India: More Cases of Antibiotic Resistance Tuberculosis

Of the 40 000 tuberculosis (TB) cases recorded in the city [Mumbai, Maharashtra state] in 2013, more than 4000 patients were relapse cases, according to civic health department data. The count of relapse cases has remained constant over the last few years -- an indicator of the poor living conditions and of the hurdles in the treatment regime followed in public hospitals. According to estimates, the actual count of relapse cases may be higher, as not all private hospitals are accounted for by the civic health department.

Over the last 3 years, the count of multi drug resistant (MDR) and extensively drug resistant (XDR) TB cases has noticeably increased. From 181 new patients diagnosed with MDR TB and 288 already receiving treatment for it in 2011, the figure rose to 2195 new patients diagnosed with MDR TB and 1935 on treatment in 2012. In 2013, a whopping 2903 patients were diagnosed with MDR TB and 2604 were on treatment.

Dr Minnie Khetarpal, BMC's TB control officer, said, "Though MDR cases are rising, patients receive 2nd-line treatment. But in XDR cases, patients respond to very few drugs. Currently, Bedaquilin is considered a wonder drug, but is under clinical trials in India." The drug, which has been used on 5 patients in Mumbai, is being imported from Belgium.

Bedaquiline was described for the first time in 2004  One of the first published trials of Bedaquiline was a Phase II trial of 47 patients, which showed that the drug was effective in reducing the time to TB-free sputum cultures

It is manufactured by Johnson & Johnson (J&J), who sought accelerated approval of the drug, a type of temporary approval for diseases lacking other viable treatment options. By gaining approval for a drug that treats a neglected disease, J&J is now able to request expedited FDA review of a future drug

It was formally approved for use by the U.S. Food and Drug Administration (FDA) for use in tuberculosis (TB) treatment, as part of a fast-track approval for use only in cases of multidrug-resistant tuberculosis, and the more resistant extensively drug resistant tuberculosis.

There is some controversy over the approval for the drug, as the FDA's ruling was based on a surrogate outcome (sputum cultures) as opposed to patient deaths. In the clinical trials used for approval, the patients taking bedaquiline were more likely to die, even though they had resolution of TB based on sputum cultures. The most common side effects of bedaquiline in studies were nausea, joint and chest pain, and headache. The drug also has a black-box warning for arrhythmias.

1/24/14 Health News: Green Tea Impedes Blood Pressure Medication - 5 Min. Test Identifies Exposure to Second Hand Cigarette Smoke - India Polio Free

’Green Tea 'Can Impede Nadolol Blood Pressure Medicine'

Green tea can weaken the effects of a commonly prescribed blood pressure pill, experts warn. Japanese researchers found the herbal drink blocks special cell transporters that normally help the body absorb the beta-blocker medicine. In tests, people who drank green tea alongside taking their tablets ended up with lower circulating blood levels of the drug nadolol. Experts say consumers need to be aware of this interaction.continue reading

Five Minute Saliva Test to Identify Smokers Rolled Out to Health Schemes, UK

Smokers who need extra incentives to quit the cigarettes this new year should take note that even private health insurance premiums may be reduced if they can prove they have stopped for good - and with the aid of a pioneering test from the University of Birmingham, the proof can be easy to acquire. The Saliva SmokeScreen test is part of the PruHealth free Vitality Healthcheck programme to verify non-smoking in their policy holders, so they can qualify for its unique non-smoker cash back reward. The saliva test, which was developed by Dr Graham Cope continue reading

1.2 Billion Reasons to Celebrate: India Set To Be Polio-free

This is a landmark achievement for global public health and the worldwide effort to eradicate polio. India, which once had the highest number of polio cases in the world, is now polio-free, an achievement reports say the World Health Organisation will certify in February. But it's been a long road to get here. With poor sanitation, densely populated areas and large numbers of people living in extreme poverty, northern states like Uttar Pradesh and Bihar were the 'perfect storm' when it came to the spread of polio. And without the vital collaboration between the Indian government and the global polio eradication initiative – a partnership among Rotary International, Unicef, WHO and the US Centre for Disease Control and Prevention – this may not have been possible.continue reading

