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AHMEDABAD

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Re: AHMEDABAD

Peripheral speculative post

If this does turn out to be bird flu, and the symptoms match too closely for comfort, one question that will have to be answered is the nature of the kidney damage. It is not one of those things that is talked about much in reports on H5N1 autopsies. We know that H5N1 can grow in the kidney--dog kidney cells are used to grow it for mammalian culture, but the nature of the damage is unclear to me. There was a tremendous amount of renal failure in soldiers during World War I, but they were all attributed to other things, not to Spanish Flu. If I get a chance tomorrow, I'm going to take a look again at the old literature to see if I can find out anything more. There are several possibilities for the renal damage that these patients are experiencing. One is that blood pressure drops very fast--as a result of internal hemorrhage, myocardial damage, shock, and this causes ischemic kidney damage. A second possibility is that the virus itself damages the kidney. The third possibility is that the hospitals are overprescribing drugs to these patients--which is a distinct possibility in the face of a severe viral infection. The fourth possibility is that a severe increase in cytokines and antibodies is damaging it. Anyway, whether bird flu or not, this is a very critical area to continue watching.
 
Re: AHMEDABAD

Mystery virus rattles Ahmedabad
[ 15 Sep, 2006 0304hrs ISTTIMES NEWS NETWORK ]

AHMEDABAD: A team from National Vector Borne Disease Control Programme, New Delhi, headed by Dr Pradeep Shrivastav arrived in Ahmedabad on Wednesday to review the increasing number of chikun gunia-like mysterious viral fever cases being reported in city.

Meanwhile, the Ahmedabad Municipal Corporation (AMC) officials sent samples of 11 patients suffering from the unidentified viral fever to the National Institute of Virology (NIV), Pune for testing.

The Times Of India, on Tuesday, reported an alarming rise in the number of patients becoming critical due to a mysterious chikun gunia-like viral fever.

This fever has sent alarm bells ringing in the medical fraternity as it rapidly leads to nervous system complications, mostly fatal, especially in the elderly people. Afflicted with this particular virus, the patients first complained of chikun gunia-like symptoms namely fever, muscle and joint pain but within days, developed rashes, low platelets, kidney complications, suffered from nervous system complications and finally had to be put on ventilator.

Dr Shrivastav is reported to have reviewed the grim situation of viral diseases wreaking havoc in the city. "The best armament to deal with the onslaught of the virus, especially the unidentified virus, is to prevent mosquito breeding," he suggested.

The AMC has sent 11 samples of patients from three hospitals namely Sterling Hospital (4), Sardar Patel Hospital (4) and Sushrusha Hospital (3)..
 
Re: AHMEDABAD

Indarjit Singh said:
Mystery virus rattles Ahmedabad
[ 15 Sep, 2006 0304hrs ISTTIMES NEWS NETWORK ]

AHMEDABAD: A team from National Vector Borne Disease Control Programme, New Delhi, headed by Dr Pradeep Shrivastav arrived in Ahmedabad on Wednesday to review the increasing number of chikun gunia-like mysterious viral fever cases being reported in city.

Meanwhile, the Ahmedabad Municipal Corporation (AMC) officials sent samples of 11 patients suffering from the unidentified viral fever to the National Institute of Virology (NIV), Pune for testing.

The Times Of India, on Tuesday, reported an alarming rise in the number of patients becoming critical due to a mysterious chikun gunia-like viral fever.

This fever has sent alarm bells ringing in the medical fraternity as it rapidly leads to nervous system complications, mostly fatal, especially in the elderly people. Afflicted with this particular virus, the patients first complained of chikun gunia-like symptoms namely fever, muscle and joint pain but within days, developed rashes, low platelets, kidney complications, suffered from nervous system complications and finally had to be put on ventilator.

Dr Shrivastav is reported to have reviewed the grim situation of viral diseases wreaking havoc in the city. "The best armament to deal with the onslaught of the virus, especially the unidentified virus, is to prevent mosquito breeding," he suggested.

The AMC has sent 11 samples of patients from three hospitals namely Sterling Hospital (4), Sardar Patel Hospital (4) and Sushrusha Hospital (3)..
Click to expand...

The unidentified virus will remain unidentified until proper H5N1 testing is done.
 
Re: AHMEDABAD

I am since 3 days in contact with India, I should have specifics soon, what they have told me is that the moonsoon has been very bad, a lot of inondations, more to come next week.

Snowy Owl
 
Re: AHMEDABAD

Florida1 said:
H5N1 infection in humans has respiratory symptoms, in addition to other manifestations.
Click to expand...

