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Subject: Biotech and Medical Sciences

  • What is a Pandemic and various other terms?

    What is the news: The World Health Organization (WHO) has declared the COVID-19 outbreak a pandemic.

    What is a pandemic?

    • Simply put, a pandemic is a measure of the spread of a disease.
    • When a new disease spreads over a vast geographical area covering several countries and continents, and most people do not have immunity against it, the outbreak is termed a pandemic.
    • It implies a higher level of concern than an epidemic, which the US Centers for Disease and Control Prevention (CDC) define as the spread of a disease in a localised area or country.
    • There is no fixed number of cases or deaths that determine when an outbreak becomes a pandemic.
    • The Ebola virus, which killed thousands in West Africa, is an epidemic as it is yet to mark its presence on other continents.
    • Other outbreaks caused by coronaviruses such as MERS (2012) and SARS (2002), which spread to 27 and 26 countries respectively, were not labelled pandemics because they were eventually contained.

    Which outbreaks have been declared pandemics in the past?

    • A major example is the Spanish flu outbreak of 1918, which killed between 20-50 million.
    • Cholera pandemics have been declared multiple times between 1817 and 1975.
    • In 1968, a pandemic was declared for H3N2 that caused about a million deaths.
    • The last pandemic declared by the WHO was in 2009, for H1N1.

    Does the declaration change the approach to the disease?

    • Describing the situation as pandemic does not change WHO’s assessment of the risk posed by the virus. However, the categorization as a pandemic can lead to more government attention.
    • The categorization by WHO indicates the risk of disease for countries to take preventive measures.
    • It will help improve funding by international organisations to combat coronavirus.

    Difference Between Endemic, Epidemic, Outbreak and Pandemic:

    • AN EPIDEMIC is a disease that affects a large number of people within a community, population, or region.
    • A PANDEMIC is an epidemic that’s spread over multiple countries or continents.
    • ENDEMIC is something that belongs to a particular people or country.
    • AN OUTBREAK is a greater-than-anticipated increase in the number of endemic cases. It can also be a single case in a new area. If it’s not quickly controlled, an outbreak can become an epidemic.

    Epidemic vs. Pandemic

    • A simple way to know the difference between an epidemic and a pandemic is to remember the “P” in the pandemic, which means a pandemic has a passport. A pandemic is an epidemic that travels.

    Epidemic vs. Endemic

    • An epidemic is actively spreading; new cases of the disease substantially exceed what is expected.
    • More broadly, it’s used to describe any problem that’s out of control, such as “the opioid epidemic.”
    • An epidemic is often localized to a region, but the number of those infected in that region is significantly higher than normal.
    • For example, when COVID-19 was limited to Wuhan, China, it was an epidemic. The geographical spread turned it into a pandemic.
    • Endemics, on the other hand, are a constant presence in a specific location.
    • Malaria is endemic to parts of Africa. Ice is endemic to Antarctica.

    Endemic vs. Outbreak

    • Going one step farther, an endemic can lead to an outbreak, and an outbreak can happen anywhere.
    • Last summer’s dengue fever outbreak in Hawaii is as an example. Dengue fever is endemic to certain regions of Africa, Central and South America, and the Caribbean. Mosquitoes in these areas carry dengue fever and transmit it from person to person.
    • But in 2019 there was an outbreak of dengue fever in Hawaii, where the disease is not endemic. It’s believed an infected person visited the Big Island and was bitten by mosquitoes there.
    • The insects then transferred the disease to other individuals they bit, which created an outbreak.

    You can see why it’s so easy to confuse these terms. They’re all related to one another and there’s a natural ebb and flow between them as treatments become available and measures for control are put in place — or as flare-ups occur and disease begins to spread.

  • Genome sequencing of Coronavirus

    Scientists across the world are trying to develop a line of treatment and a possible vaccine for COVID-19. However, with the most optimistic timelines we don’t see a line of treatment or vaccine arriving before next year.

    Genome sequencing of Coronavirus

    • A global effort is on to collect and analyse the genetic composition of the new virus, which would be key to developing a cure and a vaccine.
    • Genome sequence is the unique code of genetic material of any organism, and determines the characteristic of any organism.
    • Whole genome sequencing is the process of determining the complete DNA sequence of an organism’s genome at a single time.
    • The gene composition of novel coronavirus, for instance, is different from that of the influenza virus. Every organism has a unique genome sequence.
    • Laboratories in various countries have been isolating and sharing the genome sequences of the virus on an international platform.

