skyla: January 2025

Tuesday, January 7, 2025

What is HMPV virus currently spreading in China?

Five years after the Covid-19 pandemic, China is now grappling with a surge in cases of Human Metapneumovirus (HMPV), a respiratory virus.

Several media reports and social media posts suggest that the virus is spreading rapidly across the country. Some claim that hospitals and crematoriums are overwhelmed by the influx of patients.

Videos circulating online show crowded hospitals, with users reporting multiple viruses, including Influenza A, HMPV, Mycoplasma pneumoniae, and Covid-19, as the culprits behind the surge in respiratory illnesses.

Reports indicate that the spike in HMPV cases has led to a notable increase in sudden deaths, particularly affecting individuals aged 40 to 80.

“China is facing a surge in multiple viruses, including Influenza A, HMPV, Mycoplasma pneumoniae, and Covid-19, overwhelming hospitals and crematoriums. Children’s hospitals are particularly strained by rising pneumonia and ‘white lung’ cases,” stated a post on X by the SARS-CoV-2 (Covid-19) handle.

Data from the Chinese CDC in late December revealed a fluctuating but increasing positive rate of HMPV cases among children aged 14 and below, according to China’s state broadcaster CCTV.

What Is HMPV?

Discovered in 2001, HMPV belongs to the Pneumoviridae family, which also includes Respiratory Syncytial Virus (RSV). However, serological studies suggest that the virus has been present in humans for over 60 years and is globally distributed.

HMPV can cause both upper and lower respiratory diseases in people of all ages, with young children, older adults, and those with weakened immune systems being most vulnerable.

According to the US Centers for Disease Control and Prevention (CDC), common symptoms include cough, fever, nasal congestion, and shortness of breath.

Li Tongzeng, a chief doctor at Beijing You’an Hospital, explained that HMPV spreads through respiratory droplets, direct contact such as handshakes, or touching contaminated objects. The virus has an incubation period of three to five days.

Preventive measures include wearing masks, frequent hand washing, and boosting immunity.

Experts caution against the use of antiviral drugs to treat HMPV. In an interview with the state-backed National Business Daily, a respiratory expert in Shanghai warned against blindly using antiviral medications, as no vaccine exists for HMPV, and its symptoms often resemble those of a common cold.

In 2023, HMPV cases were reported in the Netherlands, Britain, Finland, Australia, Canada, the US, and China.

Website: International Conference on Infectious Diseases

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Monday, January 6, 2025

Ringworm

What is Ringworm?

Ringworm is a fungal infection that affects the skin, hair, or nails. It causes red, circular rashes with raised edges.
What are the Types of Ringworms?

Some common ringworm types include:

Athlete's Foot: This affects mostly males, causing itching, scaling, and blisters on the feet due to sweating and tight footwear.
Jock Itch: This is also more prevalent in males. It presents as red, itchy patches in the groin area during warm weather, rarely affecting females.
Scalp Ringworm: This is highly contagious, especially in children. Symptoms include red rash, itching, and hair loss on the scalp.
Nail infection: Affects nails, causing thickening and yellowing, more common in adolescents and adults.
Body ringworm: This is characterised by circular, raised lesions with itching, affecting all ages but more prevalent in children in warmer climates.

How Do I Know If I Have Ringworm?

If you are wondering if you have ringworm, look for a red, scaly patch or bump on your skin. It may appear as one or multiple rings with raised, bumpy, scaly edges and a clear centre. Remember, not everyone with ringworm will have the classic ring pattern.

Who Gets Ringworm?

While ringworm can affect anyone, individuals with weakened immune systems face a higher risk of contracting the infection.

What are the Symptoms of Ringworm?

Ringworm can affect various parts of the body, including the skin, fingernails, and toenails, with symptoms such as itchiness, ring-shaped rashes, redness, scaling, and hair loss. Ringworm symptoms differ by location:

Feet: Red, swollen, itchy skin between toes, potential blistering on the sole and heel
Scalp: Scaly, itchy, circular bald patches, more prevalent in children
Groin: Scaly, itchy, red spots in skin folds of the thigh
Beard: Scaly, itchy, red spots on the cheeks, chin, and upper neck, possibly crusted or pus-filled, with hair loss

What Causes Ringworm?

Ringworm causes is primarily by a fungus known as dermatophytes, which prefer warm and moist environments. These fungi can spread when individuals come into direct contact with infected people, animals, or objects, causing ringworm.

