risk of the disease spreading widely among the general population is very low.

Transmission can be stopped outside endemic countries in Central and West Africa, the WHO said, adding that fewer than 200 confirmed and suspected cases had been recorded since early May in Australia, Europe and North America.

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How air ambulances are a boon to organ transplant

The first and foremost benefit of the air ambulances is that they provide speedy transportation of both the organs and the patients in need, whenever the need arises

Fixed wing air ambulanc. Image courtesy AirOperationsManager/Wikimedia Commons

With the ever-increasing health concerns that people are going through, now it’s time to the game up in the healthcare industry. There have been many technological advances that have helped save numerous lives even from fatal diseases and life-threatening accidents. It is not just because of the skill sets of the doctors and surgeons that people have been taken out of danger, but it is also because of the people that work round-the-clock to make sure that those people’s lives are saved. Say, for example, ambulance drivers and the paramedics who rush to a location whenever there is an emergency. According to a study in 2014, it was found that at least one life is saved in the country every 30 minutes, all thanks to the emergency services.

However, there are times when the situations are more critical due to time constraints like in the case of an organ donation where time plays a crucial role. In cases like those, the facility of an air ambulance comes to the rescue. Air ambulances come to the help in dire times when there is an urgent need for an organ transplant. Air ambulance is just like any other ambulance, with all the facilities that are available in a standard ambulance. The upside of an air ambulance is that it is fast since it does not meet any road traffic. For shorter distances, helicopters are used as air ambulances since they are more feasible vehicles to operate and use. For longer distances, fixed wings i.e. aeroplanes are used. An air ambulance can transport an organ that a patient needs at a remote location. It can also transport the patient themselves from the remote location to the hospital where the surgery needs to be done. Some private institutions provide air ambulance services alongside some charitable trusts as well.

Once the donor is confirmed, the immediate next step is to transport either the organ or the patient to the location. Choosing fast air ambulances over slow road transport would be the ideal thing. Air ambulances are safe for extremely sensitive organs like kidney and liver transport. Since organs like those need extra care, air ambulances make sure that they are delivered well and safe. There is also no chance of the organs getting damaged in air ambulances while during the road transport, those chances are quite high, especially for sensitive organs.

Why air ambulances?

When it comes to critical situations for the patients, time is life – literally. Along with transporting the organs quickly and in time, it also matters how the organs are transported inside the air ambulances and stored during the transportation. In common practice, the harvested organs are washed with a refrigerant because Cooler the organs, the lower the need for oxygen to main their cell health. However, the time varies for each organ to stay healthy outside of the human body. For sensitive organs like kidneys, it can take up to 24 hours and for the liver, it can take up to 10 to 15 hours. But for the heart, it gets even more critical since the maximum time it can be kept out of the body is four to six hours. Most heart transplants are usually done within the time span of four hours. To make sure that the organs are safe and secure, they are packaged in special containers that maintain the organs’ health properly. The storage container that is used in air ambulances is most commonly referred to as cold ischemic storage.

How does air ambulance help to save time and life

Time is of the essence for organ transplant patients, the complex logistics and the extreme amount of distance the aircraft must cover can be challenging. Emergency organ transplants are not easy. It only takes a second for a heart to stop beating, but hours upon hours to get it back where it belongs. Air ambulances race against time and are able to shift people to another city without any hassle at all. These vehicles offer unparalleled speed and do not get stuck in traffic or other hindrances that ground ambulances face in moving about. An organ can survive only for a specific time without oxygen, making timely transport imperative. Air ambulances are agile and fast, capable of going hundreds of miles per hour, covering roughly 300 air miles in less than 2 hours in case of emergency cases.

Air ambulances keep up with the pace of emergency organ transport by providing rapid response times and take-off speeds. The planes are designed to move fast, and the pilots are trained to do what it takes to get your patients where they need to go as quickly as possible.

Getting organs to transplant recipients quickly is a complex and delicate process, but green corridors play a vital role in helping the transplant system work. Once the organ reaches the airport, it is transported to the planned hospital via road ambulance, Organs have limited windows of time and they have already lost a major chunk of survival time to reach all the way to the airport and the organ is in the last stage of its viability. So, to transport the organ from the airport to the hospital a Green corridor is created by seeking permission from the traffic police. This helps to deliver organ to the transplant spot as quickly as possible before it reaches their countdown and become waste.