    Why are so many genome sequences being isolated?

    • When viruses multiply, or reproduce, there is a copying mechanism that transfers the gene information to the next generation.
    • However, no copying mechanism is perfect. When the virus multiplies, there will be small changes, which are called mutations.
    • These mutations accumulate over time, and after prolonged periods, are responsible for evolution into new organisms.
    • Within a single reproduction, the changes are extremely minor. More than 95 per cent of the gene structure remains the same.

    How it helps scientists?

    • However, the small changes that occur are crucial to understanding the nature and behaviour of the organism.
    • In this case, for example, the small changes could provide scientists with information about the origin, transmission, and impact of the virus on the patient.
    • It could also hold clues to the differing effects the virus could have on patients with different health parameters.

    How many genome sequences are required?

    • India has far fewer positive cases compared to China, South Korea, Iran, Italy, or even the US.
    • Patients who have been infected with the virus in similar conditions are unlikely to show any significant changes in the genome sequences.
    • Patients with existing medical conditions could be other candidates from where genome sequences of this virus could be isolated.
    • This could help scientists to look for clues to possible impact of virus amidst those existing medical conditions.

    Currently, what is the most effective medication?

    • As of now, there is none such. Right now, drugs are being repurposed, meaning old drugs for similar diseases are being checked for their efficacy against COVID-19.
    • These drugs, if they work, will require clinical trials, and then can be made widely available for people.
    • In most cases, symptomatic treatment for fever, body ache, and cough will be sufficient. More severe cases will require oxygen and respiratory support.

  • N95 Mask

    In a new mandate to curb unnecessary demand, the Maharashtra Food and Drug Administration said that chemists cannot sell N95 masks without a doctor’s prescription. The FDA also warned that serious action would be taken against those who are found selling masks at high prices or hoarding them.

    Why such a move?

    • Personal Protective Equipment (PPE) kits and N95 masks are being sold at very high prices in medical shops. The State has received many complaints about the same.
    • It has also been found that many are making bulk purchases and hording PPE kits and N95 masks.
    • Since the COVID-19 outbreak in China, shortage of PPE gear and masks has been reported from across the world.
    • While the Indian government has currently banned exports of N95 masks, the manufacturers are focussed on making other surgical marks to get good returns from exports.

    N95 mask

    • A disposable N95 mask (respirator) is a safety device that covers the nose and mouth and helps protect the wearer from breathing in some hazardous substances.
    • An N95 respirator is designed to achieve a very close facial fit and very efficient filtration of airborne particles.
    • The ‘N95’ designation means that when subjected to careful testing, the respirator blocks at least 95 percent of very small (0.3 micron) test particles.
    • If properly fitted, the filtration capabilities of N95 respirators exceed those of face masks. However, even a properly fitted N95 respirator does not completely eliminate the risk of illness or death.

  • [pib] ICoSDiTAUS-2020

    ICoSDiTAUS-2020 a two-day International Conference on Standardisation of Diagnosis and Terminologies in Ayurveda, Unani and Siddha systems of Medicine was concluded in New Delhi.

    ICoSDiTAUS-2020

    • The conference was jointly organized by the Ministry of AYUSH and the WHO at New Delhi
    • It adopted the “New Delhi Declaration on Collection and Classification of Traditional Medicine (TM) Diagnostic Data”.
    • The New Delhi declaration emphasised the commitment of the countries to Traditional Medicine (TM) as a significant area of health care.
    • It further sought the opportunity for including traditional systems of medicine like Ayurveda, Unani and Siddha in the International Classification of Diseases (ICD) of WHO which is the standard diagnostic tool for health management across the world.

  • Explained: One Health Concept

     

    The concept of ‘One Health’ is gaining importance as most of the contagious diseases affecting humans are zoonotic (animal to man origin) in nature. It can be effectively implemented for reducing incidence of emerging zoonotic threats like COVID-19.

