The hindu editorial may 23, 2018 – gas pain left side


The outbreak of the deadly Nipah virus around Kozhikode, Kerala, is a test of India’s capacity to respond to public health emergencies. In 2018, the World Health Organisation listed Nipah as one of the 10 priority pathogens needing urgent research, given its ability to trigger lethal outbreaks and the lack of drugs available against it. As an RNA (ribonucleic acid) virus, Nipah has an exceptional rate of mutation — that is, it can easily adapt to spread more efficiently among humans than it does now. Such an adaptation would result in a truly dangerous microbe.

Nipah already kills up to 70% of those it infects, through a mix of symptoms that include encephalitis , a brain inflammation marked by a coma state, disorientation, and long-lasting after-effects , such as convulsions , in those who survive. Thankfully, in most outbreaks in South Asia so far, the virus has displayed a “ stuttering chain of transmission”. This means that once the virus spreads from fruit bats, its natural reservoir , to humans, it moves mainly to people in close contact with patients, such as hospital staff and family caregivers.

But these caregivers are at high risk, because the sicker the patients become, the more virus they secrete. Preliminary reports suggest that the Kozhikode outbreak is also displaying a stuttering chain of transmission. Of the 11 confirmed Nipah fatalities, three were from the same family. While researchers are still investigating how they were exposed, a bat colony living in a well in the family’s yard is a strong suspect .

This fits in with how outbreaks have historically begun in the subcontinent. In a 2007 outbreak in Nadia, West Bengal, for example, patient zero is believed to have acquired the virus from palm liquor contaminated by bat droppings . The next wave of infections has historically occurred among close contacts and caregivers, such as nurses; the same pattern has been detected in Kozhikode as well.

But these are preliminary reports, and new information may change what we know about the present virus. Several patients with symptoms of infection are under observation. Only when clinical investigations are complete can it be determined how contagious the virus really is. If it is found travelling over long distances, the authorities will have to be ready with strategies to combat its spread. The good news is that Kerala’s public health systems have acted with extraordinary efficiency so far. Doctors identified the virus in the very second patient, a diagnostic speed unrivalled in developing countries.

This must be commended . But big challenges remain. The death of a nurse shows that health-care workers may not be taking adequate precautions when dealing with patients, by using masks and following a strict hand-wash regimen . The virus has no specific treatment. The best defences against it are the age-old principles of infection control, which Indian hospitals have not mastered as yet. b) Venezuela: After re-election

Venezuelan protesters failed last year to force President Nicolás Maduro to step down in the midst of an economic and humanitarian crisis. After his emphatic victory in Sunday’s presidential elections, they have to reconcile themselves to his rule for another six-year term. The embattled Mr. Maduro won the poll with 68% of the vote, and with a turnout of less than 50%, according to the election commission. Potential challengers to Mr. Maduro, Hugo Chávez’s protégé and successor, are either in detention or barred from the contest after they organised mass protests against his government, alleging brutal misrule and economic mismanagement. An umbrella coalition of opposition parties and activist groups, the Broad Front for a Free Venezuela, had called on the people to boycott what they said was as a sham exercise. Mr. Maduro’s closest rival , Henri Falcón, alleged fraud and demanded a fresh ballot. It is highly unlikely that demands for a re-poll will be countenanced by the Maduro regime. But it is clear that the shrinking democratic space has exerted a toll on the polity overall. The Venezuelan health system has all but collapsed. A Minister who expressed concern over the high incidence of certain diseases that were believed to have been eradicated was sacked promptly last year. The collapse of the medical system is particularly shocking, given the emphasis on health care in Chavez’s commodity-driven growth model. Inflation has hit 13,000%, and the economy is set to contract further. It is hard to believe that Venezuela, with the world’s largest proven oil reserves, was considered Latin America’s wealthiest country not so long ago. Venezuelans have been leaving the country to escape shortages of rations and the rampant unrest. The UN estimates that each day 4,000 Venezuelans are making it across to Colombia. There is talk of a concerted international response to the Venezuelan crisis after Mr. Maduro’s re-election, especially further sanctions by the U.S. and possibly the European Union. But there are moral and practical limits to these measures against a country that is gripped by a systemic crisis — and the humanitarian costs of sanctions must not be ignored. In any case, Venezuela’s oil production has been falling steadily, and analysts do not expect that an embargo on its exports would have the desired impact. Mr. Maduro may be part of Venezuela’s problem. But he can be a big part of the solution as well. He could make a beginning by ceding democratic space for dissent both within and outside his party, and by rolling back the country’s confrontational foreign policy. Blaming the West alone for Venezuela’s economic crisis will not get him very far.

Meaning: The changing of the structure of a gene, resulting in a variant form which may be transmitted to subsequent generations, caused by the alteration of single base units in DNA, or the deletion, insertion, or rearrangement of larger sections of genes or chromosomes.

Meaning: A sudden, violent, irregular movement of the body, caused by involuntary contraction of muscles and associated especially with brain disorders such as epilepsy, the presence of certain toxins or other agents in the blood, or fever in children.

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