Swine flu virus in India 'has become more virulent' since 2009 outbreak - MIT study

nce December 2014, swine flu has claimed the lives of over 1,300 people in India, making it the worst outbreak of the virus in the country since 2009. But according to a new study by researchers from the Massachusetts Institute of Technology, the virus that has caused the current epidemic is not the same as the one responsible for the 2009 outbreak; it has acquired mutations that make it more virulent.

The 2014-15 swine flu outbreak is likely to have been caused by a more virulent strain, a new study finds.

The 2009 swine flu outbreak - caused by the H1N1 virus - originated in Mexico, rapidly spreading from country to country. It is estimated that 43-89 million people around the globe became infected with the virus, and between 8,870 and 18,300 deaths were reported as a result. Around 2,700 of these deaths occurred in India.

While the virus has been circulating worldwide ever since, late 2014 saw a major resurgence in India. Since mid-December, it is estimated that the H1N1 virus has infected more than 25,000 people in the country.

The researchers of this latest study - including Prof. Ram Sasisekharan of the Koch Institute for Integrative Cancer Research at the Massachusetts Institute of Technology (MIT) - say that in India, reports have surfaced that the current swine flu outbreak has been caused by a similar virus to the one that caused the 2009 pandemic. However, their research finds this may not be the case.

Amino acid mutations in 2014 virus 'makes it distinct' from 2009 virus

Prof. Sasisekharan and his colleague Kannan Tharakaraman, also of the Koch Institute at MIT, compared the viral proteins of the H1N1 strain responsible for the 2009 outbreak with those of the strain that is currently circulating in India.

The results of the analysis, which are published in the journal Cell Host & Microbe, revealed significant differences between the two strains.

"Examination of the Indian H1N1 flu viruses that circulated in 2014 shows amino acid mutations that make them distinct (in terms of receptor binding, virulence and antigenic drift) from the A/California/07/2009 virus (2009 virus)," explains Prof. Sasisekharan.

Put simply, the team's findings indicate that the virus has evolved in a way that allows it to spread more easily.

As such, the study authors question the effectiveness of the current H1N1 vaccine, claiming it may not have the ability to tackle the most recent strain of the virus. "Effectiveness of the current H1N1 flu vaccine is debatable, and there have been calls for updating the vaccine," adds Prof. Sasisekharan.

The researchers also highlight the lack of scientific information regarding the 2014 swine flu outbreak in India, which they believe has led to conflicting reports about the virus. They point out, for example, that since 2012, a relatively low number of viral sequences from India have been submitted for public analysis.

Based on their findings, the authors call for better assessment and monitoring of the swine flu outbreak in India going forward:

"The influenza outbreak in India should be further examined to determine the virulence and potential threat of the virus. Improved surveillance and monitoring of the influenza outbreak will significantly enhance the options of how best we can manage outreach to both treat as well as prevent spread of the virus."

Medical News Today recently reported on a study published in PLOS Biology, in which researchers claim adults over the age of 30 can only catch the influenza A H3N2 virus twice every 10 years.

Written by Honor Whiteman

Copyright: Medical News Today

Source

Comment: The Government of India has immediately denied this report, and the Director of National Institute of Virology has stated that as per the samples received by them, the said mutations have not been seen in the current epidemic, and it closely resembles the original H1N1 2009 Pandemic virus. The truth will take some time to come out, I believe

Just 2 questions to screen for Mental health & signs of Depression in Teenagers

In a busy clinical practice, it is cumbersome to do a detailed mental health evaluation for every child. This is especially true for teenagers, who while being especially vulnerable to mental health issue are less likely to open up in the short space of time that a typical doctor visit involves.
Here are 2 questions that we can ask every teen to get a simplified overview on whether they require further detailed evaluation for mental health issues, depression, anxiety etc.

1) Over the past 2 weeks, have you ever felt depressed, down, or hopeless?
2) Have you felt little interest or pleasure in doing things?

Source: Transitioning Young women to Adult care - American Society of Obstetrics & Gynecology

India Parent Vaccination FAQ - Missed pneumonia & chicken pox immunization

Q: My daughter age is 4.3 year . My question in vaccine she don't received Pneumococcal and chicken pox vaccine. Now we want this vaccine for our daughter . Is this possible ?

