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The Hindu
5 days ago
- Health
- The Hindu
Scrub typhus is now the most common infectious cause of acute encephalitis syndrome in southern India
A large multicentre study of 587 children with acute encephalitis syndrome (AES) from Karnataka, Andhra Pradesh, and Tamil Nadu has revealed that scrub typhus, a bacterial infection, is now the most common infectious cause of AES in southern India. The study by a team of researchers from NIMHANS, Indira Gandhi Institute of Child Health, Bangalore Medical College and Research Institute, and St. John's Medical College Hospital has been recently published in The Lancet Regional Health - Southeast Asia. Global challenge AES, characterised by acute onset fever and altered mental status and/or new seizures, presents a significant global public health challenge. It has an incidence of 3.5 to 13.8 cases per 1,00,000 patient-years, disproportionately affects children, and is associated with high morbidity and mortality. In India, over 10,000 cases of AES are reported annually to the National Vector Borne Disease Control Programme (NVBDCP). Historically, surveillance efforts have prioritised Japanese encephalitis (JE), even as its incidence has significantly declined due to widespread vaccination. Moreover, recent studies reveal a dynamic, region-specific, and evolving aetiology of AES in India. Scrub typhus (caused by bacterium Orientia tsutsugamushi), an under-recognised cause of AES, has been increasingly reported in certain regions. Aimed at systematically investigating infectious aetiologies of AES in children from southern India and developing clinical prediction models for diagnosing scrub typhus, the study found that the bacterial infection is now the most common infectious cause (44%) of AES in southern India, far exceeding Japanese encephalitis virus (11%). Scrub typhus and other doxycycline-treatable infections are significant contributors of AES in India. However, limited surveillance in southern India has hindered their recognition and the inclusion of doxycycline in treatment protocols. From tertiary care hospitals The prospective study enrolled children aged above 28 days to 18 years with AES presenting to three tertiary care hospitals in Bengaluru - Indira Gandhi Institute of Child Health, Vani Vilas, and St. John Medical College Hospital. Primary outcomes were microbiological diagnosis of AES and clinical prediction models for diagnosing scrub typhus and identifying patients with doxycycline-treatable causes. Models were developed using multivariable logistic regression, internally validated, and simplified into point-scoring systems. Between March 2020 and February 2023, 714 children were screened, of whom 587 were included. Of these, 315 (54%) had a microbiological diagnosis. Scrub typhus accounted for 138/315 (44%), and doxycycline-treatable causes were diagnosed in 193/315 (61%) of these cases. Key predictors associated with both scrub typhus and doxycycline-treatable causes were age, illness duration, lymphadenopathy, oedema, hepatomegaly, lymphocyte count, platelet count, and serum albumin levels, said Tina Damodar, clinical virologist and DBT-Welcome Trust fellow, Department of Neurovirology at NIMHANS, who is the lead author of the study. 'Among the 315 children with an identified infectious cause, dengue (10%), leptospira (5%), and chikungunya (5%) were also notable. Other detected pathogens included herpes viruses, enteroviruses, pneumococcus, tuberculosis, and measles, reflecting a diverse and region-specific AES landscape. These findings highlight the need to update AES surveillance and treatment protocols,' Dr. Damodar told The Hindu on Thursday. 'The study found that over 60% of microbiologically confirmed AES cases were caused by doxycycline-treatable infections, primarily scrub typhus. Despite this, doxycycline is not routinely included in empirical AES treatment in many parts of India,' she said. Recommendation Another author Reeta S. Mani, head of Neurovirology at NIMHANS, said that based on the results, the study recommends including doxycycline or azithromycin in the initial treatment of children with AES or acute febrile illness (AFI) in southern India - a change already implemented at the participating referral tertiary care hospitals. 'Timely treatment is critical. Among the 138 children with scrub typhus, nearly 40% either died or developed neurological complications, largely due to delayed diagnosis. To address this, the study calls for wider availability of scrub typhus diagnostic tests (IgM ELISA or PCR) at primary and secondary care levels,' the doctor said. The researchers have also developed a clinical prediction model - a simple point-based tool that can help frontline clinicians identify children likely to benefit from doxycycline, even before lab confirmation is available.