Benefits of air ambulances

The first and foremost benefit of the air ambulances is that they provide speedy transportation of both the organs and the patients in need, whenever the need arises. Air ambulances provide 100% safe transportation with advanced tech medical facilities alongside the attendants to handle an emergency condition. They are also the fastest means of transport (yet), so the organ transportation is handled very well and the organ transplant is performed in a great condition eventually. They provide a bump-free and comfortable flight in case there needs to be a transport of the patient and that eventually avoids any further complications. Another major benefit of an air ambulance is that it can operate almost anywhere in the world, even at places where a ground vehicle is not able to reach. That gives it an upper hand over ground ambulances. There are also increased chances of survival when an air ambulance is dispatched as to the times when a ground one has been dispatched. A statistical analysis shows that an average of 12 more lives are saved every 100 times when an air ambulance is dispatched over a ground ambulance.

The major transport for organ transplantation is from Hyderabad to Chennai resulting in about 90 per cent of total organ transport in India. The estimated time of travel from Hyderabad to Chennai is approximately 1 hour and 30 minutes. With this time constraint, the team at hospitals operates as fast as possible once it gets the call for a patient who needs an emergency transplant. This has led to the establishment of a dedicated Air Ambulance service between these two cities which transports organs cooled by liquid nitrogen tanks on board. Specialists teams of doctors and nurses travel aboard the aircraft to provide care during long-distance transports.

The way ahead

Organ transplants from remote, big, and small places of district headquarters to the hospitals in far-off cities and countries would become a reality with the activation of air ambulance services in major parts of the world. Also, transporting organs via drones is considered one possible solution to this concerning problem. The scope of AI in life-critical transport will transform the entire air ambulance industry and organ transplant field. One research suggests that introducing new airline routes reduces the discard rate of donated kidneys and increases the number of kidneys sent to transplant centres across India.

To conclude, air ambulance flight is a vital part of the organ transplant process. The grand synchronization of these two concepts- Organ transportation and air ambulance gave birth to the solution to the most surging problem of the time gap in organ transplantation. Organ transplant and air ambulance network plays a very vital role in saving lives and the service provided by these institutions is essential for saving lives and it should be recognized for its role and importance in our society and industry.

The author is the founder Air Rescuers Worldwide Pvt Ltd. Views are personal.

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Billie Eilish finds dealing with Tourette’s ‘exhausting’: What is syndrome, what are its symptoms?

The Centre for Disease Control and Prevention defines Tourette’s Syndrome (TS) as a condition of the nervous system. It causes people to have “tics” – sudden twitches, movements, or sounds that people make repeatedly

File image of Billie Eilish.

In an interview with David Letterman for his Netflix show My Next Guest Needs No Introduction, singer Billie Eilish spoke of dealing with Tourette’s syndrome.

As per CNN, Eilish, who was diagnosed at the age of 11 with the neurological disorder, said people sometimes misunderstand what is happening.

“The most common way that people react is they laugh because they think I’m trying to be funny,” she said. “And I’m always left incredibly offended by that.”

The singer, who at age 18 became the youngest person to win all four top Grammy Awards – new artist, album, record and song of the year in 2020 – said that while some of her tics have subsided, she still has some subtle ones.

“These are things you would never notice if you’re just having a conversation with me,” Eilish said, as per CNN. “But for me they’re very exhausting.”

What is it?

The Centre for Disease Control and Prevention defines Tourette’s Syndrome (TS) as a condition of the nervous system. It causes people to have “tics” – sudden twitches, movements, or sounds that people make repeatedly.

People who have tics cannot stop their body from doing these things. For example, a person might keep blinking over and over or might make a grunting sound unwillingly.

How is it diagnosed?

Unfortunately, no test to diagnose Tourette’s syndrome exists. The assessment is based on the patient’s history and symptoms.

The criteria used to diagnose Tourette syndrome include:
Motor tics and vocal tics, though not necessarily at the same time
Tics occur several times a day, nearly every day or intermittently, for more than a year
Tics begin before age 18
Tics aren’t caused by medications, other substances or another medical condition
Tics must change over time in location, frequency, type, complexity or severity.

How is it treated?

There’s no cure for Tourette’s syndrome.

The treatment – which can range from a slew of pharmaceutical interventions to several different types of therapy – is focussed on controlling tics to help increase every day quality of life.

How many people have it?

Eilish is far from the only one diagnosed with the syndrome.