A: She can certainly take the Chicken Pox vaccine. I am not so sure about the need for Pneumococcal vaccines since it primarily works for Pneumonia & ear infections up to the age of 5 years. While there absolutely NO HARM in using the Pneumonia vaccine, it may be of minimal benefit.

PM Modi launches World's Cheapest Rotavirus vaccine - ROTAVAC in India

PTI  |  10 March 2015,NEW DELHI: India today unveiled its indigenously developed and manufactured Rotavirus vaccine, claimed to be the world's cheapest at the rate of around Rs 60 per dose and aimed at boosting efforts to deal with diarrhoea that kills upto 80,000 children under 5 every year.

'Rotavac', launched by Prime Minister Narendra Modi, is the third such vaccine available globally against Rotavirus.

The Bharat Biotech India Limited, which was involved in the development and production of the vaccine, has given an undertaking to keep the cost of the vaccine at $1 (approx Rs 60) per dose, a PMO statement said, adding at the current prices, it will be the cheapest.

The successful launch was the result of an extraordinary effort spread over the last 25 years, it said.

Each year, diarrhoea caused by rotavirus results up to 10 lakh hospitalizations and kills nearly 80,000 children under the age of 5 years.

Modi hoped that the development of the rotavirus vaccine would inspire higher levels of research, development and manufacturing activities in India, not just in medical science, but also in other advanced areas of science and technology.

He felt that solutions found in India would have great relevance to the rest of the world, especially the developing world.

Modi felicitated all the partners in the development of the first indigenous rotavirus vaccine, which involved the complete cycle from basic research to product development of this advanced vaccine in India, a PMO statement said.

He lauded this initiative as an example of India's capabilities for high-end research and development; manufacture of sophisticated pharmaceutical products in India; and, effective Public-Private-Partnership model for finding affordable solutions to societal challenges.

He highlighted the vaccine as a successful example of collaboration between India and the United States in the area of medical research, for the benefit of ordinary citizens.

The vaccine has been developed under an innovative public-private partnership model. It involved partnership between the Ministry of Science and Technology, institutions of the US Government, various government institutions and NGOs in India, supported by the Bill and Melinda Gates Foundation, the PMO statement said.

Funding by the Government of India supported basic research in educational and scientific institutions in India. This was also supplemented by the support of US Government institutions like the National Institute of Health.

The Gates Foundation and Bharat Biotech India Limited contributed towards product development and testing.

Bharat Biotech India Limited that was involved in the development and production of the vaccine was selected in 1997-1998 by the India-US Vaccine Action Programme and the standard government procedures.
Source

Comment: The price of USD 1 is for government supply, while the vaccine is likely to cost 10 times more for private doctors, as per my understanding. However this needs to be confirmed.

Using iphone for Medical Research - its happening now!

SAN FRANCISCO: Apple on Monday unveiled an initiative to help researchers tackle some of the world's most critical medical conditions by gathering data from willing iPhone users.

The plan will use, on a voluntary basis, data from medical tracking apps to aid research on asthma, breast cancer, cardiovascular disease, diabetes and Parkinson's disease.

The move aims "to transform medical research," Apple chief executive Tim Cook said, by gathering real-time data from millions of users.

In collaboration with large medical research centers, Apple will gather data through apps develop for its new ResearchKit platform.

The program may speed up efforts to collect and analyze data by using the iPhone for monitoring user movements, glucose level and other medical information.

The initiative "turns the iPhone into a diagnostic tool," said Jeff Williams, Apple's senior vice president of operations, at a San Francisco media event.

"ResearchKit gives the scientific community access to a diverse, global population and more ways to collect data than ever before."

The program aims to help research by getting more frequent data than is available during conventional research studies, while at the same time protecting privacy.

"Users decide if they want to participate in a study and how their data is shared," Apple said.

To participate in Parkinson's research, for example, users merely walk while the app monitors their movements, or speak into the phone. Diabetes and asthma, meanwhile, can be tracked with devices that connect to the iPhone.

Jan Dawson at Jackdaw Research said the program appears to change the model for medical research.

"In the healthcare space, many companies have tried to use technology to transform key processes, but the focus has been almost exclusively on transforming them from the enterprise out," he said.