Is Ringworm Contagious?

Ringworm is contagious and spreads through direct skin-to-skin contact. Transmission occurs through various means:

Human-to-human: Typically spreads through direct skin-to-skin contact.
Animal-to-human: Contracted by touching infected animals, common in petting or grooming dogs, cats, and cows.
Object-to-human: Can spread via contact with objects recently touched by infected individuals or animals, such as clothing, towels, and combs.
Soil-to-human: Rare transmission occurs through contact with heavily infected soil, usually requiring prolonged exposure.

Will Ringworm Go Away on Its Own?

Yes, ringworm can resolve without treatment, but it may take several weeks to months. However, opting for no ringworm treatment or jock itch can lead to prolonged itching and discomfort.

How is Ringworm Diagnosed?

There are various stages for ringworm diagnosis. A dermatologist can typically diagnose ringworm by visually examining the affected area. They may also inspect other parts of your body, as ringworm can manifest concurrently with conditions like athlete's foot. Additionally, your dermatologist might take a sample of the infected skin, hair, or nail for laboratory analysis. Examining the sample under a microscope allows the doctor to identify the presence of fungi responsible for ringworm.

What is the Best Cure for Ringworm?

The most effective ringworm treatment depends on the location and severity of the infection. However, common treatments include:

Over-the-counter antifungal creams, lotions, or powders for skin infections like athlete's foot and jock itch
Prescription oral antifungal medications for severe or scalp infections
Keeping the affected area clean and dry
Avoid sharing personal items like towels or clothing
Practising good hygiene and regularly washing hands
Treating pets for ringworm if they are carriers.

What’s the Treatment for Ringworm?

Ringworm treatment varies depending on the diagnosis and the severity of the condition-;
Oral Medication

Non-prescription options include clotrimazole, miconazole, terbinafine, and ketoconazole.
Prescription options include griseofulvin, terbinafine, itraconazole, and fluconazole.
Antifungal Creams and Powders

Clotrimazole (Lotrimin, Mycelex)
Miconazole (Monistat, Micatin)
Terbinafine (Lamisil AT)
Tolnaftate (Tinactin)
Ketoconazole (Nizoral)

Home Remedies for Ringworm
While over-the-counter and prescription treatments are typically the most effective options for treating ringworm, some home remedies may provide relief. Here are some simple home remedies for ringworm:

Try using diluted tea tree oil directly on the affected area
Use diluted apple cider vinegar to alleviate symptoms and fight fungal growth
Apply crushed garlic or garlic oil to the skin to combat the infection
Coconut oil can be applied to soothe itching and aid in healing
Apply fresh aloe vera gel to reduce itching and inflammation
Create a paste with turmeric powder and water, then apply it to the affected area
Soak the affected area in warm salt water to reduce itching and inflammation

What are the Risk Factors for Ringworm?

Depending upon the ringworm stage, the following factors that increase the risk of ringworm:

Warm climate
Close contact with infected individuals or animals
Sharing personal items
Wearing tight clothing
Weak immune system
Obesity
Diabetes

Can You Prevent Ringworm?

Ringworm prevention is possible by adhering to the following practices-;

Maintain cleanliness and dryness of your skin
Choose footwear that promotes air circulation
Avoid walking barefoot in communal areas such as locker rooms or public showers
Keep fingernails and toenails trimmed short and hygienic

What are the Complications of Ringworm?

If left unaddressed, ringworm can extend to different body regions, increasing the risk of transmission to others. Additional complications may include:

Hair loss and scarring
Pigmentation changes, especially noticeable on darker skin tones like under the armpits
Nail abnormalities
Secondary infections due to bacteria penetrating broken skin
Majocchi’s granuloma is an uncommon condition where the fungus penetrates deeper skin layers.

Can Ringworm Come Back?

Yes, ringworm can return because the fungi that cause it can stay on the skin for a long time. After treatment, it may come back, so you might need to treat it again.

When to See a Doctor?

Seek medical attention if the rash spreads quickly. Also, if the over-the-counter remedies prove ineffective, or if the rash appears on sensitive areas like the face, scalp, or genitals.

How Does Ringworm Affect Pregnancy?

Ringworm fungus does not affect pregnancy, but you should consult with your healthcare provider before using over-the-counter antifungal creams or powders.