H5N1 or H5N1 antibodies have been dected in humans (in Vietnam, Indonesia, Japan, South Korea) in th absence of respiratory symptoms:

"However, the deaths of 2 children in Vietnam who did not develop respiratory symptoms, but were positive for H5N1 are cause for concern."

http://www.recombinomics.com/News/02160503/Neurotropic_H5N1_Children.html

>> These cases have important clinical, scientific, and public health implications. In both cases, the clinical presentation led to diagnoses of gastrointestinal infection and acute encephalitis, which alone or in combination are common clinical syndromes in southern Vietnam. Patient 1 had no respiratory symptoms and a normal chest radiograph less than 24 hours before she died. Although Patient 2 showed signs of pneumonia during the last day of his life, a respiratory illness was not considered his most relevant clinical problem. Recently, another patient with influenza H5N1 was described with an initial presentation of fever and diarrhea alone.<<


http://www.recombinomics.com/News/02160504/Neurotropic_H5N1_Complex.html
 
Re: AHMEDABAD

Florida1 said:
H5N1 infection in humans has respiratory symptoms, in addition to other manifestations.
Click to expand...

Not always, Florida1. There are several case reports in the New England Journal of Medicine in which the authors specifically say that H5N1 does not always present with respiratory symptoms. See the Vietnam diarrhea and encephalitis report. Besides, these patients in Ahmedabad are being placed on ventilators. The fact that hundreds of them have died so quickly means that something critical is occurring to them rapidly, and viral pneumonia is one of those things that can do that. Just because the report doesn't mention pneumonia (and they're not going to--because these reporters realize that any mention of pneumonia or ARDS or rapid breathing is immediately going to alert everyone to H5N1, but they don't realize that talking about hemorrhage, neurological complaints and low platelets will alert some to it anyway), doesn't mean the patients don't have it.
 
Re: AHMEDABAD

vaffie said:
Not always, Florida1. There are several case reports in the New England Journal of Medicine in which the authors specifically say that H5N1 does not always present with respiratory symptoms. See the Vietnam diarrhea and encephalitis report. Besides, these patients in Ahmedabad are being placed on ventilators. The fact that hundreds of them have died so quickly means that something critical is occurring to them rapidly, and viral pneumonia is one of those things that can do that. Just because the report doesn't mention pneumonia (and they're not going to--because these reporters realize that any mention of pneumonia or ARDS or rapid breathing is immediately going to alert everyone to H5N1, but they don't realize that talking about hemorrhage, neurological complaints and low platelets will alert some to it anyway), doesn't mean the patients don't have it.
Click to expand...

Yes, placing the patient on a ventilator is a very big red flag for respiratory problems (and H5N1).
 
Re: AHMEDABAD

In the cases stated above it appears that the patients were placed on ventilators AFTER other major systems began to fail.

Of course, this affected their breathing.

Please cite me the NEJM articles so that I can look them up. We should have them here in the scientiific library.
 
Re: AHMEDABAD

Florida1 said:
In the cases stated above it appears that the patients were placed on ventilators AFTER other major systems began to fail.

Of course, this affected their breathing.
Click to expand...

As noted in the NEJM article on two fatal H5N1 infections, one patient did not develop respiratory symptoms, while the second developed symptoms a day before death. Respiratory symptoms, espcially in cases that involve neurological complications, do not always present early.
 
Re: AHMEDABAD

They mention in this article that they're putting the patients on ventilators. The way that they say it however makes the reader assume that it is not because of the obvious--that they have pneumonia, but because they have some neurological symptoms. There are four possibilities for the use of ventilators, which I will list, and they are not mutually exclusive, mind you, some could be occurring in some patients and others in other patients. A little more information on the reports will be able to tell us a lot in this regard.

1) The virus is causing encephalitis and is infecting the medulla in such a way that it has disrupted the respiratory center. The patients are therefore not breathing regularly.

2) The virus, either via cytokine storm or muscle infection itself, is causing paralysis not only of muscles in the arms and legs but also of the diaphragm and other respiratory muscles. The patient's breathing is thus paralyzed. Numerous diseases can have this result, including polio, lyme disease, diphtheria, and botulism. Hemorrhage into the diaphragm can also have a similar effect.

3) Viral pneumonia/ARDS. This is the most obvious one. Rapidly infiltrating neutrophils secreting toxins and cytokines result in overwhelming entry of fluid into the lung parenchyma resulting in an inability to continue gas exchange. No amount of oxygen support will help with this, and the patient will usually die.