According to the American Brain Foundation, about 200,000 people in the United States exhibit severe symptoms of Tourette’s syndrome with as many as 1 in 100 people in the United States showing milder symptoms.

‘Really love answering questions about it’

As per The News, the topic came up after Eilish turned her head and opened her mouth, to which Letterman asked if she’d seen a fly.

“No I’m ticcing,” she replied, adding that the lights had triggered her tics.

“If you film me for long enough, you’re going to see lots of tics. I don’t care. It’s really weird, I haven’t talked about it at all.”

“I really love answering questions about it, because it’s very, very interesting. And I am incredibly confused by it. I don’t get it,” she added, as per the report.

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COVID-19 is not over yet and why vaccination is important for better fighting chance

Vaccination is a worldwide accepted strategy to encounter the COVID-19 as soon as possible with the vaccines approved by their public health authorities

A healthcare worker inoculates a dose of the COVID-19 vaccine to a student. ANI

Vaccination is boon to humankind as it gives strong protection against various diseases, hospitalisation, and death. Effective vaccines are also available for COVID-19. Billions of people have been vaccinated against COVID-19. Getting vaccinated is one of the most important things one can do to safeguard oneself against COVID-19. There are various studies that imply being vaccinated will not only protects you but also additionally safeguards everyone around you. India has approved the Covishield, Covaxin, Sputnik Light, Sputnik V, Corbevax and Covovax so far. Everyone is free to take any one of them as per the availability. It is important to be jabbed as soon as possible.

COVID-19 vaccines are safe for most people who are 18 years and older, including those individuals with pre-existing diseases like diabetes, asthma, hypertension, pulmonary, liver, and kidney diseases, as well as chronic infections that are stable. Whether it’s pregnancy or breastfeeding, getting vaccinated is important for all women and their families. As per operational guidelines released by the Government of India on 2 July 2021, any one of the three vaccines Covishield, Sputnik V and Covaxin can be given to these women. One should also get vaccinated if they are menstruating. If anyone is aged 60 and over, they are also eligible for vaccination.

There is evidence that children can be safely vaccinated against COVID-19. India’s drug regulator has also approved the emergency use of two COVID-19 vaccines, Bharat Biotech’s Covaxin (cleared for use in children aged 6-12 years.) and Biological E’s Corbevax (cleared for use in children aged 5-12 years). Vaccine trials for the use of other COVID-19 vaccines in children and teenagers are ongoing and WHO will update its recommendations when the proof or epidemiological situation justifies a change in policy. Children and teenagers over five years old with comorbidities that put them at higher risk of COVID-19 may be offered vaccines alongside other high-priority groups.

Sputnik V, the world’s first COVID vaccine with demonstrated viability for people living with HIV as exhibited by a joint report between the Gamaleya Center and Moscow City Center for AIDS Prevention and Control published in The Lancet. The adequacy of Sputnik V is 79 per cent against infection as confirmed by a retrospective cohort study breaking down information from more than 24,000 HIV+ patients on antiretroviral treatment (ART). The data presented are the first scientific results on the preventive efficacy of a COVID vaccine to shield against infection in people living with HIV (PLWH). Based on the data from more than 24,000 HIV-positive patients in Moscow on antiretroviral therapy (ART), Sputnik V’s efficacy was 79 per cent. The vaccine’s viability against hospitalisation was over 90 per cent. Sputnik V is also more than 97 per cent effective against the development of moderate or severe disease among PLWH.

The COVID-19 pandemic is still ongoing, as we can see many new variants appearing, and the after-effects of COVID-19. COVID-19 is also harmful to those individuals with pre-existing diseases. Vaccination is a worldwide accepted strategy to encounter the COVID-19 as soon as possible with the vaccines approved by their public health authorities.

The author is a public health expert. Views are personal.

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SII might have to destroy 200 million COVID-19 vaccines due to oversupply, says Adar Poonawalla

The Serum Institute of India’s chief executive is advocating a global pandemic treaty and proposing that next time there is a framework for leaders to work with rather than having to negotiate

File image of Adar Poonawalla. Image courtesy: Twitter@adarpoonawalla

Serum Institute of India (SII) chief executive Adar Poonawalla has told CNBC-TV18 that the world’s largest vaccine maker might have to destroy a minimum of 200 million doses of COVID-19 vaccine as there is an oversupply.

