The Indian Express | 1 week ago | 06-08-2022 | 12:45 am
At a time when Covid cases were registering a spike during the second wave – that of Delta variant – across the country in 2021, Malegaon city continued to report low numbers. Intrigued by the phenomenon, the Maharashtra University of Health Sciences (MUHS) undertook the Magic Malegaon project to find out why the deadly wave somewhat spared the city situated in Maharashtra’s Nashik district. To their bafflement, the researchers, in the preliminary analysis of a second round of survey in April-May this year, have found that unlike several other parts of the country, there has been no rapid drop in the level of antibodies against Covid among the residents of Malegaon.“The first survey conducted in January this year indicated that the Covid-19 neutralising antibody prevalence was found to be much higher in the population (96 per cent) and this was mostly associated with younger age, gender, diet and vaccination status of the population. Now, preliminary analysis of a second survey of the same participants – around 1,670 in number — indicates that the decay in antibody titres was not rapid and continued to remain satisfactory in all, barring 80 persons,” Lt Gen (retd) Madhuri Kanitkar, Vice Chancellor of MUHS, told The Indian Express.“Decay in antibody levels has been slower in Malegaon than rest of the country. In almost 88 per cent of individuals, the decline in antibodies was less than 20 per cent even after three months. In the third phase of the study, we will also assess whether the memory cells of the 80 persons with very low antibody levels are able to mount an antibody response if they are exposed to the virus,” the MUHS VC said. She pointed out that there were some people who were Covid negative in the first round of their survey and were found positive during the second serosurvey. “However, they do not remember ever getting the infection as they did not have symptoms. So, it would be interesting to know if a possible low-level infection circulating in the community worked as a natural booster to give them immunity. We are following up on these patients and looking at other demographic and social factors,” Kanitkar said.Notably, Malegaon corporation area was a hotspot of infection in the first wave of the Covid pandemic in 2020, witnessing 178 deaths and 4,560 total infections, with a positivity rate of 18.5 per cent in the April-September period. In 2021, between February and mid-July 2021, there were 6,222 Covid positive cases and 120 reported deaths. During the third Omicron wave from January 1 till date, Malegaon has reported approximately 450 cases and no death.“The spread of Covid-19 infection was low in this population of seven lakh in Malegaon in the second wave and even during the third wave now. This is despite the high vaccine-hesitancy,” Dr Sapna Thakare, Malegaon health officer, said. The health official said an approximate 60 per cent beneficiaries have got the first dose while few were fully vaccinated.Newsletter | Click to get the day’s best explainers in your inboxAt MUHS, researchers took up this epidemiological study to determine demographic factors influencing Covid-19 IgG antibody production among the adult population in Malegaon. Study findings of the first survey have also been accepted for publication in the Asian Journal of Medical Science. This includes data on a total of 2,454 participants who were screened for Covid-19 neutralising antibody by ELISA technique in the first survey in January this year.Serological tests to detect the presence of IgG antibodies may provide a more reliable estimation of the prevalence of SARS-CoV-2 past infection in the population. “We collected 5 ml venous blood in a plain bulb for testing and found the prevalence of neutralising antibodies to be 93.9 per cent. Females had 95 per cent positive antibodies vis a vis males (92.34 per cent). Maximum positive antibody status was seen in the age group of 20 – 40 (55.6 per cent). Around 77.9 per cent persons who followed a mixed diet (vegetarian and non-vegetarian) had higher levels of antibodies as compared to those with a pure vegetarian diet (10.2 per cent). Around 83.2 per cent of people who were vaccinated also had higher antibody levels. The lowest level of antibody positivity was seen in persons who were underweight (8 per cent) followed by those who were obese (12.7 per cent). Also, maximum antibodies were seen in persons who had taken Vitamin C and Zinc tablets (92.1 per cent),” Dr Nirmalkumar A Rawandale, Head of Department of Medicine at Bhausaheb Hire Government Medical College Dhule, Maharashtra, and principal investigator of the project said.Extensive studies are required to establish any association between prophylactic methods other than vaccination and Covid-19 antibody response, researchers said.
NAGPUR: The 11 districts in the Vidarbha region together reported 164 new cases while 247 patients recovered in the last 24 hours. No death was reported due to Covid in the last 24 hours. More than 6,000 tests were conducted in the region during the last 24 hours. With 164 of them positive, the test positivity is less than 3.5% in the region. Now, less than 1,300 patients are under treatment. Out of them, 600-odd are in Nagpur district alone. Out of the 1,300 under treatment patients, less than 100 are hospitalized. In Nagpur, 43 patients are hospitalized. Only 12 are hospitalized in Akola. Total 1,773 tests were conducted in Nagpur district. Out of them, 1277 were conducted in the city and 496 in rural part. Out of them, 41 tested positive in the city and 40 in rural. Total 164 patients recovered in a day. Now, 609 patients are under treatment in the district. Out of them, 43 are in the hospitals. City now has 365 patients under treatment and rural has more than 250. The change in statistics indicate that cases are coming down in city and increasing slowly in district.