4) Heart failure (due to myocarditis for instance) and/or renal failure will result in fluid collecting in the lungs--resulting in a similar picture to #3.
 
Re: AHMEDABAD

It appears that the child had respiratory problems - but late in the disease progression:

"Although some respiratory signs developed late on in the illness (bilateral mild crackles and wheezes, and radiographic evidence of infiltrates) and respiratory failure eventually followed, doctors treating the child did not consider respiratory problems to be the most relevant clinical problem for most of the duration of the illness."
 
Information on Nipah virus

Information on Nipah virus

<TABLE cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD>Emerg Infect Dis. 2006 Feb;12(2):235-40.</TD><TD align=right>Related Articles,<SCRIPT language=JavaScript1.2><!--var PopUpMenu2_LocalConfig_jsmenu3Config = [ ["ShowCloseIcon","yes"], ["Help","window.open('/entrez/query/static/popup.html','Links_Help','resizable=no,scrollbars=yes,toolbar=no,location=no,directories=no,status=no,menubar=no,copyhistory=no,alwaysRaised=no,depend=no,width=400,height=500');"], ["TitleText"," Links "]]var jsmenu3Config = [ ["UseLocalConfig","jsmenu3Config","",""]]//--></SCRIPT><SCRIPT language=JavaScript1.2><!--var Menu16494748 = [ ["UseLocalConfig","jsmenu3Config","",""], ["Substance via MeSH","window.top.location='http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=pubmed_Abstract&db=pubmed&cmd=Display&dopt=pubmed_pcsubstance_mesh&from_uid=16494748'","",""], ["Cited in PMC","window.top.location='http://www.pubmedcentral.gov/tocrender.fcgi?action=cited&tool=pubmed&pubmedid=16494748'","",""], ["Books","window.top.location='http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=pubmed_Abstract&cmd=Retrieve&db=pubmed&list_uids=16494748&dopt=Books'","",""], ["LinkOut","window.top.location='http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=pubmed_Abstract&cmd=Retrieve&db=pubmed&list_uids=16494748&dopt=ExternalLink'","",""]]//--></SCRIPT> Links </TD></TR></TBODY></TABLE><DD>
[SIZE=+1]Nipah virus-associated encephalitis outbreak, Siliguri, India.[/SIZE]

Chadha MS, Comer JA, Lowe L, Rota PA, Rollin PE, Bellini WJ, Ksiazek TG, Mishra A.

National Institute of Virology, Pune, India.

During January and February 2001, an outbreak of febrile illness associated with altered sensorium was observed in Siliguri, West Bengal, India. Laboratory investigations at the time of the outbreak did not identify an infectious agent. Because Siliguri is in close proximity to Bangladesh, where outbreaks of Nipah virus (NiV) infection were recently described, clinical material obtained during the Siliguri outbreak was retrospectively analyzed for evidence of NiV infection. NiV-specific immunoglobulin M (IgM) and IgG antibodies were detected in 9 of 18 patients. Reverse transcription-polymerase chain reaction (RT-PCR) assays detected RNA from NiV in urine samples from 5 patients. Sequence analysis confirmed that the PCR products were derived from NiV RNA and suggested that the NiV from Siliguri was more closely related to NiV isolates from Bangladesh than to NiV isolates from Malaysia. NiV infection has not been previously detected in India.

PMID: 16494748 [PubMed - indexed for MEDLINE
</DD>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?holding=npg&cmd=Retrieve&db=PubMed&list_uids=16494748&dopt=Abstract<HR>
 
Nipah Virus Info

Nipah Virus Info

Nipah virus



Overview

Nipah virus is a newly recognized zoonotic virus. The virus was 'discovered' in 1999. It has caused disease in animals and in humans, through contact with infectious animals. The virus is named after the location where it was first detected in Malaysia. Nipah is closely related to another newly recognized zoonotic virus (1994), called Hendra virus, named after the town where it first appeared in Australia. Both Nipah and Hendra are members of the virus family Paramyxoviridae. Although members of this group of viruses have only caused a few focal outbreaks, the biologic property of these viruses to infect a wide range of hosts and to produce a disease causing significant mortality in humans has made this emerging viral infection a public heath concern.

Natural Host

It is currently believed that certain species of fruit bats are the natural hosts of both Nipah and Hendra viruses. They are distributed across an area encompassing northern, eastern and south-eastern areas of Australia, Indonesia, Malaysia, the Philippines and some of the Pacific Islands. The bats appear to be susceptible to infection with these viruses, but do not themselves become ill. It is not known how the virus is transmitted from bats to animals.