Time of India
5 days ago
- Health
- Time of India
New study links oral hygiene to cancer risk: 10 tips to protect your oral health
We often view oral hygiene as a cosmetic habit, important for white teeth and fresh breath, but new research suggests it may be far more vital to our health. A recent commentary in The Lancet Regional Health, Southeast Asia links poor oral hygiene to a higher risk of cancer, especially in head and neck cases. Professionals from AIIMS urge a shift in focus: from daily brushing to broader public health efforts like school-based dental care and stricter sugar marketing regulations. As cancer rates rise in Southeast Asia, maintaining good oral health could be a simple yet powerful tool for prevention and survival. What the study says: Link between oral hygiene and cancer outcomes In a commentary published in The Lancet Regional Health , Southeast Asia, AIIMS oncologists Dr Abhishek Shankar and Dr Vaibhav Sahni discussed the rising body of evidence linking oral bacteria such as Porphyromonas gingivalis and Prevotella intermedia with higher cancer incidence and poorer survival outcomes. The researchers noted that routine dental checkups are associated with reduced cancer mortality, underlining that oral hygiene should be integrated into standard oncology care. With the cancer burden increasing in Southeast Asia and preventative care often neglected, they stress the urgent need for structured public health programmes that prioritise oral health. Some of the interventions they proposed include School-based toothbrushing programmes Oral rinse-based point-of-care testing for gum disease detection Distribution of free toothbrushes and toothpaste Health warnings on high-sugar food packaging Incentives for educators and families to promote oral care Dr Shankar noted that 'oral healthcare plays a significant role in enhancing health-related outcomes, including those related to cancer survivorship.' by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Many Are Watching Tariffs - Few Are Watching What Nvidia Just Launched Seeking Alpha Read More Undo His colleague, Dr Sahni, also warned against the marketing of sugary foods using cartoon characters, calling for region-specific research to better inform prevention strategies. 10 Tips to maintain your oral hygiene Brush your teeth twice a day Brushing your teeth in the morning and before bed is crucial. Night brushing removes plaque, food debris, and bacteria that build up during the day, reducing your risk of tooth decay and gum disease. Use proper brushing technique A rushed brushing job can leave plaque behind. Use a soft-bristled brush in gentle, circular motions for at least two minutes. Avoid aggressive scrubbing, which can erode enamel and damage gums. Don't forget your tongue Bacteria can accumulate on your tongue, contributing to bad breath and oral health problems. Gently brushing your tongue every time you brush your teeth helps keep your whole mouth clean. Choose fluoride toothpaste Fluoride is essential for strengthening tooth enamel and protecting against decay. Always choose a fluoride toothpaste, regardless of the brand or flavour. Floss daily Flossing helps clean areas your toothbrush can't reach between the teeth and under the gumline. Daily flossing reduces plaque buildup and lowers your risk of cavities and gum disease. Rinse with a mouthwash A fluoride-based mouthwash can further protect your teeth and freshen your breath. Use it at a different time of day than brushing, such as after meals, to avoid rinsing away fluoride from toothpaste. Drink plenty of water Water, especially if fluoridated, helps rinse away food particles and maintain saliva flow, which is vital for neutralising harmful acids in the mouth. Limit sugary and acidic foods Frequent consumption of sugar and acidic drinks like sodas, tea, and citrus can erode enamel. Try to reduce their intake and rinse your mouth with water after consuming them. Schedule regular dental checkups Visit your dentist every six months for a professional cleaning and exam. Dentists can detect early signs of decay, gum disease, or other issues before they become serious. Maintain a complete oral care routine Good oral health involves consistent habits. Brushing, flossing, tongue cleaning, and regular dentist visits form the foundation of long-term dental wellness. Also Read: Alzheimer's disease: Causes, early symptoms, and 11 lifestyle changes that could help prevent it
The Hindu
07-07-2025
- Health
- The Hindu
Polluting cooking fuel users may be at a higher risk of cognitive impairment finds study in Karnataka
A recent study published in The Lancet Regional Health - Southeast Asia has found that polluting cooking fuel users may be at a higher risk for cognitive impairment. Highlighting the need for policies promoting the adoption of clean cooking fuel/technology, the study found that rural females, who tend to be more exposed than males, could have greater vulnerability to household air pollution's (HAP) adverse effects on the brain. A team of researchers from the Centre for Brain Research at the Indian Institute of Science (IISc) in Bengaluru and University of Chicago, United States, used baseline data from participants of the ongoing prospective cohort study, Centre for Brain Research - Srinivaspura Aging, Neuro Senescence, and COGnition (CBR-SANSCOG). Data was collected between January 2018 and December 2023. Under the CBR-SANSCOG cohort, adults aged over 45 years from the villages of Srinivaspura taluk in Kolar district of Karnataka were recruited. Of the sample size of 4,145 adults, as many as 994 participants who passed the MRI quality control were included in the MRI analysis. Household air pollution HAP is a specific type of indoor air pollution, which primarily results from the use of polluting cooking technology - coal stoves, biomass stoves, chullahs (earthen stoves) and polluting fuels such as firewood, cow dung cake, coal, lignite or charcoal, and kerosene, in and around the house, leading to the production of gaseous toxins. While HAP from polluting cooking fuels, a rampant issue in rural India, is suspected to be a significant modifiable risk factor for cognitive impairment, evidence supported by neuroimaging in this population was lacking. 