PUNE: Amid the increase in Covid-19 cases nationwide, Dr NK Arora, chairperson of the Covid Working Group of the National Technical Advisory Group on Immunisation (NTAGI), said on Saturday that besides positivity, states should also closely track hospitalisation and mortality data. In most states, positivity rates are high due to low testing and high circulation of the virus, Dr Arora told TOI. "The way forward is tracking the actual severity of the infection. There are around 10-12 Omicron sub-lineages circulating and many of the current strains are all 20-30% more infectious than the original Omicron variant. But hospitalisation and deaths are still low. The new variants of Omicron with higher transmission rates are causing a spike in cases and an increase in positivity rates," he added. Omicron subvariants include BA.4, BA.5, BA.2.75 and BA.2.38. Every week, INSACOG - the surveillance network of labs - reviews data on circulating viruses and clinical outcomes, including hospitalisation and deaths. Dr Arora said there has been no increase in hospitalisation rates anywhere in the country. "We have been regularly seeing new Omicron sub-lineages in the country for the last eight months but fortunately, none of these variants have led to an increased severity of cases," he said. He also urged people to follow all precautions, especially if a variant emerges with the potential to cause severe disease. Some regions and states, including West Bengal and Delhi, have kept up the mask rule. "And this needs to be welcomed," Dr Arora said, adding that it will take a few more months of surveillance to know if a virulent variant has emerged or if it's time for more relaxations. Maharashtra's overall weekly positivity rate is at 5% and state officials said hospitalisation rates have been stable, even if 10 districts have positivity rates higher than 10%. Pune, Gondia and Nagpur are some of the districts with positivity rates over 10%. Pune district's positivity rate is currently at 12%, much lower than the 14% it had early in August. But hospitalisation rate in the state is at 6% and only 1.5% of the caseload are serious patients, officials said. On Saturday, the Pune Metropolitan Region recorded 302 Covid cases and one death. Some 403 people were also discharged from care. The region has 139 Covid patients in hospital. Another 1,868 are in home isolation. The state reported 2,040 cases. The overall case tally is now 80,70,258 and toll is at 1,48,168, an official said.
MUMBAI: Draft charges were submitted on Friday in a case allegedly involving assembly speaker Rahul Narvekar and state minister Mangal Prabhat Lodha for assembling with others at BEST Bhavan to protest against a hike in electricity bill during the Covid lockdown in 2020. The charges against the 20 accused were filed under various sections of the IPC, the Epidemic Diseases Act and the Prevention of Damage to Public Property Act. The court is likely to hear arguments on August 26, and will finally decide which charges, if any, are to be framed against the accused.
LUCKNOW: The UP Special Task Force (STF) on Friday arrested Khurshid and Ashraf from Shohratgarh area of Siddharthnagar district. The duo has been named in 12 cases of robbery, dacoity and theft in Thane and one theft case in Madhya Pradesh. The two had fled from the Maharashtra police custody in 2021. They had earlier been arrested for a dacoity at a jewellery store in Thane and were sent to jail where they tested positive for Covid in 2021 following which they were hospitalized. They, however, fled from the hospital and were absconding since then. Additional superintendent of police, STF, Vishal Vikram Singh said that during interrogation Khurshid disclosed that they used to commit docoities along with their aides. Khurshid further stated that in the last week of November when they were shifted from jail to a hospital because of Covid they planned their escape. "Finally one day both Khurshid and Ashraf managed to escape from the 16th floor of the hospital where they were admitted with the help of a downpipe. Thereafter, they drove to Siddhartnagar and started living there," the ASP said. Last month the Thane police tracked the mobile phone of one of the accused in Siddharthnagar and alerted the STF. Bothe the miscreants were planning to escape to Nepal on fake identity when they were arrested by the STF. A car, bearing registration number of Maharashtra and two mobile phones were recovered from them.