Speaking exclusively to CNBC-TV18 at Davos, Poonawalla said, “We will lose 200 million doses of vaccines minimum. We might have to destroy them as they are nearing expiry by August-September this year.”

Poonwalla is advocating a global pandemic treaty and proposing that next time there is a framework for leaders to work with rather than having to negotiate.

After Covishield for adults, Serum also produced the Covovax vaccine for those in the age group of 12-18 years. The company has submitted all the research documents related to the vaccine for administration in the 2-11 years age group to the Drugs Controller General of India (DCGI).

“Children also need to start getting vaccinated. We hope that picks up, and that’s the only age group left to be vaccinated,” Poonawalla said.

India’s drug regulator had approved Covovax for restricted use in emergency situations in adults on 28 December last year and in the 12-17 age group, subject to certain conditions, on 9 March.

Globally, SII has sold 80 million doses of Covovax and expects to sell another 100 million doses. The company is hoping to get USFDA approval for Covovax by June this year.

SII is making a cervical cancer vaccine, and it is expected to launch in November-December this year. It is also mulling launching a 6-in-1 vaccine for children, a 5-in-1 meningitis vaccine and a vaccine for Malaria. SII is also starting clinical trials for a dengue vaccine.

Poonawalla also said the firm might raise its stake in Biocon-Biologics by a couple of percentage points soon.

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Watch: Dr Lovneet Batra explains ‘stealthy’ calories you may be forgetting to count and their impact

We hardly include these ‘stealthy calories’ when we count our daily caloric intake. However, these liquid calories tend to spike glucose and insulin levels faster than solid calories

Representational Image. ANI

As many parts of the country continue to reel under soaring temperatures, most of us are tempted to drink Summer beverages such as still and carbonated soft drinks, 100 percent juices and so on. However, the liquid calories in these drinks do have an impact if they are consumed regularly.

We hardly include these ‘stealthy’ calories when we count our daily caloric intake. But, it is a mistake to ignore them, according to Dr Lovneet Batra. The nutritionist released a video recently on the impact of these ‘mindless’ calories in energy drinks, soda, tea, juices, soft drinks and other sugary beverages that never fill us up. These calories are more dangerous as they tend to spike glucose and insulin levels faster than solid calories. Check it out:

View this post on Instagram

Here are the effects of these ‘stealthy’ liquid calories on our body:

Raises blood sugar levels: Liquid sugar calories can lead to elevated insulin resistance and blood sugar levels. High fructose intake can lead to increased risk of type 2 diabetes as well as a decrease in insulin sensitivity. Sugary beverages deliver a large amount of fructose in a short time. As your body converts the extra fructose into fat and stores it in the liver, it can lead to inflammation, insulin resistance and higher blood sugar levels.

Increases heart risk: Liquid sugars have an adverse impact on the heart as high levels of fructose intake can increase the amount of triglycerides and other fat molecules in your blood. This is turn increases the risk of heart disease.

Leads to weight gain: The body does not register these stealthy calories, meaning they do not provide the same feeling of fullness as solid foods. This can prompt individuals to keep eating even after consuming a high-calorie beverage, increasing their calories, and ultimately leading to weight gain.

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US, Europe, Australia, monkeypox is spreading: Can the virus lead to a pandemic?

Cases of monkeypox are being reported in several countries across the world – the US, Canada, UK, Europe and Australia. There’s growing concern that the virus is spreading undetected

COVID-19 is far from over but another disease is already creating a scare. Monkeypox, a rare viral disease associated with the tropical rainforests of Central and West Africa, is spreading in Europe and the United States.

At least 75 monkeypox cases – 33 confirmed and 42 suspected – have been reported across countries outside Africa.

The first case in the United Kingdom was reported 7 May, in someone with a travel history to Nigeria. The UK Health Security Agency had said monkeypox is a rare viral infection that does not spread easily between people and is usually a mild “self-limiting illness”.

However, cases are on the rise.

Where have monkeypox cases been detected so far?

In the latest outbreak, monkeypox cases have been detected in the US, Canada, UK, France, Sweden, Spain, Portugal, Italy, Belgium, Germany and Australia.

France, Belgium and Germany declared their first cases on Friday.

There are now 20 confirmed cases in the UK, Health Secretary Sajid Javid said on Friday.

In the US, one case has been confirmed but the Centers for Disease Control and Prevention, the country’s national public health agency, is monitoring six people for possible infection after they sat next to an infected traveller who had symptoms while on a flight from Nigeria to the United Kingdom in early May, reports CNN.