Transmission

The mode of transmission from animal to animal, and from animal to human is uncertain, but appears to require close contact with contaminated tissue or body fluids from infected animals. Nipah antibodies have been detected in pigs, other domestic and wild animals. The role of species other than pigs in transmitting infection to other animals has not yet been determined.
It is unlikely that Nipah virus is easily transmitted to man, although previous outbreak reports suggest that Nipah virus is transmitted from animals to humans more readily than Hendra virus. Despite frequent contact between fruit bats and humans there is no serological evidence of human infection among bat carers. Pigs were the apparent source of infection among most human cases in the Malaysian outbreak of Nipah, but other sources, such as infected dogs and cats, cannot be excluded. Human-to-human transmission of Nipah virus has not been reported.

Clinical features

The incubation period is between 4 and 18 days. In many cases the infection is mild or inapparent (sub-clinical). In symptomatic cases, the onset is usually with "influenza-like" symptoms, with high fever and muscle pains (myalgia). The disease may progress to inflammation of the brain (encephalitis) with drowsiness, disorientation, convulsions and coma. Fifty percent of clinically apparent cases die.

Treatment

No drug therapies have yet been proven to be effective in treating Nipah infection. Treatment relies on providing intensive supportive care. There is some evidence that early treatment with the antiviral drug, ribavirin, can reduce both the duration of feverish illness and the severity of disease. However, the efficacy of this treatment in curing disease or improving survival is still uncertain.

Protection of health care professionals

The risk of transmission of Nipah virus from sick animals to humans is thought to be low, and transmission from person-to-person has not yet been documented, even in the context of a large outbreak. Therefore, the risk of transmission of Nipah virus to health care workers is thought to be low. However, transmission without percutaneous exposure (through a break in the skin barrier) is theoretically possible, as respiratory secretions contain the virus. This is why it has been categorized as a biohazardous agent that should be managed in a high-level biosecurity laboratory. It is recommended that close contact with body fluids and infected tissues be avoided if Nipah infection is suspected.

Outbreaks of Nipah and Hendra viruses

From September 1998 - April 1999, there was a large outbreak of encephalitis in Malaysia. During the investigation of this outbreak, Nipah virus, a previously unrecognized virus, was identified as the causal agent. A total of 265 people were infected, of whom 105 died. Ninety-three percent of cases had occupational exposure to pigs. An associated outbreak among abattoir workers in Singapore during March 1999 led to 11 cases, with 1 death. These workers had been handling pigs that had been imported from the outbreak areas in Malaysia.
There have been 3 recognized outbreaks of Hendra virus in Australia in 1994, 1995 and1999. Three human cases, leading to 2 deaths were recorded in the 1994 and 1995 outbreaks. In 1995 a horse was infected, with associated human cases. The precise mode of virus transmission to the three Australian patients is not fully understood. All 3 individuals appear to have acquired their infection as a result of close contact with horses which were ill and later died.

http://www.who.int/mediacentre/factsheets/fs262/en/print.html
<!-- start contributor information -->
 
Re: AHMEDABAD

<TR valign="top"><TD colspan="3">[FONT=Arial, Helvetica, sans-serif]Cong sets agenda: no-confidence move against Modi Govt[/FONT]</TD></TR>

<TR valign="top"><TD colspan="3" height="10"></TD></TR><TR valign="top"><TD colspan="3">[FONT=Arial, Helvetica, sans-serif]Modhvadia says move because of BJP Govt?s overall failure: inept handling of floods and disease, power availability as well as law and order situation in State[/FONT]</TD></TR>

<TR valign="top"><TD colspan="3" height="10"></TD></TR><TR valign="top"><TD colspan="3">Express News Service</TD></TR>
<TR valign="top"><TD colspan="3" height="10"></TD></TR><TR valign="top"><TD colspan="3">
[FONT=Arial, Helvetica, sans-serif]Ahmedabad, September 16:[/FONT]

[FONT=Arial, Helvetica, sans-serif]MONSOON session clouds are hanging heavy over the Modi Government. [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]As if the Chief Minister didn?t have enough on his plate, the Congress Legislature Party (CLP) has announced that it will bring a no-confidence motion in Assembly against the Bharatiya Janata Party (BJP) Government during the forthcoming monsoon session, which begins on Monday. [/FONT]