12/3/13 Health News: Drug Resistance Law Proposed, Herbal Supplements Contain No Herbs, India Running Out of Water

India's Running Out of Water For Agriculture

India is now the world's third-largest grain producer after China and the United States. The adoption of higher-yielding crop varieties and the spread of irrigation have led to this remarkable tripling of output since the early 1960s. Unfortunately, a growing share of the water that irrigates three-fifths of India's grain harvest is coming from wells that are starting to go dry. This sets the stage for a major disruption in food supplies for India's growing population continue reading

Herbal Supplements Are Often Not What They Seem

Not-So-Herbal Supplements: A study using DNA testing offers perhaps the most credible evidence to date of adulteration, contamination and mislabeling in the herbal supplement industry.

Americans spend an estimated $5 billion a year on unproven herbal supplements that promise everything from fighting off colds to curbing hot flashes and boosting memory. But now there is a new reason for supplement buyers to beware: DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds.continue reading

US Rep. Louise Slaughter Discusses Antibiotic Resistance

About 80 percent of all antibiotics distributed in the U.S. are for food animals. They're commonly used to promote growth and to prevent, control and treat disease. Overuse can promote the prevalence of antibiotic-resistant bacteria in the food supply and ultimately cause resistant infections in humans. In September, the U.S. Centers for Disease Control and Prevention released a report noting that, although the majority of drug-resistant infections.continue reading

Malaria Cases in U.S.Reach 40-Year High

Increase underscores importance of taking recommended medicines to prevent malaria when traveling

In 2011, 1,925 malaria cases were reported in the United States, according to data published in a supplement of the Morbidity and Mortality Weekly Report (MMWR) released today by the Centers for Disease Control and Prevention (CDC). This number is the highest since 1971, more than 40 years ago, and represents a 14% increase since 2010. Five people in the U.S. died from malaria or associated complications.

Almost all of the malaria cases reported in the U.S. were acquired overseas. More than two-thirds (69%) of the cases were imported from Africa, and nearly two-thirds (63%) of those were acquired in West Africa. For the first time, India was the country from which the most cases were imported. Cases showed seasonal peaks in January and August.

“Malaria isn’t something many doctors see frequently in the United States thanks to successful malaria elimination efforts in the 1940s,” said CDC Director Tom Frieden, M.D, M.P.H. “The increase in malaria cases reminds us that Americans remain vulnerable and must be vigilant against diseases like malaria because our world is so interconnected by travel.”

Malaria is caused by a parasite transmitted by the bite of an infective female Anopheles mosquito. In 2010, it caused an estimated 660,000 deaths and 219 million cases globally. The signs and symptoms of malaria illness are varied, but the majority of patients have fever. Other common symptoms include headache, back pain, chills, increased sweating, muscle pain, nausea, vomiting, diarrhea, and cough. Untreated infections can rapidly progress to coma, kidney failure, respiratory distress, and death.

“Malaria is preventable. In most cases, these illnesses and deaths could have been avoided by taking recommended precautions,” said Laurence Slutsker, M.D., M.P.H., director of CDC’s Division of Parasitic Diseases and Malaria. “We have made great strides in preventing and controlling malaria around the world. However, malaria persists in many areas and the use of appropriate prevention measures by travelers is still very important.”

Travelers to areas with malaria transmission can prevent the disease by taking steps such as use of antimalarial drugs, insect repellent, insecticide-treated bed nets, and protective clothing.

Travelers in the United States should consult a health-care provider prior to international travel to receive needed information, medications, and vaccines. CDC provides advice on malaria prevention recommendations on-line (http://www.cdc.gov/malaria/travelers/drugs.html). If a traveler has symptoms of malaria, such as fever, headaches, and other flu-like symptoms, while abroad or on returning home, he or she should immediately seek diagnosis and treatment from a health-care provider.

Clinicians should consult the CDC Guidelines for Treatment of Malaria and contact CDC’s Malaria Hotline for case management advice, as needed. Malaria treatment recommendations can be obtained online (http://www.cdc.gov/malaria/diagnosis_treatment) or by calling the Malaria Hotline (770-488-7788 or toll-free at 855-856-4713).