Separately, CDC officials are investigating the case of monkeypox confirmed in a man in Massachusetts who had recently travelled to Canada. And the New York City Health Department is investigating a possible infection in a patient currently at a hospital.

In Canada, there are at least a dozen suspected monkeypox cases, AFP reported. Two of them were confirmed on 19 May.

Australia’s first case was detected in a man who fell ill after travelling to the UK, the Victorian Department of Health said, reports BBC.

How is the virus transmitted?

Monkeypox is a virus transmitted to humans from animals, with symptoms very similar to smallpox but less severe clinically.

In Africa, monkeypox has been found in many animals including rope squirrels, tree squirrels, Gambian poached rats, dormice as well as different species of monkeys and others.

The World Health Organization (WHO), however, says human-to-human transmission is limited.

Animal-to-human transmission can happen as a result of direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. Secondary or human-to-human transmission can happen through close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects, reports AFP.

Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, putting health workers, family members and other close contacts of infected people at greater risk.

Person-to-person transmission isn’t common, as it requires close contact with bodily fluids, such as saliva from coughing or pus from the lesions. So the risk to the general population is low, according to the UK health agency notes.

However, in England, seven of the eight cases don’t involve recent travel to Africa, suggesting the patients involved in those cases caught the virus in England. On top of that, those individuals haven’t had contact with the one patient known to have travelled to Nigeria in early May.

Together, this data suggests the virus is spreading in the community undetected, reports NPR.

A child affected by monkeypox receives treatment at the centre of the international medical NGO, Doctors Without Borders, in Zomea Kaka, in the Lobaya region, in the Central African Republic in 2018. AFP

Have there been outbreaks in the past?

There has been an outbreak in the US in 2003. Forty-seven confirmed and probable cases of monkeypox were reported from six states – Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin.

All people infected with monkeypox in this outbreak became ill after having contact with pet prairie dogs. The pets were infected after being housed near imported small mammals from Ghana. This was the first time that human monkeypox was reported outside of Africa, according to the US CDC.

In 2020, over 6200 suspected cases were reported in the Democratic Republic of the Congo. An outbreak occurred in Nigeria from 2017 to 2019, with cases still being reported in 2021. In addition to Nigeria, outbreaks have also been reported in nine other countries in central and western Africa since 1970, says WHO.

Can monkeypox lead to a pandemic?

Like previous monekypox outbreaks, contact tracing can be used to curb the spread, say experts.

However, a pandemic is unlikely. “I don’t think the science points to that at this moment,” Canadian epidemiologist John Brownstein told News Scientist. “It’s important not to put this on the same level as a novel coronavirus.”

However, it’s unusual that cases are not been traced to a similar source or contacts.

Is there a vaccine for monkeypox?

There is no proven safe treatment for the infection. To control outbreaks, the smallpox vaccine, antivirals, and vaccinia immune globulin (VIG) can be used.

A smallpox jab offers 85 per cent protection since the two viruses are quite similar, reports BBC.

With inputs from agencies

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COVID-19: India’s first case of Omicron subvariant BA.4 detected in Hyderabad

This strain of coronavirus, like BA.2 subvariant, has been found capable of immune evasion from past infection and vaccination

Representational image. AFP

India’s first case of BA.4 subvariant of the Omicron strain of coronavirus was detected in Hyderabad through a genomic surveillance program on Thursday.

Scientists associated with the Indian SARS-CoV-2 Consortium on Genomics (INSACOG) said that from India, details of a BA.4 subvariant were entered on GISAID, a global science initiative that provides open access to genomic data of influenza viruses and the coronavirus responsible for the COVID-19 pandemic, on 9 May, Moneycontrol reported.

A scientist associated with the Indian Council for Medical Research told Moneycontrol that it’s possible that random cases of BA.4 may have also been detected in other cities in the country over the last few days.

According to Mint, the patient is a foreign national who tested positive upon arrival at Hyderabad airport. The samples were later sent for genome sequencing.

This strain of coronavirus, like BA.2 subvariant, has been found capable of immune evasion from past infection and vaccination.

The subvariant is behind the spike in cases in countries like South Africa, UK and US.

Experts, however, said that the strain is unlikely to cause a surge in hospitalisation in India, Moneycontrol reported.