    The One Health concept

    • The World Organization of Animal Health, commonly known as OIE (an abbreviation of its French title), summarizes the One Health concept.
    • It says that as “human health and animal health are interdependent and bound to the health of the ecosystems in which they exist”.
    • Circa 400 BC, Hippocrates in his treatise On Airs, Waters and Places had urged physicians that all aspects of patients’ lives need to be considered including their environment; disease was a result of imbalance between man and environment.
    • So One Health is not a new concept, though it is of late that it has been formalized in health governance systems.

    Why accept this model?

    • Of the contagious diseases affecting humans, more than 65% are of zoonotic or animal to man origin.
    • One Health model is a globally accepted model for research on epidemiology, diagnosis and control of zoonotic diseases.
    • One Health model facilitates interdisciplinary approach in disease control so as to control emerging and existing zoonotic threats.
    • Increasing stress on animals due to loss of their habitat would increase scope of zoonotic diseases.

    Why corona is so deadly?

    • Current outbreak of COVID-19 still could not find out the actual source of virus.
    • Even though genomics of the virus has been published ambiguity still exists whether it was from bats, snakes, pangolin, etc.

    Frequent Outbreaks of Zoonotic Diseases

    • Not so long ago, the widespread prevalence of avian influenza in poultry, or bird flu as it commonly became known, created nationwide panic resulting in the culling of millions of poultry birds.
    • It was concern for human health that prompted the extreme reaction and subsequent establishment of protocols; containment of avian influenza is managed quite effectively now.
    • Similarly in 2003, SARS or Severe Acute Respiratory Syndrome emanated suddenly in China and vanished soon.

    Followed by hues and panic

    • These outbreaks culminated emergency response that included extreme measures like travel bans and restrictions.
    • In both cases, panic spread much faster than the virus.
    • Besides drawing a response from governments, these events also brought forth the hitherto forgotten philosophy of One Health.
    • This idea recognizes inter-connectivity among human health, the health of animals, and the environment.

    Why rise in zoonotic outbreaks?

    • As human populations expand, it results in greater contact with domestic and wild animals, providing more opportunities for diseases to pass from one to the other.
    • Climate change, deforestation and intensive farming further disrupt environment characteristics, while increased trade and travel result in closer and more frequent interaction, thus increasing the possibility of transmission of diseases.

    Need for a robust animal health system

    • Private sector presence in veterinary services is close to being nonexistent.
    • Unlike a physician, a veterinarian is always on a house call on account of the logistic challenge of transporting livestock to the hospital, unless they are domestic pets.
    • There could not be a stronger case for reinventing the entire animal husbandry sector to be able to reach every livestock farmer, not only for disease treatment but for prevention and surveillance to minimize the threat to human health.
    • Early detection at animal source can prevent disease transmission to humans and introduction of pathogens into the food chain. So a robust animal health system is the first and a crucial step in human health.

    Conclusion

    • Developing countries like India have a much greater stake in strong One Health systems on account of agricultural systems resulting in uncomfortably close proximity of animals and humans.
    • This builds a strong case for strengthening veterinary institutions and services.
    • Further delay may pave way for emergence of new communicable diseases.

    Way Forward

    • The most effective and economical approach is to control zoonotic pathogens at their animal source.
    • It calls not only for close collaboration at local, regional and global levels among veterinary, health and environmental governance, but also for greater investment in animal health infrastructure.
    • Need of the hour is to scale up such a model across the country and to establish meaningful research collaborations across the world.
    • Health, veterinary, agriculture and life science research institutions and universities can play a lead role.

  • Remdesivir: Under-trail vaccine against Coronavirus

    The Wuhan Institute of Virology at Wuhan, China has filed for a patent on Remdesivir, an antiviral experimental drug from the US which may help treat the novel coronavirus (nCoV-2019).

    Remdesivir

    • It is an experimental drug and has not yet been licensed or approved anywhere globally. It has not been demonstrated to be safe or effective for any use.
    • It is currently being developed for the treatment of Ebola virus infection.
    • Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro.
    • Chloroquine is a “widely used” anti-malarial and autoimmune disease medicine that has recently come to light as a potential antiviral drug.

    Can Remdesivir treat coronavirus?