"What's unique about Apple's ResearchKit is that it works from the consumer-in. In other words, it empowers consumers rather than healthcare providers and in the process changes the healthcare research model."

The data collected "will provide takes us one step closer to developing more personalized care," said Patricia Ganz, director of cancer research at UCLA's Jonsson Comprehensive Cancer Center.

"Access to more diverse patient-reported health data will help us learn more about long-term aftereffects of cancer treatments and provide us with a better understanding of the breast cancer patient experience."

An asthma monitoring app developed by the Icahn School of Medicine at Mount Sinai and LifeMap Solutions, looks for triggers for the lung disease to help provide personalized treatment.

For Parkinson's -- a progressive neurological disorder than affects movement and speech -- volunteers who download the app and agree to participate in the study will allow for measurement of dexterity, balance and gait, voice and memory at multiple times per day.

"To have a dedicated Parkinson's disease app backed by research that will allow patients to engage with their care and receive feedback on their condition is amazing," said neurologist Ray Dorsey of the University of Rochester, one of the centers working with Apple.

"To make that data in the aggregate available for research is heartening. Five years ago this would have been inconceivable."
Source

India parent FAQ - Missed vaccination - what should a parent do?

Sir,
For my son I forgot to give vaccine of dtwp and dtap first booster during at the time of 18 months . Know his age is 25 months . Should I take that Dtwp and Dtap vaccine know. Please inform. Sir, I am in big confusion.

A: YES, you should give the missed dose as soon as possible.

India's first swine flu diagnostic kit developed

NEW DELHI: The swine flu flare-up has pushed an indigenous innovation faster into the market, a rare silver lining in an otherwise gloomy narrative, as India battles the worst outbreak of the virus in the past five years. The government has approved in February the first India-made swine flu diagnostic kit, developed by Bengaluru-based Molbio Diagnostics, which promises cheaper, faster results with a portable device.

The kit developed by Molbio costs about Rs 850, less than half the price of most imported kits (which sell for about Rs 2,000 to 2,800) while producing equally accurate results, claims Sumit Mitra, marketing manager, global business at Molbio Diagnostics. The one-time hardware cost at Rs 5 lakh is roughly about one-fourth of other imported platforms, he added.

Molbio, a name derived by combining Molecular Biology, is a 50:50 joint venture between Goa-based Tulip Group that makes and sells in-vitro diagnostic reagents, and Bengaluru-headquartered Bigtec Labs that specialises in portable devices that brings 'lab on chip'. The test also makes it possible to deliver results in an hour, much quicker than about six hours or more other tests usually take.

"The turnaround time for tests on other platforms is longer primarily because it is very expensive to carry out a single sample test on their platforms. Usually, the labs wait to collect a minimum number of samples before they run such tests. Our kit makes it economical to run test on each sample separately, one reason why we can promise faster results in case of many infections," explains Mitra. Another reason why reports take longer is because the conventional hardware is usually bulky and installed at a central lab, where all the samples have to be transported.

Mitra says their hardare is much lighter and easier to operate. Their portable device is also designed to take the sample from the patient's bedside, instead of making him or her travel to where the lab is located. At present, India is almost fully dependent on imports for such kits a lion's share coming from Swiss firm Roche Diagnostics and US-based Life Technologies. Sanjiv Vashishtha, chief executive of SRL Ltd, a national diagnostic chain owned by Fortis Healthcare, which has carried out over 20,000 swine flu tests this season, said, "Innovations are always laudable. But at this time, when the stakes are so high, we have to go with a time-tested model, which has been proved to be fully accurate and safe for our clinicians and health workers working with the samples on a round-the clock basis".

On a daily basis, SRL is testing about 1,500 samples and can ramp up the capacity to 2500, if the need arises, he added. Molbio's platform has been technically ready to test the H1N1 virus since 2013 and is currently installed in 40 labs across the country.

"It was early this year, when flu cases soared, we approached the Centre and got the nod from Indian Council of Medical Research and Drug Controller General of India within a few days," Mitra confirmed. However, the challenges for the firm are far from over. Despite central clearances, the labs equipped with Molbio's technology are struggling to convince their respective state governments that they have the permissions to do the tests, Mitra said.
Source