'Our study aimed to explore the relationship between polluting cooking technology, as a proxy for HAP, and cognitive performance, and brain morphology in the Srinivaspura cohort. We hypothesised that HAP exposure is associated with poorer cognitive performance and adverse brain morphology in this population. We also examined how factors such as age and sex affected this association and complemented our findings with insights from structural brain MRI,' one of the authors from the CBR team told The Hindu. Cognitive functions According to the study, only polluting cooking technology users had significantly lower scores in global cognition, visuospatial ability and executive functions, whereas at least one polluting cooking technology user had lower scores in global cognition only, compared to the clean cooking technology users. 'This study noted significantly poorer performance in global and domain-specific cognitive functions among polluting cooking technology users. Moreover, polluting cooking technology use was significantly associated with lower hippocampus volumes in females, the region which is primarily implicated in Alzheimer's disease (AD) pathology,' the CBR team said. 'When solid fuels are burned indoors for cooking, especially in poorly ventilated spaces, air pollutants like oxides of carbon, nitrogen, sulphur, heavy metals, volatile organic compounds, and suspended particulate matter are released. These pollutants have been implicated in adversely affecting brain health via different mechanisms. The primary mechanisms may be related to inflammation and oxidative stress, wherein ultrafine air pollutants affect the brain directly by entering the brain through the olfactory bulb or by crossing the blood–brain barrier (BBB),' the study noted. The impact of household air pollution on health According to the World Health Organization (WHO), 3.2 million premature deaths occurred worldwide from illnesses attributed to HAP as of 2020. These include ischaemic heart disease, stroke and chronic pulmonary conditions. In India, as of 2019, 0.81 million deaths were attributed to HAP. The 2019–21 National Family Health Survey-5 reported that 41.4% of households in India lacked access to clean cooking fuels. This disparity was more pronounced in rural areas, wherein 56.8% of households utilised polluting cooking fuels, compared to 10.3% in urban areas. In Karnataka, 30.7% of rural households relied on unclean cooking fuel in 2019–20. A 2017 nationwide study found that deaths and DALYs (disability-adjusted life years) due to HAP in Karnataka were significantly higher than those caused by ambient particulate matter pollution, contrasting with the trends in most other States. Modifiable risk factor While a large body of evidence exists documenting the effects of air pollution on cardiovascular and pulmonary health, its impact on cognition and brain health is only recently being explored. Besides the well-recognised risk factors for cognitive impairment, such as age, genetic predisposition, and cardiovascular diseases, increasing evidence suggests that air pollution is a modifiable risk factor. 'Our study echoes the findings from a harmonised analysis of ageing studies across India, China and Mexico that revealed poorer cognitive function among polluting cooking fuel users. It is among the first few studies to produce findings specific to a rural Indian setting. Recent findings from cross-sectional data of the Longitudinal Aging Study in India (LASI) showed that HAP was negatively associated with cognitive functioning among rural residents, particularly in older rural women. Another study among rural adults in South India found a higher prevalence of cognitive impairment among polluting cooking fuel users,' the study added.
The Irish Sun
27-05-2025
- Health
- The Irish Sun
The children's cancer that takes the longest to diagnose – and the signs to watch for
TEENAGERS and children with bone cancer face longer waits for a diagnosis than those with other types of the disease, a new review has revealed. The longer cancers are left untreated the bigger they can grow and harder they are to cure, Cancer Research UK warns on its website. 3 Most childhood cancers are only picked up during emergency trip to A&E or hospital Credit: Getty Scientists from the University of Nottingham analysed data on 2,000 young patients diagnosed with the disease between September 2020 and March 2023. They found the average time to diagnosis was 4.6 weeks – but some children waited up to six years. Young people aged 15 to 18 had the longest delays, waiting an average of 8.7 weeks to be diagnosed. But kids with bone cancer faced the worst delays overall, waiting an average of 12.6 weeks – more than three months. Read more on bone cancer In contrast, babies under one were diagnosed after just 3.7 weeks on average, and children with kidney cancer were diagnosed in just 2.3 weeks. The most common form of bone cancer in children is osteosarcoma - with 30 new cases diagnosed in the UK year, according to Although it can develop in any bone, it occurs most often in the bones on either side of the knee (tibia or femur) and in the upper arm. The symptoms are: Most read in Health Bone pain – this may come and go initially but then become more persistent Tenderness Redness Swelling Fracture may occur after a minor injury at the site of the weakened bone Experts said half of all children and young people with cancer in the UK are still waiting four weeks or longer for a diagnosis. 