Scientists told Moneycontrol that given the extensive immunity in the Indian population due to the Omicron wave that hit India in January this year, a new COVID-19 surge-if any-is most likely to stay at low levels.

With inputs from agencies

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Why preparation for the next pandemic needs One Health approach implementation in letter and spirit

COVID-19 is not the last pandemic, and the next ones are quite likely, unless we come together to prevent it

A healthcare worker collects a nasal swab sample of a woman for a COVID-19 test – ANI

One Health is one of the many phrases that has now entered the common parlance after the COVID-19 pandemic. This was once a niche area, mostly where veterinarians called attention to the importance of animal health and its significance in the broader health agenda, though with limited interest from the rest of the sectors. The increased awareness in the public consciousness of how the wildlife, domestic animals and human health are intertwined in this biosphere is encouraging.

For any movement to gather momentum, the first step is spreading awareness. This is followed by acceptance and then an urgency as a society to solve the challenges facing it. The problem of climate change went through these transitions and now we are entering the frantic phase of ‘solution finding’. It is significant therefore that the area of One Health is now entering the very first stage of public awareness.

While increased awareness is a good outcome, the very definition of One Health needs clarity. The commonly offered descriptions of it being about ‘humans, animals and the planet’ makes it seem about everything. When a concept is about everything, it has the risk of being about nothing specific. Therefore, we need clear problem definitions of what ‘One Health’ is.

The second issue follows from the vagueness mentioned above. One Health in the current construct comes across as a set of feel-good statements that is hard to disagree with, but it stops there. As the concept of ‘world peace’ is broadly appealing but challenging to build specific strategies and solutions around. Repeating phrases such as ‘multisectoral collaborations’ and not moving further on ‘what’ and ‘how’ of this concept will be implemented on the ground may risk losing the momentum.

Third and the final challenge is the missing integrated thinking. If we take the example of disease surveillance, there are many efforts that are ongoing today. Some are vertically funded global priorities such as malaria. Others are routine national priorities such as foot and mouth disease control in cattle. These efforts are often limited to one single compartment among the wildlife, livestock, and humans, even though diseases transcend two or all the three compartments. Even the cross-compartmental topics such as rabies control are often implemented on a siloed basis without the context of underlying operating systems across these compartments.

What we need instead is a comprehensive understanding of all the three compartments, their intricacies, and the incentives that drive certain behaviours within and across. Built on top of such broad-based understanding, we need specific issues to be solved, be it rabies, tuberculosis, foot, and mouth disease or covid. When these are built on existing systems, be it the forestry and wildlife professionals, veterinarians and technicians, and the spectrum of medical and paramedical workforce that handle routine issues, they tend to integrate and sustain better. We need programmes that bring the full spectrum of these stakeholders together in rabies or tuberculosis control that spans across the three compartments, each of them has its own mandates and incentives in such a way that complements instead of working against each other.

Similarly, and even more importantly, pandemic preparedness requires real collaboration across the spectrum to be successful. In this case, we are dealing with not only diseases such as Avian Influenza, about which we know something about and know what to look for, but also potentially a new class of disease about which we don’t understand much about. Also, for this system of preparedness to work in the long term, it needs to be built on the existing systems and linked to routine surveillance programs. If implemented as a standalone initiative, as the present crisis passes, it risks losing the attention and resources that are required to keep the system in an active form of readiness.

In addition to the intellectual understanding of these issues, we need real pilots with this integrated thinking as a strategy. In fact, many such pilots in diverse contexts are needed. This is because we don’t yet know how to do this sustainably, what works on the ground and how complementary or opposing incentives play out in the real world. In this context, it is significant to note the recently launched ‘One Health‘ programme in Uttarakhand by Department of Animal Husbandry and Dairying (DAHD) ( The approach includes wildlife, animal and human surveillance, workforce development, laboratory strengthening and networking, outbreak detection, reporting and response, biosecurity in animal production systems and community awareness.

The country looks forward to the successful implementation of this ambitious programme, with lessons coming out of these on what is working and what is not. In the end, we learn just as much if not more from what doesn’t work, as what ends up succeeding in predicting, preventing, and controlling the diseases that afflict our biosphere.

The author is a Visiting PSA Fellow at the Office of Principal Scientific Advisor to the Government of India and a Senior Visiting Scholar at Huck Institutes, PennState. He is also a member of the Project Steering Committee for the One Health programme of the Department of Animal Husbandry and Dairying, Government of India.

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