Source CDC

India: Anthrax scare in Urigam Reserve Forests

The Karnataka Forest Department is on ‘high alert’ following the death of an eight-year-old Elephant suspected of anthrax, at Urigam reserve forests in Tamil Nadu on Monday last.

Principal Chief Conservator of Forests G S Prabhu said that the Cauvery Wildlife Sanctuary is situated adjacent to Krishnagiri Forests of Tamil Nadu and this was one of the major worries for them. Officers concerned had been asked to intensify patrolling within the sanctuary as well as to have an eye on elephants.

He said the Department of Veterinary Sciences has agreed to vaccinate cattle for anthrax in villages all along the sanctuary border after 8-10 days as they had vaccinated them for foot and mouth disease recently.

The forest officials have sealed all entry points for cattle into the sanctuary as a precautionary measure. Villagers have also been asked not to enter forests, he added.

Prabhu said the surveillance units are kept on high alert and the department has taken all precautionary steps to make sure that the disease doesn't spread to wild animals in the Cauvery Wildlife sanctuary. “We are closely monitoring the situation and we will take appropriate steps regularly.”

Anthrax is a disease caused by the bacterium Bacillus Anthracis. Most forms of the disease are lethal and it affects both humans and animals. It commonly infects wild and domesticated herbivorous mammals that ingest or inhale the spores while grazing. Carnivores living in the same environment may become infected by consuming infected animals. Diseased animals can spread anthrax to humans, either by direct contact or by consumption of a diseased animal’s flesh.

The vaccine is only given to at risk individuals and animals. Anthrax can be cured by a 60 day treatment with antibiotics.

Source Express News Service

California Finds the 17th Candy Contaminated with Lead in 2013

California Department of Public Health (CDPH) warns consumers not to eat three santos brand Rewadi and Sesame Candies imported from India

Dr. Ron Chapman, director of the California Department of Public Health (CDPH) and state health officer, today warned consumers not to eat three candies imported from India after tests conducted by CDPH found the products contained levels of lead that exceeded the state’s standards. Consumers in possession of these candies should discard them immediately.

The three candies are:

• Santos Rewadi Gur (7- and 14-ounce packages)

• Santos Sugar Rewadi  (2 lb. package)

• Santos Sesame Candy (2 lb. package)

CDPH determined that Santos Rewadi Gur, Santos Sugar Rewadi, and Santos Sesame Candy, contained as much as 0.31 parts per million (ppm) of lead. Both California and the FDA  considers candies with lead levels in excess of 0.10 ppm to be contaminated.

These candies are imported and distributed by Santos Inc., of San Leandro, California.  Santos Inc. has initiated a voluntary recall of the candy and is currently working to ensure the product is removed from the marketplace.

Pregnant women and parents of children who may have eaten these candies should consult their physician or health care provider to determine if medical testing is needed.

Including these three candies the CDHP has found 17 candys with too much lead. They retest any candy that the tests find that have to much lead to be sure their tests were accurate. These candies were three times the limit. Many of the candies that were tested were much higher. It brings into question, should we should be importing candy ?

Consumers who find any of these three candies for sale should call the CDPH Complaint Hotline at 1 800-495-3232. For more information about lead poisoning, contact your county childhood lead poisoning prevention program or public health department.

     

India Works to End Childhood Malnutrition

Close to 1.3 million children die every year in India because of malnutrition, according to the World Health Organization (WHO). Ninety nine per cent of all under-five deaths occur in developing countries, with the most common causes of death being pneumonia, diarrhoea and malaria. These are illnesses to which children are particularly vulnerable, especially when they are malnourished, a condition that weakens their immune systems. Malnutrition contributes to more than a third of all child deaths.

Worldwide, over 100 million children are underweight. While it is a serious problem in sub-Saharan Africa, even higher rates of stunting are found in South Asia, particularly in India. Along with Nepal and Bangladesh, India has the world’s highest rate of malnutrition.

One way to fix the problem is to teach mothers about the right nutrition for their children or to incentivize them through conditional cash transfers. Distributing information is an important part of a solution, although it does not always lead to behavioural changes. Mothers are advised that when their child has diarrhoea they should increase their child’s fluid intake and continue to feed them normally. According to the National Family Health Survey (NFHS) -3, nine out of 10 mothers do not follow this recommendation. In fact, four out of 10 mothers actually reduce their child’s fluid intake.

