Diseases Current Affairs

Kerala Government declares Kozhikode and Malappuram districts free from Nipah virus

Kerala Government has declared Kozhikode and Malappuram districts free from Nipah virus infection. These districts were declared as temporarily Nipah free as no positive case of the infecton was reported till completion of double incubation period of the virus. Earlier in June 2018, state government had lifted the travel advisory issued in the wake of the virus for travelling to any part of the state. It also had lifted high alert in districts and said the virus has been brought under control and its spread checked. Educational institutions were also reopened.

Nipah Virus (NiV) Infection

NiV infection is zoonotic disease (disease transmitted to humans from animals) that causes severe disease in both animals and humans. The organism which causes Nipah Virus encephalitis is RNA or Ribonucleic acid virus of family Paramyxoviridae, genus Henipavirus, and is closely related to Hendra virus.

Origin: It was first identified in 1999 during outbreak among pig farmers in Malaysia and Singapore. It gets its name from Sungai Nipah, a Malaysian village, where pig farmers became ill with encephalitis. In these subsequent outbreaks, there were no intermediate hosts of the virus. In Bangladesh in 2004, humans got infected after consuming date palm sap that had been contaminated by infected fruit bats.

Natural Host: Fruit bats of Pteropodidae Family, Pteropus genus are natural host of the virus. The virus is present in bat urine and potentially, bat faeces, saliva, and birthing fluids. Presumably, first incidence of NiV infection occurred when pigs in Malaysian farms came in contact with fruit bats who had lost their habitats due to deforestation.

Transmission: The virus spreads fast and is mostly fatal. Infected bats shed virus in their excretion and secretion. It cannot be transmitted through air. It is transmitted through direct contact with infected bats, pigs. Human to Human transmission from other NiV-infected people is also reported.

Signs & Symptoms: NiV infection in humans has range of clinical presentations i.e., from asymptomatic infection to acute respitatory syndrome and fatal encephalitis (inflammation of brain). After exposure and incubation period of 5 to 14 days, illness presents with 3-4 days of fever and headache, followed by drowsiness, disorientation and mental confusion. These signs and symptoms can progress to coma within 24 to 48 hours. The mortality rate of patients infected with NiV infection is reportedly 70%. It is capable of causing diseases in domestic animals too.

Treatment: There is no vaccine for NiV disease either for humans or animals. The main treatment for those infected is intensive supportive care and supportive medicines. NiV Infection can be prevented by avoiding exposure of infected people without protective gear. In disease prone areas, fruits strewn on the ground should not be eaten, for safety.

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International Classification of Diseases: WHO classifies gaming addiction as mental health disorder

The World Health Organisation (WHO) has classified gaming addiction as mental health disorder in its International Classification of Diseases (ICD) 11. This is as per draft of new document that was released in December 2017. This classification will be used by health professionals across the globe to uniformly diagnose and classify risks for addictive gaming behaviour.

WHO definition of gaming addiction

WHO defines gaming disorder as pattern of gaming behaviour (video-gaming or digital-gaming) characterized by impaired control over gaming, increased priority given to gaming over other activities to such extent that gaming takes precedence over other interests and daily activities. It also includes continuation or escalation of gaming despite occurrence of negative consequences. For its diagnosis, behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and normally have been evident for at least 12 months.

Need

Mental health experts and psychiatrists believe that internet and gaming addiction though affecting small population now, has become emerging psychological malady and it is likely to be major mental health problem in the coming years. The Diagnostic and Statistical Manual (DSM) of Mental Disorders-V, a diagnostic bible for mental health professionals published by American Psychiatric Association already has classified gaming disorder as mental health condition. Nearly 7% of population studied for gaming and internet addiction have exhibited depressive symptoms, somatisation and anxiety, including behavioural changes and sleep disturbances.

International Classification of Diseases (ICD)

ICD is the international standard diagnostic tool for epidemiology, health management and clinical purposes. Its full official name is International Statistical Classification of Diseases and Related Health Problems. It is maintained by WHO and is revised periodically.

ICD serves as foundation for identifying health trends and statistics worldwide. It is designed as health care classification system to provide system of diagnostic codes for classifying diseases, including nuanced classifications of wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease.

It provides common language that allows health professionals to share health information across the globe. It contains around 55,000 unique codes for injuries, diseases and causes of death.

It maps health conditions to corresponding generic categories together with specific variations, assigning for these designated code, up to six characters long. It also promotes international comparability in collection, processing, classification, and presentation of these statistics.

ICD-11

It will be presented at World Health Assembly in May 2019 for adoption by WHO member states, and it will come into effect on January 1, 2022. It also has for first time added chapter on traditional systems of medicine. This will pave way for such treatments to be covered by insurance as insurance reimbursements based on ICD coding.

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