Thursday, November 03, 2016

Best way to spread Infectious diseases !

 Today morning  I was having a telephone talk with an old friend of mine in Hyderabad Telangana  India ( I will explain why I am giving the specific geographic location).
Infectious pathogens do not respect country borders, and therefore some disease outbreaks are not solely the concern of the “index” country—intensified global public health response may become essential.
( this was made so clear to me  when I was  searching  for measles in Hyderabad ( without putting telangana in the search box)  I came  across  a number  of reports of  measles deaths  in Hyderabad ,Pakistan
My daughter and  2 grand kids are on an extended vacation in India
 3days ago I got a call from her saying my grandson has measles and that they may have to postpone their return to USA.

I mentioned this to my friend who said he was not aware of any increased measles incidence in the city.When I told him to look up the Deccan Chronicle article published yesterday,his response was  "DC is an opposition news paper they will print anything to defame the Government".
I was in a hurry to reach my work so I did not have  a longer conversation.
So when I had  some  free time at work as one of the  patients cancelled  I started with this post .while searching  I came across another  article  from  Deccan chronicle.
I have theses questions.I would like some answers.

1) If isolation  of  people with infections is a good idea  isn't congregations  like this are the best way to spread those  infectious diseases?
2) How come  we still have  only the one fever/ID hospital  for the state  which was built by a former ruler of Hyderabad  state. What was being done about this all theses  60 + years  of independent  Indian rule?
3) What happened  to preventive medicine ? why do we have  so many diarrhea cases  are we not teaching  our children  the basics of  cleanliness. when I was in school  55 years ago  we had  a lesson on  keeping  one clean  how to keep surroundigs clean  and  how to avoid contaminating  ground water  etc.
Now we talk of high technology and  indian space program. What has happened to clean drinking water and  pollution  free air  and  effective vaccinations.
4) How good is the coldchain  mangement  in India when  vaccinations  are given on a massive scale?
5)  As my grandson was vaccinated  in USA I could possibly assume proper cold chain management  so  what is the  effectiveness of MMR?
here is an article  on  MUMPS vaccine effectiveness

Evaluation of Mumps Vaccine Effectiveness by outbreak investigation in one kindergarten in Ulsan city, 2006.  
http://www.koreamed.org/SearchBasic.php?RID=0073KJE/2008.30.1.110&DT=1

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(2 Aug) Hyderabad: More than 1,500 out-patients were treated at Fever Hospital on Monday complaining about diarrhoea, viral fevers, typhoid fever, diphtheria and mumps. Of these 22 cases were of dog bites including largely children from the age-group of 5 years to 10 years. According to doctors most of the dog bite cases were from Ranga Reddy, Mahbubnagar and Nalgonda districts surrounding the city. Fever Hospital superintendent Dr K. Shanker said, "Due to the rainy season we are seeing 500 to 700 patients every day in the out-patient department. On Monday, the number was the highest. Earlier we have had 1,000 patients in the out-patient department."Of these patients, admissions were 15 as they required hospitalisation. A senior doctor said, "Six of the patients had severe gastro-intestinal problems, two were suffering from typhoid fever, two from diphtheria and one from mumps. The others came in a critical stage and their diagnostic tests are going to confirm the disease later." The cases of diarrhoea were from L.B. Nagar, Rajendranagar and Musheerabad while the typhoid fever is from Nalgonda district and diphtheria and mumps are from surrounding Ranga Reddy areas. In July, there were 30 cases of diphtheria, 15 cases of dengue, 20 cases of dog bites, ( once again my favourite topic) 10 cases of mums and measles and also nine cases of cholera reported in the hospital.



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