3 Symptoms of bone cancer, including swelling, tenderness, redness and fractures The signs and symptoms of cancer Most cases (67 per cent) were only picked up after an emergency trip to A&E or hospital. Writing in The Lancet Regional Health – Europe, the researchers said there were 'disparities for age and diagnostic groups' and called for urgent action to speed up diagnosis for those facing lengthy waits. Dr Shaarna Shanmugavadivel, from the University of Nottingham, said: 'For the first time, we understand the current landscape of childhood cancer diagnosis in the UK. 'There is an urgent need to focus efforts on young people and tumour types such as bone tumours that are still experiencing lengthy intervals. 'Earliest possible diagnosis is key as time is crucial. Untreated, tumours grow bigger and can spread around the body, requiring more extensive surgery and more intensive therapies to offer cure. 3 Kids with bone cancer faced the worst delays overall Credit: Getty 'The findings will help focus efforts towards closing the gap for these groups, ensuring more children and young people receive a diagnosis sooner.' Ashley Ball-Gamble, chief executive of The Children and Young People's Cancer Association, and co-author of the study, added: 'It's crucial that we understand why certain groups, such as older teenagers, or those with certain cancers, such as bone and brain tumours, are likely to face a lengthier diagnosis. 'By recognising these differences, we hope to work towards faster diagnoses and improved survival rates.' How long it takes to diagnose different childhood cancers Bone cancer – 12.6 weeks Skin and other carcinomas – 9.6 weeks Lymphoma – 7.9 weeks Brain and spine tumours – 7.6 weeks Soft tissue cancers – 6.9 weeks Germ cell tumours – 5.9 weeks Liver tumours – 5.1 weeks Neuroblastoma – 4.4 weeks Eye cancer (Retinoblastoma) – 4.1 weeks Leukaemia – 3.1 weeks Kidney cancer – 2.3 weeks Source: University of Nottingham
Yahoo
02-05-2025
- Health
- Yahoo
Top virologists sound the alarm on bird flu and plead with world leaders to prepare for another pandemic
Leading virologists from over 40 countries are sounding the alarm over the increasing threat of H5N1 avian flu—which can cause coughing, body aches, fatigue, pneumonia, and other symptoms in humans—urging global leaders to step up with a range of measures and to use knowledge gained during the COVID pandemic. 'In the U.S. sporadic human infections with no known contact with infected animals highlight the possibility of viral adaptation for efficient human-to-human transmission,' Global Virus Network (GVN) scientists write in a commentary published this week in The Lancet Regional Health–Americas. 'Concurrently, the virus continues to circulate in wild birds, backyard flocks, and hunted migratory species, further amplifying the risk to humans and domestic animals.' The experts compel leaders to address the issue by boosting surveillance, enhancing biosecurity, and preparing for potential human-to-human viral transmission. The authors note that more than 995 dairy cow herds and at least 70 people have been infected with H5N1, including severe cases and the first reported U.S. death. 'Understanding the current landscape of H5N1 infections is critical for effective prevention and response,' Dr. Sten H. Vermund, chief medical officer of the GVN and dean of the USF Health College of Public Health at the University of South Florida, said in a press release. 'The virus's ability to infect both animals and humans, combined with recent genetic changes, underscores the importance of proactive surveillance and rapid response measures.' The highly pathogenic influenza virus is now circulating in all 50 states and Canada, the virologists warn, resulting in the loss or culling of more than 168 million poultry animals in the U.S. since 2022. While human-to-human transmission is not documented, experts warn that virus mutations or the combination of two flu viruses could increase transmissibility. The researchers made several recommendations: Continuously monitoring animals, including testing milk, wastewater, and people working with infected animals, to track virus evolution that may lead to human-to human transmissibility. Accelerating the sharing of genomic data among global research networks to track virus evolution and spread. Using personal protective equipment and strict farm-cleaning protocols. Advocating for self-administered diagnostic tests for farmworkers and health care access for frontline medical workers. Providing more funding for responses, especially in high-risk regions. Investing in predicting traits of avian flu viruses from genetic data. Developing and rapidly administering vaccines to people and animals. Conducting clinical studies on the properties of emerging virus strains, potential therapies, and vaccines. 'A robust nationwide monitoring system is essential to quickly detect and quarantine affected animals and implement preventive measures to curb further spread and human infections,' said Elyse Stachler, GVN member and a research scientist at the Broad Institute of MIT and Harvard. 'Further, we believe it is crucial to maintain trust and stakeholder buy-in for monitoring programs, particularly from farmworkers.' 'We are advocating for community-driven strategies to ensure the successful implementation of vaccines, if necessary,' said Dr. Christian Bréchot, president emeritus of the GVN and director of the USF Health Microbiomes Institute and senior associate dean for research in global affairs in the USF Health Morsani College of Medicine. 'The situation with H5N1 demands heightened vigilance and collaboration across public health sectors. Early detection and robust surveillance are critical to prevent further spread.' More on infectious disease: At this rate, measles could become endemic again within 2 decades, researchers warn As measles spreads throughout the U.S., here's how to tell if you need a booster shot What are the symptoms of bird flu and how does it spread? This story was originally featured on