[FONT=Arial, Helvetica, sans-serif]??We will bring in a no-confidence motion against the Modi Government in the monsoon session against the BJP Government for its overall failure on several fronts, including the inept handling of floods in Surat and other parts of the State,?? CLP leader Arjun Modhvadia said on Saturday. [/FONT]

<TR valign="top"><TD colspan="3">[FONT=Arial, Helvetica, sans-serif]According to Modhvadia, the State Government failed miserably in tackling the floods in Surat and other parts of South and Central Gujarat in August. [/FONT]

[FONT=Arial, Helvetica, sans-serif]The Government also failed in checking the spread of water-borne post-flood diseases like chikungunya and leptospirosis which have caused loss of lives and infected several people in the State, he said. ??The Government was also unsuccessful in solving other problems related to availability of power and issues concerning law and order,?? he said. [/FONT]

[FONT=Arial, Helvetica, sans-serif]To take these issues to the street in a bid to elicit common man?s involvement in its protest, GPCC has also decided to take out a rally against the Government in Gandhinagar just before beginning of the monsoon session on Monday.[/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif] ?We will take out a rally to the State Assembly in which all district and taluka unit office-bearers and party workers will take part,? Modhvadia said. He said his party MLAs were determined to hold the rally even if the Government refused to give permission. [/FONT]

[FONT=Arial, Helvetica, sans-serif]Venting ire over the short duration of the monsoon session, Modhvadia said: ?The Government does not want to entertain any healthy debate on the flood or any other issues. By fixing a two-day session, the Government is merely fulfilling its Constitutional obligation,? he added. [/FONT]

[FONT=Arial, Helvetica, sans-serif]Asked whether the Congress was expecting backing from rebel BJP MLAs who are unhappy with Chief Minister Modi?s style of functioning, Modhvadia said, ?All those who do not have confidence in the existing Government should support us.?? Modhvadia also criticised Narendra Modi for ??seeking cheap publicity?? by getting his photographs printed on packets of condoms and contraceptives.[/FONT]

</TD></TR><TR><TD colspan="3">

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Re: AHMEDABAD

Chikungunya cases rising, but it?s not a bitter pill for pharmacists
http://cities.expressindia.com/fullstory.php?newsid=201552

[FONT=Arial, Helvetica, sans-serif]Ahmedabad, September 16:[/FONT]

[FONT=Arial, Helvetica, sans-serif]PHARMACISTS around the city are making hay while the sun shines. Even if the common prescriptions for treating chikungunya ? pain killers and anti-biotics ? are not too costly, the rise in their sales has left a big smile on their faces. [/FONT]

[FONT=Arial, Helvetica, sans-serif]Even as doctors are prescribing the said medicines as preventive measures for chikungunya, patients too are stocking up these medicines. [/FONT]

Naranbhai Patni, whose three family members were diagnosed of chikungunya, finds it safe to buy these medicines in bulk. ??With me, my two sons and my mother being affected by the disease, the doctors prescribed some common medicines.

So, I found it wiser to buy some more strips of the pain killers keeping in mind the fact that my wife and daughter could get affected too,?? said Patni, who runs a rickshaw in Naroda area.

[FONT=Arial, Helvetica, sans-serif]?Usually the common symptoms of chikungunya are high fever, arthalgia which is commonly known as joint pain and vomiting. The regular medicines that we prescribe for these symptoms are Paracetemol, Ibuprofin, Diclofenac and Ofloxacin. While three of them are pain killers, Ofloxacin is an antibiotic,?? said Dr S T Malhan at V S Hospital.
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]Malhan believes that chikungunya being subconsciously present in his mind, most of his prescriptions tend to be either of the pain-killers or antibiotics. [/FONT]

[FONT=Arial, Helvetica, sans-serif]Pharmacists in the city claim that the sales of these medicines and injections have almost doubled. [/FONT]
[FONT=Arial, Helvetica, sans-serif]??People are coming to us with prescriptions of either Paracetemol, Ibuprofin or Diclofenac very often nowadays. Although we are unable to keep a record of the sales, it has definitely gone up by over 100 per cent,?? said a pharmacist at an Apollo 24 Hour Pharmacy near Shivranjini Crossroads. [/FONT]

[FONT=Arial, Helvetica, sans-serif]Milan Surkhatha, a pharmacist at Apna Bazaar Chemist Shop at V S Hospital says, ??Though the medicines are priced at as low as Rs 10 per strip, the increase in the number of patients has raised the sales.??[/FONT]
[/FONT]
 