Dr. Atul Patel is a director and chief consultant for the Department of Infectious Diseases, Sterling Hospital. He is a visiting assistant professor at the Medicine Division of Infectious Diseases at the University of South Florida, Tampa, US. He has a special interest in HIV/TB co-infections. His group is researching on an effective programme to prevent mother-to-child transmission at the ID Clinic, AhmedabadThe past two years were largely uneventful with respect to swine flu and/or seasonal influenza cases and related mortality. We are again witnessing a surge this year. What is driving it?The term, swine flu, is used for the 2009 H1N1 strain, which was a recombinant of influenza viruses in birds, pigs and humans. The strain evolves every year, which is why these subsequent strains are termed under the broad category of seasonal influenza. The surge in seasonal influenza cases in a specific year depends on the general population’s immunity to the specific strain circulating in a specific year. We are seeing swine flu patients and seasonal influenza patients at present as both the viruses are in circulation. If we look at the epidemiology of seasonal influenza, it circulates in the community in tropical countries throughout the year with two big spikes — first in winter and the second in the monsoon. So this is the time when we expect an increase in the number of seasonal influenza cases. This is a major difference compared to temperate countries such as the US or Europe where only one surge is seen in the year that is winter.Right now we can say we are seeing an equal number of Covid-19 and seasonal influenza patients. In fact, the number of seasonal influenza cases is more compared to the last two years. That may be because we are not strictly wearing masks and sanitising hands, something that we did consistently through the two years during Covid-19. These are two important non-pharmaceutical interventions, which reduce the susceptibility to seasonal influenza as well as Covid-19. Furthermore, routine vaccination for seasonal influenza has gone down. It is not being highly recommended in high-risk groups by the government unlike pre Covid-19 years and has now taken a backseat following Covid-19. We can control the number of seasonal influenza patients in the community through vaccination and post-exposure prophylaxis with Oseltamivir (Tamiflu). We should promote an annual shot of the seasonal influenza vaccine in the media also.How does seasonal influenza impact an individual’s morbidity risk?Like Covid-19, those with co-morbidities are at a high risk of disease progression and complication when it comes to seasonal influenza. We are seeing that there is mortality in patients with significant co-morbidities. The sensitivities are almost the same as those for Covid-19 — haemato-oncological problems, malignancy, post-transplant cases, chronic obstructive lung disease, obesity, diabetes and so on.In terms of susceptibility to seasonal influenza, it is more or less equal across all age groups, except in paediatric patients and those aged above 65 years. These two groups are such that even without any co-morbid conditions, they are more prone to disease severity. For a majority of youngsters, most of whom are immuno-competent, seasonal influenza is a self-limiting disease. Symptoms include high grade fever, throat pain, headache, body pain, runny nose, which last for five to seven days or so. Then they report spontaneous and uneventful recovery. Taking fever-reducers such as Paracetamol work for healthy immuno-competent individuals but for paediatric and aged people, and those with comorbidities, we generally prescribe the antiviral drug Tamiflu, a very effective agent for influenza.With fever being the first symptom and the monsoon known for the resurgence of viral infections, seasonal influenza, vector-borne diseases, and now Covid-19, what should one look out for?With most viral infections, including dengue fever, the first episode is usually self-limiting in immuno-competent people. Such individuals report an uneventful recovery without much medical intervention. But those in high risk and co-morbid groups, should not ignore their fever, visit their doctor, get tested and secure a definite diagnosis.They should get a diagnostic evaluation done on the first day of the onset of symptoms rather than waiting for a few days as by then the disease can progress and complications may crop up. For healthy individuals who do not have many symptoms, except for fever and body pain, there is not much cause for worry. Their assessment and evaluation should be symptom-driven.With Covid-19 and seasonal influenza circulating in the population, how do we go about the diagnosis, given that most individuals just opt for a Covid-19 test? Surely a negative Covid-19 test doesn’t rule out an individual’s probability of seasonal influenza instead?We usually recommend the RT-PCR for both COVID-19 and seasonal influenza. In clinical practice, we have multiplex PCR. This assay includes a target panel of all the common viruses producing respiratory symptoms. So a single multiplex PCR can confirm whether it’s influenza A, influenza B, parainfluenza, COVID19, swine flu or other respiratory viruses. But it is very expensive, costing around Rs 11,500 or so, as it checks multiple pathogens. The results come within two-and-a-half hours and are highly reliable.How is a confirmed diagnosis of the type of seasonal influenza one is afflicted with significant for health management?Knowing the final and confirmed diagnosis is very important, as for the three viruses — influenza A, B and swine flu — Tamiflu is highly effective. Besides, most of these patients will respond to the antiviral drug within 48 hours of taking it. This is also one of the diagnostic traits that can be an indicator. So basically if someone improves markedly after taking Tamiflu, it can be said that he/she has been affected by one of the three viruses. That apart, a PCR test can tell you which kind it is because symptoms are more or less the same for seasonal influenza, swine flu or influenza B virus. From a clinical examination perspective, one can say that an individual has seasonal influenza but for the specific virus, only a PCR test can give a final and confirmed diagnosis.