    • Significantly, Remdesivir has demonstrated in vivo (experimentation using a whole living organism) and in vitro (activity performed in a controlled environment) activity in animal models against viral pathogens that cause MERS and SARS.
    • Even so, the use of the experimental drug has been allowed only as an emergency treatment, which can be administered in the absence of any other approved treatment options.
    • These two diseases are also caused by coronaviruses structurally similar to the nCoV-2019.
    • Additionally, limited clinical data is available from the emergency administration of Remdesivir in patients with Ebola.
    • Even so, it is yet to be seen if Remdesivir and chloroquine can be effective against the novel coronavirus in humans.

    How can the novel coronavirus infection be treated?

    • As of now, there is no known treatment for the novel coronavirus, and an appropriate antiviral drug is required for this.
    • Ideally, a vaccine against the infection can also prove to be effective, but such a development does not seem to be in the offing for at least three-four months.

  • [pib] Classical Swine Fever (CSF) Cell Culture Vaccine

    Department of Agricultural Research and Education (DARE) released the Classical Swine Fever Vaccine (IVRI-CSF-BS) Technology developed by ICAR -Indian Veterinary Research Institute (IVRI).

    About the Vaccine

    • CSF is one of the most important diseases of pigs causing high mortality with annual loss of approx. Rs.4.299 billion.
    • A lapinized CSF vaccine (Weybridge strain, UK) is being used in India since 1964 for controlling the disease.
    • The vaccine is produced by sacrificing large numbers of rabbits for each batch.
    • In order to do away sacrificing of rabbits and increase the productivity, IVRI had earlier developed a cell culture CSF vaccine by adapting the lapinized vaccine virus in cell culture.
    • The vaccine virus has very high titre and lakhs of doses can be produced very easily in cell culture and country’s requirement can be easily fulfilled using this new vaccine.

  • [op-ed of the day] A sneeze, a global cold and testing times for China

    Context

    The World Health Organization (WHO) has declared the coronavirus outbreak a global emergency, as the outbreak continues to spread outside China.

    Coronavirus outbreak and Chinese response

    • What is coronavirus? Normally, coronavirus is a large family of viruses that are often the source of respiratory infections, including the common cold.
      • A small number of common infecting virus: Most of the viruses are common among animals and only a small number of them infect humans.
      • Mutation of animal base virus: Sometimes, an animal-based coronavirus mutates and successfully finds a human host.
    • Dangers of rapid urbanisation: Rapid urbanisation that forces animals and humans into closer proximity (as in the “wet market” in Wuhan) creates a perfect petri dish from where such zoonotic outbreaks can originate.

    Concern for India

    • Reported case in Nepal and cause of concern for India: For India, the most critical is cases being reported in Nepal since India and Nepal share an open border though so far.
    • All tests undertaken in India have been negative.
    • A tweet by the Ministry of Health and Family Welfare on January 30 said that one positive case of a novel coronavirus patient

    Understanding the new virus

    • The possible mode of transmission: According to the World Health Organization, during previous outbreaks due to other coronavirus, human-to-human transmission occurred through droplets, contact and fomites (objects or materials which are likely to carry infection, such as clothes, utensils, and furniture).
    • This suggests that the transmission mode of the 2019-nCoV can be identical.
    • The transmission even in incubation period: More significant is the new understanding that the virus is contagious even during incubation, that is even before a patient exhibits any symptoms.
      • This characteristic amplifies

    Experience from the past outbreaks

    • Comparison with SARS: Comparisons are being drawn the Severe Acute Respiratory Syndrome) outbreak in 2002-03.
      • Zoonotic case: SARS is also a zoonotic case, part of the coronavirus family with clues pointing to horseshoe bats in China as the likely source.
      • Late reporting by China in SARS:
      • The first incidents were reported in Guangdong province in November 2002 but WHO was officially informed only after three months.
    • Different response this time: Comparison with SARS: Comparisons are being drawn the Severe Acute Respiratory Syndrome) outbreak in 2002-03.
      • Zoonotic case: SARS is also a zoonotic case, part of the coronavirus family with clues pointing to horseshoe bats in China as the likely source.
      • Late reporting by China in SARS: The first incidents were reported in Guangdong province in November 2002 but WHO was officially informed only after three months.
      • Different response this time: This time around, the Chinese government has been more open but the question being asked is whether it has been open enough?
      • The difference in time to develop vaccine: For SARS, it took 20 months from the genome sequencing to the first human vaccine trials; for the 2019-nCoV, authorities in the U.S. are working on a deadline of 90 days.

