Let's link hands against diabetes

A 68-year old Mrs. S. developed high fever and had to be hospitalised since her blood sugars were very high. With no personal income or medical insurance, she had to depend on her son for paying hospital expenses for which he was not too willing.

Mr. S, 58, a watchman in a company, developed fever and infection in the foot. He had very high blood sugars and was hospitalised. Despite all efforts, his left leg had to be amputated and he had to use his entire savings which he had kept aside for his daughter’s wedding. This was a sad story of a man who lost his leg and his personal savings because he had diabetes, of which he was unaware. Innumerable are such pathetic cases.

Diabetes is one of the major health and development challenges of the 21st century. In India, it is estimated that around 62 million people have diabetes. One in two people with diabetes doesn’t know he/she has it. But diabetes and its complications are largely preventable, and proven, affordable interventions available. Everyone is concerned and everyone has a role to play in helping to turn the tide of diabetes to protect our future.

What can be done?

There are two major components of the burden of diabetes in India — genetic and environmental factors. Environmental factors such as physical inactivity and unhealthy diet pattern play an important role. There is an immediate need to seek the involvement of several stakeholders in prevention and control of diabetes.

To start with, the media plays a major role in not only creating awareness of the risk factors but also making policymakers and others focus on various avenues leading to a better living environment. The existing knowledge of prevention of diabetes can be disseminated to all with the help of the Ministry of Information and Broadcasting, NGOs and healthcare centres in both the private and public sectors.

Next, to put the knowledge into practice, it is necessary to create a conducive environment for the public to increase their physical activity. This needs earmarked funding for construction of parks, safe footpaths and cycle pathways.

In order to ensure healthy eating habits, retail shops, fast food outlets and chain restaurants should be encouraged to provide alternative healthy food choices. An additional tax could be levied on junk food. Regulation of pricing policy for fruits and vegetables is necessary.

The government should encourage small entrepreneurs to manufacture nutritious and palatable snacks for people belonging to different economic strata at an affordable cost. Agricultural research is also required for producing low glycemic cereals and grain. More operational research is necessary to develop strategies to reduce the burden of diabetes and its risk factors. Allocation of funds for such projects has to be given high priority by the funding agencies.

In order to help people with pre-existing diabetes, insurance companies should introduce policies which will cover both outpatient and hospitalisation costs.

This will help a large number of people in India with diabetes to have good control of their blood sugar levels and thus prevent dreadful complications.

Although various stakeholders are required to build the web of partnership for diabetes prevention, the most essential is individual commitment to a better living.

(The writer is Head and Chief Diabetologist, MV Hospital for Diabetes, and Prof. M Viswanathan Diabetes Research Centre, Chennai. Email: drvijay@mvdiabetes.com)

What is Q fever?

The ‘Q’ in Q fever stands for ‘query’. This is because when this bacterial infection was first indentified, its cause was unknown. The cause is now understood but the name has remained the same. Q fever is spread to humans through animals – usually goats, sheep and cattle. In rare cases it can be spread from human to human, usually through sexual intercourse. It is caused by the coxiella burnetii bacteria and is most common in Australia and the south of France. Those who are most at risk of contracting the disease are farmers, meat packers, stablehands, vets and abattoire workers.

What causes it?

Q fever is caused by the coxiella burnetii bacteria. This is usually spread to animals through infected ticks and most commonly affect farm animals and household pets. The animals themselves often do not experience any symptoms, so it can be hard to identify whether or not they are infected, although it can increase the likelihood of miscarriage in cows and sheep.

Drinking unpasteurised milk can give you Q fever

The bacteria can be released by an infected animal through its:

  • urine
  • milk
  • faeces
  • birth by-products, such as the placenta, which is sometimes known as the afterbirth.

It can be spread both by direct and indirect contact. Infection through direct contact, which is most common, happens when a person breathes in the bacteria, which can also survive up to 10 months and people can become infected through the spread of contaminated soil, dust or hay. It is thought to be very unlikely to catch the fever from a person who has it, unless it is through sexual intercourse or a pregnant woman passing it on to her unborn child.