Conclusion

Ringworm is a common fungal infection that can be effectively treated with proper medical intervention. While it may not pose a direct threat to pregnancy, seeking guidance from healthcare providers before using over-the-counter remedies is recommended. At Metropolis Labs, we understand the importance of accurate diagnosis and tailored treatment plans. Our state-of-the-art facilities and experienced healthcare professionals are dedicated to providing comprehensive testing and expert guidance for managing conditions like ringworm. Trust Metropolis Labs for reliable diagnostic solutions and personalized care.

Website: International Conference on Infectious Diseases

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Saturday, January 4, 2025

Poliomyelitis

Polio (poliomyelitis) mainly affects children under 5 years of age.
One in 200 infections leads to irreversible paralysis. Among those paralysed, 5–10% die when their breathing muscles become immobilized.
Cases due to wild poliovirus have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries, to just two endemic countries.
As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in a global resurgence of the disease.
In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems.

Symptoms and risk

Polio is a highly infectious disease caused by a virus. It invades the nervous system and can cause total paralysis in a matter of hours. The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (for example, contaminated water or food) and multiplies in the intestine. Initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs. One in 200 infections leads to irreversible paralysis (usually in the legs). Among those paralysed, 5–10% die when their breathing muscles become immobilized.

Polio mainly affects children under 5 years of age. However, anyone of any age who is unvaccinated can contract the disease.

There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life. There are two vaccines available: oral polio vaccine and inactivated polio vaccine. Both are effective and safe, and both are used in different combinations worldwide, depending on local epidemiological and programmatic circumstances, to ensure the best possible protection to populations can be provided.

Eradication

The strategies for polio eradication work when they are fully implemented. This is clearly demonstrated by the successful eradication of the disease in most countries of the world.

The Polio Eradication Strategy lays out the roadmap to securing a lasting and sustained world, free of all polioviruses, and transition and polio post-certification efforts are ongoing to assure that the infrastructure built up to eradicate polio will continue to benefit broader public health efforts, long after the disease is gone.

Key to success is ensuring the Strategy is fully implemented in all areas and is fully resourced. Failure to implement strategic approaches, however, leads to ongoing transmission of the virus. Endemic transmission of wild poliovirus is continuing in areas of Afghanistan and Pakistan. Failure to stop polio in these last remaining areas could result in global resurgence of the disease. That is why it is critical to ensure polio is eradicated completely, once and for all.

Once polio is eradicated, the world can celebrate the delivery of a major global public good that will benefit all people equally, no matter where they live. Economic modelling has found that the eradication of polio would save at least US$ 40–50 billion, mostly in low-income countries. Most importantly, success will mean that no child will ever again suffer the terrible effects of lifelong polio-paralysis.

The global effort to eradicate polio has been declared a Public Health Initiative of International Concern, under the International Health Regulations, and temporary recommendations by an Emergency Committee under the International Health Regulations have been issued to countries affect by poliovirus transmission or are at high risk of re-emergence of the disease.

The polio effort continues to support broader public health efforts, including helping respond to natural disasters, humanitarian emergencies, droughts, earthquakes, outbreaks of other infectious diseases and supporting disease surveillance for broader public health initiatives.

WHO Response

WHO, together with its GPEI partners, continues to support countries which remain affected by poliovirus or are at high risk of polio re-emergence in implementing eradication strategies, focusing in the first instance on immunization and disease surveillance. Since the GPEI was launched, the number of cases has fallen by over 99%.

In 1994, the WHO Region of the Americas was certified polio-free, followed by the WHO Western Pacific Region in 2000 and the WHO European Region in June 2002. On 27 March 2014, the WHO South-East Asia Region was certified polio-free, meaning that transmission of wild poliovirus has been interrupted in this bloc of 11 countries stretching from Indonesia to India. In 2020, Africa became the fifth region to be certified wild poliovirus-free.

More than 20 million people are able to walk today who would otherwise have been paralysed. An estimated 1.5 million childhood deaths have been prevented through the systematic administration of vitamin A during polio immunization activities.