    Lessons from Kerala in Nipah outbreak

    • Managing an outbreak with few casualties: Kerala managed to curtail the Nipah outbreak with few casualties.
      • Nipah is also zoonotic and made the jump from fruit bats to humans.
      • Though there were 17 deaths in India, effective quarantine measures by local authorities prevented the spread.
    • Infectious disease on the rise: Infectious diseases including those of the zoonotic variety are on the rise in India.
      • In addition, regions in India suffer from seasonal outbreaks of dengue, malaria and influenza strains.
      • The nation-wide disease surveillance programme needs to be strengthened.

    Conclusion

    India should brace itself for the possible outbreak of infectious diseases and frame policies to deal with such outbreaks in fast and effective ways.

  • Why China has emerged as the epicentre of global outbreaks of disease?

    Several deadly new viruses in recent years have emerged in China — Severe Acute Respiratory Syndrome (SARS), bird flu, and now the novel Coronavirus (nCOV).

    Zoonotic infections

    • Closely packed stalls in busy marketplaces, the Chinese taste for exotic meats, and the high population density of cities create the conditions for the spread of zoonotic infections.
    • The reason could lie in the busy food markets dotting cities across the country — where fruits, vegetables, hairy crabs and butchered meat are often sold next to bamboo rats, snakes, turtles, and palm civets.
    • The relationship between zoonotic pathogens and global pandemics are not new.
    • The WHO estimates that globally, about a billion cases of illness and millions of deaths occur every year from zoonoses, i.e, diseases and infections naturally transmitted between people and vertebrate animals.
    • Some 60% of emerging infectious diseases globally are zoonoses. Of the over 30 new human pathogens detected over the last three decades, 75% originated in animals.

    Major cause: Animal markets

    • In animal markets, there are greater chances of transmission of a virus from animals to humans, and its mutation to adapt to the human body.
    • It has happened wherever in the world there is unregulated mixing of humans and animals, either wild or domesticated.
    • The official referred to the Ebola outbreak in Africa there it was wild chimpanzees who had the disease. It came into humans after these were killed and consumed.

  • Corona Virus

     

    Chinese scientists have confirmed can spread between human beings.

    Corona Virus

    • Corona viruses are large family of viruses, which cause illnesses to people and also circulate in animals including camels, cats and bats.
    • They cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome.
    • 2019-nCoV is a new strain that has not been previously identified in humans.
    • Much remains to be understood about the new coronavirus, which was first identified in China earlier this month.
    • Not enough is known about 2019-nCoV to draw definitive conclusions about how it is transmitted, clinical features of disease, or the extent to which it has spread. The source also remains unknown.

    Why is it called the Wuhan Virus?

    • The first cases emerged in Wuhan in central China’s Hubei province.
    • On December 31 last year, authorities confirmed that a large number of patients with unexplained pneumonia were admitted in hospitals in the city.

    Symptoms of infection

    • According to the WHO, common signs include fever, cough, and shortness of breath. Serious infections can lead to pneumonia, kidney failure, and death.
    • Although human-to-human transmission has now been confirmed, the WHO says animals are the outbreak’s likely primary source. It is not known yet which animals are responsible.
    • To prevent the spread of all respiratory infections, the WHO in general asks people to cover their mouths and noses when coughing or sneezing, and to frequently wash their hands.
    • Direct contact with farm or wild animals should be avoided — similar outbreaks in the past, like the Severe Acute Respiratory Syndrome (SARS) emerged from markets where people were in contact with live animals.

    Why is there concern around the world?

    • People see a similarity with the SARS outbreak that infected over 8,000 people and killed around 775 in more than 35 countries worldwide in 2002-03.
    • SARS too, was caused by a mystery coronavirus, and started in China.
    • The source of the virus remained unknown for 15 years, until Chinese scientists in 2017 traced it back to a colony of horseshoe bats living in remote cave in Yunnan province.
    • The virus was carried by civet cats which are sold in markets in China.
    • Fears that SARS could reappear and memories of China misleading the rest of the world on the extent and seriousness of the outbreak have not gone away.