What are the symptoms?

There are two types of Q fever. Acute is the most common and least serious. Some people develop chronic Q fever, which is more serious. It is not known exactly why some people develop it and not others, but affected infividuals usually have a pre-existing health condition, which makes them vulnerable to infection.

You won't think these sheep are so cute if they're infected with Q fever

Acute Q fever symptoms include:

  • high temperature (fever) of 394°C (104°F) or above
  • severe headache
  • muscle and joint pain
  • sweating
  • sensitivity to light
  • weight loss
  • a skin rash (less common)

In a few cases the condition can also lead to mild pneumonia and hepatitis. Endocarditis (inflammation of the inner lining of the heart) is the most common symptom of chronic Q fever.

How is it treated?

The symptoms of acute Q fever usually get better within 2 weeks of developing. A course of antibiotics is often recommended to shorten the time of infection. Chronic Q fever can be more difficult to treat as the particular bacteria which causes the condition can sometimes be resistant to antibiotics. So, a course of a combination of pills over an 18-month period is recommended.

Click here to read more about Croup and Impetigo, which can also be accompanied by a fever.

Images: Wikipedia

What is malaria?

Malaria is commonly known as a fever that can be contracted by mosquitoes when traveling to an exotic country. This is true, but there is so much more to the disease that affects nearly half the global population.

Malaria is a disease that is caused by a parasite. In order for the life cycle of the parasite to function, two hosts are needed: namely the anopheles mosquitoes and humans. A mosquito that carries the parasite will transmit the disease into the human body when biting them. The disease will enter the human’s blood stream, where it will make its way to the liver. From there it will affect the body’s red blood cells. This phase, where the parasite matures in the liver, is called the incubation period, and can last anywhere from 7 to 30 days before the first symptoms appear, the Center for Disease Control writes.

The CDC lists the following as the most common symptoms of malaria:

  • Fever
  • Headache
  • Vomiting
  • Chills
  • Flu-like symptoms
  • Sweats
  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue, weakness

More complicated infections of malaria carry far more severe symptoms, including neurologic abnormalities (seizure, coma), kidney failure and acute respiratory distress syndrome. To find out more about the symptoms, please click here to go to the CDC website.

Malaria usually occurs in stages. It begins with a “cold stage”, where the patient may shiver and feel cold. This is followed by what is called “the hot stage”, where the patient will present symptoms of fever and headaches. The third stage is referred to as the “sweat stage”, where the patient’s temperature slowly returns to normal and sweats.

Malaria is typically diagnosed via a blood test, in which a lab technician will recognize the parasite (under a microscope) in the patient’s red blood cells.

Anopheles mosquito

Where does malaria exist?

When considering malaria affects nearly half the world population, one could assume it is found in 50 percent of the globe. Not so. Malaria is restricted to these key areas: Central Africa, India, some parts of South East Asia, and some parts of Latin America. For a map of where malaria occurs and what conditions it needs to survive, click here.

How is malaria treated?

The first and most important step in treatment is prevention. Prophylactic drugs are currently available for individuals to consume before and during trips to where malaria exists. This oral medication that are used to treat patients suffering from malaria, are also used (in smaller dosages) preventatively, Wikipedia.org writes.

Another effective method to prevent malaria include long-lasting nets to sleep in, and indoor residual spraying, in which insecticides are sprayed onto the walls of the home. These practices are currently being implemented strongly in Africa, where one in five babies will die because of malaria.

Other tips include having mosquito repellent with you at all times, and spraying your body and your clothing with it.

While generations of research have been put into finding a malaria vaccine, no effective vaccine has so far been found. Malaria is generally not a fatal disease, particularly in a mild form, however appropriate medical care is a necessity.

Read our coverage of World Malaria Day.

Images: http://www.sxc.hu/photo/391233, http://commons.wikimedia.org/wiki/File:Anopheles_albimanus_mosquito.jpg