Re: AHMEDABAD

Acu-magnotherapy to patients? rescue
http://cities.expressindia.com/fullstory.php?newsid=201553

[FONT=Arial, Helvetica, sans-serif]Ahmedabad, September 16:[/FONT]

[FONT=Arial, Helvetica, sans-serif]AFTER the recovery from chikungunya, body pain, especially back and joints, is baffling many. For them, alternative treatment like acupressure and magnetic therapy have been proved quite relieving as it helps in reducing the pain. [/FONT]

[FONT=Arial, Helvetica, sans-serif]An acu-magnotherapists camp, organised at Rakshapark society near Danilimdi, has shown that acupressure measures followed by magnetic treatment get better results in curing body pain which is a common complaint of most chikungunya patients despite recovery. ?The process of acupressure and magnetic treatment easily treat a number of diseases like back pain, slip-disk, acidity and diabetes. Body ache is a common fallout of a patient who has freshly recovered from the disease. We have arranged this camp so such patients could get treatment,? informed Amin Baig, an acu-magnotherapist at the camp.[/FONT]
 
Re: AHMEDABAD

<TR valign="top"><TD colspan="3">[FONT=Arial, Helvetica, sans-serif]Expert?s poser: chikungunya or CCHF?[/FONT]</TD></TR>
http://cities.expressindia.com/fullstory.php?newsid=201657

<TR valign="top"><TD colspan="3" height="10"></TD></TR><TR valign="top"><TD colspan="3">Vivek Vijayapalan</TD></TR> <TR valign="top"><TD colspan="3" height="10"></TD></TR><TR valign="top"><TD colspan="3">
[FONT=Arial, Helvetica, sans-serif]Ahmedabad, September 17:[/FONT]

[FONT=Arial, Helvetica, sans-serif]After chikungunya, a new scare. What many thought was the disease spread by the aedis aegypti mosquito may actually have been undetected cases of Congo-Crimean Haemorrhagic Fever (CCHF). [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]The symptoms are similar to chikungunya, thus there are more chances that the fever would not have been diagnosed correctly, says Dr Jeram Parmar, a consultant for Centre of Management of Health Services at the Indian Institute of Management. [/FONT]
[FONT=Arial, Helvetica, sans-serif]Cases of CCHF are found in eastern and southern Europe, Central Asia, Middle East and the Indian sub-continent. [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]The virus jumps from animal to humans through infected blood, ticks or fleas. [/FONT]

<TR valign="top"><TD colspan="3">[FONT=Arial, Helvetica, sans-serif]Parmar claims that deaths, thought to be caused by chikungunya, may have been due to CCHF. [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]According to Parmar, ?Case fatality is more common in CCHF. Chikungunya is a self-limiting disease, which means people don?t die due to it and recover in a few days. Hence, there might have been several CCHF cases gone undetected.? [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]Parmar also says that sudden outbreak of the disease has been mainly reported in areas like Khanpur, Mirzapur, Jamalpur and Gomtipur. [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]He says, ?Cases of chikungunya have been mainly reported from areas where slaughter houses exist and where people come in constant contact with animals. [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]CCHF is contracted through ticks and so it becomes necessary to find out whether people living in these areas are suffering from chikungunya or CCHF.? [/FONT]

[FONT=Arial, Helvetica, sans-serif]Jeram Parmar who has worked with the Government of Fujairah (UAE) as a senior public health specialist in 1998, says, ?My observations are based on the experiences that I had in Fujairah where I detected cases of CCHF at animal skin export houses where workers contracted the disease.? [/FONT]
[FONT=Arial, Helvetica, sans-serif][/FONT]
[FONT=Arial, Helvetica, sans-serif]Parmar has also worked for the Vadodara Municipal Corporation as a malaria officer in 1981. [/FONT]

[FONT=Arial, Helvetica, sans-serif]He says, ?Although the diagnosis made by the AMC in most cases cannot be ruled out, I feel that there is too much concentration on mosquito-borne diseases whereas it is necessary to concentrate on the tick-borne disease too.? [/FONT]

[FONT=Arial, Helvetica, sans-serif]?Civic bodies should create awareness about the disease and repellents like DEET (Diethyl Toluamide Derivatives). People working in abattoirs should be asked to wear protective clothing.?[/FONT]

</TD></TR><TR><TD colspan="3">

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Re: AHMEDABAD

As soon as they start thinking it's really a hemorrhagic fever that's spreading (and possibly even affecting their animals too), all alarm bells should be ringing.
 
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