Is there a spurt in infections with some experiencing lingering effects? How real is the haze around an apparent sense of general malaise? If not a Nipah outbreak in Kerala, viruses causing concern in Kolkata or Hyderabad, there are questions that abound today around a vector-borne ailment like dengue elsewhere in the country.
We turned to veteran virologist Dr Gagandeep Kang on what exactly is happening and here is what she has to say: “One of the things that we have been seeing recently in India and gathering from multiple reports is that there is a lot of typhoid around and some of it is extensively drug resistant.” This means cephalosporins (a group of antibiotics usually administered to treat the bacteria causing typhoid fever) do not work. This, she therefore feels, is something that should cause concern and would need monitoring.
Referring to possible challenges it can throw up, Dr Kang, a director-Enterics, Diagnostics, Genomics and Epidemiology, Global Health at the Bill and Melinda Gates foundation, describes the experience of Pakistan, “a few years ago when it witnessed cephalosporins-resistant infections and wound up not being able to treat people with anything oral which meant they had to admit patients in hospitals and administer intravenous antibiotics.”
Other than typhoid, she points to ailments that have a seasonal component to them. Typically, she says, “in the rainy season there are always going to be vector-borne diseases. Bangladesh for instance, has been having a bad year with dengue.”
Chikungunya is another ailment that tends to surface and is usually accompanied by fever that does not last longer than a week but joint pains linger. “There is little bit of chikungunya being reported in the country but dengue is much more prevalent,” she says.
The good doctor who for the past 23 years contributed with her expertise as the professor at the Christian Medical College, Vellore, finds “Malaria to be reasonably under control with not many reported malaria” cases. Therefore, the common causes of fever today, she says, are scrub typhus, typhoid, dengue and chikungunya. What off course cannot be missed is the major
killer in India – tuberculosis- which, she describes as one that “is usually with much longer lasting fever and other associated symptoms.”
For people wanting to know what is happening to them, a crucial first step, she urges, “is to meet a doctor and get the ailment diagnosed with the right kinds of tests.” For instance, she points to a test for typhoid called the Widal test (though not necessarily the best) it checks for antibodies that the body makes against salmonella bacteria that causes typhoid fever. A correct diagnosis, she reminds, is after all, a necessary pre-condition to an appropriate treatment.
For typhoid, a bacterial infection, an important sign to be watched is fever that is not subsiding even after a course of antibiotics as it could then suggest drug resistance. So, are the infections on a rise overall? “No. Infections, if anything, have declined on a longtime scale and the outbreaks in general have become fewer (leave aside the pandemic) and the infectious diseases are not more than what they were earlier,” says the doctor. Always on a look out for data, she says rather categorically that today, “there is no objective data to show any significant increase or change in number of infected cases.
Also, it is not as if hospitals are suddenly getting overwhelmed with a rise in number of patients getting admitted.” Typically, she also cautions that in the monsoon and winter months there are more cases of fever and influenza. So, what is broadly explaining the developments today is a confluence of factors that are both cyclical and triggered by greater awareness. But then she adds: “Of the lot, only typhoid seems an area of concern. Dengue is cyclical, chikungunya comes in different areas at different times.”
There is also today the element of greater awareness among people which possibly is one reason why disease reporting is seeming higher coupled with heightened discussions around ailments.