Medical solutions to the problem of malnutrition include deworming and nutritional supplements. De-worming campaigns are quite effective and have been conducted in many day care centres and health encampments. The treatment has been especially popular in Kenya and other parts of Africa, and now in India, the practice has become compulsory in all schools. Popularly used nutritional supplements include vitamin A, zinc, iron, and various minerals. In addition, iodised salt has been a popular weapon of the government of India as it continues to try and promote its consumption over normal salt.

There is also a behavioural approach that attempts to alter the behaviour of mothers and workers who interact with the child. This includes giving children the right type and amount of nutrition. They  try to change behaviour towards calorific food and encourage the consumption of a variety of foods.

About 50,000 people live In the slums that surround the city limits of Chandigarh. Less than 5% of the houses have working water filters. At the same time, however, 70% of the households own mobile phones. The people living in these slums are typically migrants from rural areas where wages are extremely low. The mothers in this treatment group are women who send their children to daycare centres in the slums.

India is home to the world’s largest child care programme. There are currently over one million of these day care centres run by the government across India. Each day care centre serves around 30 children on an average. The children go to the centre every morning at 9am and are fed their midday meals by daycare workers. The workers are given training on child health and nutrition when they are hired by the government.

Another aspect of the daycare workers’ responsibilities is to visit and communicate with the mothers whose children attend the centre, giving them advice on how to keep their children healthy. The daycare centres offer two potential channels by which to help children living in the slums. The first is by the distribution of the midday meal and the second is by providing information and counsel to the mothers. However, a World Bank report finds leakages in the provision of meals and almost no effective communication between workers and mothers. A total of 145 daycare centres were sampled for this study.

The experiment tackles the question of whether it is the lack of information on nutrition given to mothers, or the lack of child care worker motivation that makes child malnutrition persist. The total children weighed twice (before and after an intervention. There were 4,101 children with around 1,000 in each one of three treatment groups (subject to an intervention) and a control group (not subject to any intervention). In the first treatment group, mothers receive recipe books written in Hindi. As around half of these mothers cannot read, the information is also distributed to other family members, including fathers, older sons and daughters. Government workers may also assist by reading and sharing information from the recipe book. The recipe book is designed with the help of a local nutritionist and contains 10 recipes, which provide an array of vitamins and minerals as well as sufficient calories.

In the second treatment group The child care workers were provide incentives to perform better. They are paid bonuses of Rs.100 for each child whose weight they successfully increase so that he or she is no longer classified as malnourished after three months. For each child under their care, the workers are given a goal card with the weight at which the child will no longer be considered malnourished. If a child at a normal weight becomes malnourished, however, I subtract Rs.100 from the total. This motivates the worker to make the necessary household visits.

To test how the two types of treatments interact, the informational and incentives treatments are combined in the third group. Complementarity may exist if incentivized workers are able to be more effective with nutritional information available to the mother. On the other hand, one of the two treatments may be sufficient for improving weight. A separate set of centres form the control group where no intervention is assigned.

Results show that malnutrition is reduced significantly in three months for children in the combined treatment group by 4.2% but there are negligible effects in the individual treatment groups. The combined treatment effect persists for a year even after the incentives are removed after three months. One estimate suggests that the country gains Rs.20 for every rupee spent on the combined treatment in terms of increase in future wages for these children due to an improvement in health and attendance.

Policy recommendations should be based on evidence from experiments and that increasing fixed wages to child care workers will not solve the problem. Similarly, offering performance pay is likely to be ineffective unless mothers have nutritional information available to them. Not only does this empower them, but it also facilitates communication between mothers and workers which enables a behavioural change to occur. Mothers receiving the combined treatment feed their children more protein and calories. A small push is required on both the demand side as well as the supply side to target child malnutrition in India. Further experimentation in development economics can bring us closer to understanding how this serious problem can be fixed efficiently and permanently.

 

Source Hindu Times

India's Farmers Want a Piece of Fonterra,s Business Their Botulism Scare

India’s dairy farmers are hoping to take advantage of the contamination scare in New Zealand to boost their exports to China and other emerging markets.

