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Kerala Student Infected With Nipah

NEW DELHI, June 4: A 23-year-old college student, admitted in a private hospital in Kerala's Ernakulam, has tested positive for the deadly Nipah virus, which killed 17 people in the state last year.

The National Institute of Virology, which tested his blood samples, confirmed the presence of the virus, the government said today.

Four more people, including two nurses, are down with fever and two of them had come in contact with the 23-year-old man. 311 people, among them 22 students, are under surveillance.

"The test results have come from the National Institute of Virology, Pune, and it's positive for Nipah. The health authorities have made elaborate arrangements... NIV authorities will be handing over the medicines that have come from Australia," said Kerala Health Minister KK Shailaja, adding Union Health Minister Harsh Vardhan has assured of full support.

Here are 10 points on the story:

The 23-year-old studied in a college in Thodupuzha in Idukki and had stayed in Thrissur recently. According to Thrissur district medical officer, the student was in Thrissur only for four days and had been suffering from fever. Health officials have started inspecting all the areas where the student visited over the last few days. "Good care is being given to the patient. The patient sometimes becomes restless due to fever... We expect a good result," said KK Shailaja.

"The centre will send monoclonal antibody (medicines) to Kerala. Everything that needs to be done in a scientific manner has been initiated. Nothing to panic," said Harsh Vardhan, adding he is in touch with the Kerala Health Minister. He said the wildlife department has been told to catch bats to test presence of the virus. The centre today sent a six-member team to Kerala.

The medicine, sourced from Australia after the Nipah outbreak last year, is available only with the National Institute of Virology. It was used as a preventive medicine for people who were exposed to the Hendra virus in Australia, which mainly infects large fruit bats (flying foxes) and can be passed on to livestock and people.

The source of the latest Nipah virus outbreak is not known, said KK Shailaja. "We have confidence that we can face it. We have faced it in Kozhikode last year and contained it," said Ms Shailaja.

"The news of confirmation should not be a cause for panic... Stringent action will be taken against those who spread misinformation," the office of Kerala Chief Minister Pinarayi Vijayan tweeted. "We are in constant contact with the Union ministry for Health. A team experts have arrived in Kochi. Their inputs will also inform the efforts to contain the outbreak. Together, we overcame the battle against Nipah in 2018. In this battle also, we are going to prevail," it said.

Nipah virus is transmitted from animals to humans and then spreads through people to people contact. It is associated with fatal encephalitis and respiratory illness. In initial stages, it causes fever, headache, muscle pain, dizziness and nausea. There is no known vaccine against the virus.

As precautionary measures, isolation wards have been set up in three districts - Ernakulam, Thrissur and Kozhikode. "We are prepared with all precautionary measures, especially because we have trained staff from the last outbreak in 2018," said Ms Shailaja.

According to the World Health Organisation, 18 Nipah cases were reported in Kerala last year; 17 of them died. The first death was reported on May 19, 2018. Since then, more than 2,600 contacts were identified and followed up with during the outbreak.

Multi-disciplinary teams - comprising members from the Health Ministry, animal husbandry department, National Centre for Disease Control, AIIMS, Safdarjung Hospital and the Indian Council of Medical Research - were sent to assist the Kerala government after the outbreak.

The last known outbreak in the subcontinent before Kerala last year was in 2004 in Bangladesh. The virus was first identified in 1999 during an outbreak affecting farmers and others in close contact with pigs in Malaysia and Singapore. More than 100 people died in that outbreak that year, and about a million pigs were killed to try to halt its spread.

World not delivering quality maternal health care to poorest mothers: UNICEF

By Deepak Arora

NEW YORK/ VANCOUVER, June 3: More than 5 million families across Africa, Asia, and Latin America and the Caribbean spend over 40 per cent of their non-food household expenses on maternal health services every year, UNICEF said today in a new analysis on maternal health.

Nearly two-thirds of these households, or around 3 million, are in Asia while approximately 1.9 million are in Africa. According to the analysis, the costs of antenatal care and delivery services can deter pregnant women from seeking medical attention, endangering the lives of mothers and their babies.

“For far too many families, the sheer costs of childbirth can be catastrophic. If a family cannot afford these costs, the consequences can even be fatal,” said UNICEF Executive Director Henrietta Fore. “When families cut corners to reduce maternal health care costs, both mothers and their babies suffer.”

The report notes that although much progress has been made around the world in improving women’s access to maternal services, every day over 800 still die from pregnancy-related complications. At least 7,000 stillbirths also occur every day, half of these babies who were alive when labor began, and 7,000 babies die in the first month of life.

The reality is stark for the poorest women. Across South Asia, three times as many rich women receive four or more antenatal care visits than women from poorer families. When it comes to women giving birth at a facility, the gap between the poorest and the richest is more than double in West and Central Africa.

Doctors, nurses and midwives play a critical role in saving mothers, yet millions of births occur every year without a skilled attendant. According to the analysis, from 2010 to 2017, the coverage of health personnel increased in many countries. However, the increase in coverage has been minimal in the poorest countries where maternal and neonatal mortality levels were the highest. For example, from 2010 to 2017, coverage increased from 4 to 5 health workers per 10,000 people in Mozambique, and from 3 to 9 in Ethiopia. In Norway that number increased from 213 to 228 health personnel per 10,000 people over the same period.

The report also notes that globally, pregnancy-related complications are the number one cause of death among girls between 15 and 19 years of age. Because adolescent girls are still growing themselves, they are at great risk of complications if they become pregnant. In addition, their children are at higher risk of dying before their fifth birthday. Yet the report finds that child brides are less likely to receive proper medical care while pregnant or to deliver in a health facility, compared to women married as adults.

Typically, child brides end up having many children to care for, often more than women who marry as adults, thwarting their own life chances while increasing the overall financial burden on their families. In Cameroon, Chad and the Gambia, over 60 per cent of girls aged 20-24 who married before turning 15 had three or more children, compared to less than 10 per cent of women at the same age who married as adults.

“We are failing to deliver quality care to the poorest and most vulnerable mothers,” said Ms. Fore. “Too many mothers continue to suffer endlessly, especially during childbirth. We can stop this suffering and save millions of lives with a safe pair of hands, functional facilities and better quality of care before, during and after their pregnancy.”

UNICEF’s Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns, is calling on governments, health care providers, donors, the private sector, families and businesses to keep every mother and child alive by:

1. Investing financial resources in health systems, starting at the community level;
2. Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;
3. Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;
4. Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and
5. Empowering adolescent girls and families to demand and receive quality care.

 


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