The Kiwi’s Fonterra, the world’s biggest dairy exporter, said last week that a dirty pipe in one of its plants may have tainted whey protein with a bacteria that causes botulism, a potentially fatal food poisoning. The news prompted recalls in China, Vietnam, Sri Lanka, Thailand and most recently Singapore. New Zealand’s government has expressed concern that the growing recalls would prompt China to extend the ban on milk powder to other dairy products from the country.

New Zealand accounted for 90% of China’s $1.9 billion milk powder imports last year. In comparison, India, the world’s largest milk-producing country, managed exports of just $230 million last year.Indian farmers would like to have more of that.

Part of the reason India exports so little milk is because the government keeps a lid on exports to ensure that domestic prices remain low. But with increased production—milk output is forecast to rise 5% to 133 million metric tons—slated to outstrip domestic demand, which is pegged at around 128 million metric tons, there is no reason to restrict exports.

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India Refuses to Ban Deadly Pesticides

Nearly a decade ago, the Indian government ruled out a ban on the production and use of monocrotophos, the highly toxic pesticide that killed 23 children this month in a village school providing free lunches under a government-sponsored programme.

Despite being labelled highly hazardous by the World Health Organisation (WHO), a panel of government experts was persuaded by manufacturers that monocrotophos was cheaper than alternatives and more effective in controlling pests that decimate crop output.

India, which has more hungry mouths to feed than any other country in the world, continues to use monocrotophos and other highly toxic pesticides that rich and poor nations alike, including China, are banning on health grounds.

Just weeks before the school tragedy in Bihar state, the Indian government advised farmers via SMS to use monocrotophos to kill borer pests in mandarin fruits and rice, records on the agricultural meteorology division's website show.

The WHO has cited a 2007 study that about 76 000 people die each year in India from pesticide poisoning. Many of the deaths are suicides made easy by the wide availability of toxic pesticides.

In the school tragedy, police suspect the children's lunch was cooked in oil that was stored in a used container of monocrotophos.

The Indian government has issued 15 pages of regulations that need to be followed when handling pesticides—including wearing protective clothing and using a respirator when spraying. Pesticide containers should be broken when empty and not left outside in order to prevent them being re-used.

But in a nation where a quarter of the 1.2-billion population is illiterate and vast numbers live in far-flung rural districts, implementation is almost impossible. For instance, monocrotophos is banned for use on vegetable crops, but there is no way to ensure the rule is followed.

According to the WHO, swallowing 1 200 milligrams—less than a teaspoon—of monocrotophos can be fatal to humans. In 2009, it called for India to ban the product because of its extreme toxicity.

"It is imperative to consider banning the use of monocrotophos," it said in a 60-page report. WHO officials say the school tragedy reinforces the dangers of the pesticide.

"We have to take decisions depending on our need, our priorities, and our requirements. No one knows these things better than us," said the government source.

For India, providing more food to its people is a national priority. According to the World Bank, nearly 400-million people in the country live on less than $1.25 per day.

India’s New Food Safety Act Working

India: Three Hotels were shut down and thirty eight were served warning by the Food Safety Department for selling stale food. According to officials, three hotels were closed down after unhygienic conditions were reported.The department also have collected Rs 1,80,000 as fine from various hotels.

The three hotels were closed down for unhygienic conditions  They were located in Kaloor, Thripunithara and Hill Palace. During the raid they found that food was prepared in very unhygienic conditions, plates were not washed, waste was dumped without care, and workers were wearing dirty clothes. The Food Safety Department will Continue to check hotels as required by the new food safety act,

Officials said that people should be wary of eating food from hotels as most hotels add synthetic colour to the food. About 70 per cent of the non-vegetarian food and 40 per cent of the vegetarian food are prepared using colours. This is very harmful, since there are chances of causing cancer and infertility. “These colours were so sticky that we had to wash our hands several times after collecting samples from the hotels,” officials said.

Food safety officials also found that several bakeries and hotels were using milk which was past its expiration date.

Indias new Food safety Law is a great step forward. For the first time they will be able to have food recalls.