Website: International Conference on Infectious Diseases

Friday, January 3, 2025

Rabies

Key facts

Rabies is a serious public health problem in over 150 countries and territories, mainly in Asia and Africa. It is a viral, zoonotic, neglected tropical disease that causes tens of thousands of deaths annually, with 40% being children under 15.
Dog bites and scratches cause 99% of the human rabies cases, and can be prevented through dog vaccination and bite prevention.
Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100% of cases.
However, rabies deaths are preventable with prompt post exposure prophylaxis (PEP) by stopping the virus from reaching the central nervous system. PEP consists of thorough wound washing, administration of a course of human rabies vaccine and, when indicated, rabies immunoglobulins (RIG).

Overview

Dog-mediated rabies

Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system. In up to 99% of the human rabies cases, dogs are responsible for virus transmission. Children between the age of 5 and 14 years are frequent victims.

Rabies infects mammals, including dogs, cats, livestock and wildlife.

Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal.

The global cost of rabies is estimated to be around US$ 8.6 billion per year including lost lives and livelihoods, medical care and associated costs, as well as uncalculated psychological trauma.

Rabies is present on all continents except Antarctica. Globally there are an estimated 59 000 deaths from rabies annually; however, due to underreporting, documented case numbers often differ from the estimate.

Rabies, a neglected tropical diseases (NTD), predominantly affecting marginalized populations. Although effective human vaccines and immunoglobulins exist for rabies, these are often inaccessible or unaffordable to those in need.

As of 2018, the average estimated cost of rabies post-exposure prophylaxis (PEP) was US$ 108 (along with travel costs and loss of income), which can be a financial burden on those earning US$ 1–2 per person, daily.

Over 29 million people worldwide receive human rabies vaccine annually.

Rabies from sources other than dogs

In the Americas, where dog-mediated rabies is mostly controlled, hematophagous (blood-feeding) bats are now the primary source of human rabies. Bat-mediated rabies is also an emerging public health threat in Australia and parts of western Europe.

Human deaths following exposure to foxes, raccoons, skunks, and other wild mammals are very rare, and bites from rodents are not known to transmit rabies.

Contraction of rabies through inhalation of virus-containing aerosols, consumption of raw meat or milk of infected animals, or through organ transplantation is extremely rare.

Human-to-human transmission through bites or saliva is theoretically possible but has never been confirmed.

Symptoms

The incubation period for rabies is typically 2–3 months but may vary from one week to one year, depending on factors such as the location of virus entry and the viral load. Initial symptoms of rabies include generic signs like fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Clinical rabies in people can be managed but very rarely cured, and not without severe neurological deficits.

There are two forms of rabies:

Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest.
Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Diagnosis

Currently there are no WHO-approved diagnostic tools for detecting rabies infection before the onset of clinical disease.

Clinical diagnosis of rabies is difficult without a reliable history of contact with a rabid animal or specific symptoms of hydrophobia or aerophobia.

Accurate risk assessment is crucial for deciding on PEP administration.

Once symptoms emerge, and death is inevitable, offering comprehensive and compassionate palliative care is recommended.

Postmortem confirmation of rabies infection is done by various diagnostic techniques that detect whole viruses, viral antigens, or nucleic acids in infected tissues (brain, skin or saliva) (Laboratory techniques in rabies.

Where possible, the biting animal should be tested.

Prevention

Vaccinating dogs

Vaccinating dogs, including puppies, through mass dog vaccination programs is the most cost-effective strategy for preventing rabies in people because it stops the transmission at its source.

Culling free roaming dogs is not effective in controlling rabies.

Awareness

Public education for both children and adults on dog behaviour and bite prevention, what to do if bitten or scratched by a potentially rabid animal, and responsible pet ownership are essential extensions of rabies vaccination programmes.

Vaccinating people

Effective vaccines are available to immunize people both before and after potential exposures. As listed under the WHO - Prequalification of Medical Products, as of 2024, there are only 3 WHO pre-qualified human rabies vaccines available globally: RABIVAX-S by Serum Institute of India Pvt. Ltd., VaxiRab N by Zydus Lifesciences Limited, and VERORAB by Sanofi Pasteur.

WHO response

Rabies is included in WHO’s 2021–2030 Roadmap for the global control of NTDs, which sets regional, progressive targets for the global strategic plan to end human deaths from dog-mediated rabies by 2030 (see also: Zero by 30). This entails:

improving access to human rabies vaccines through the efforts of the WHO and its partners, Gavi, the Vaccine Alliance, which had included human rabies vaccines in its Vaccine Investment Strategy for 2021–2025. Despite pandemic-related delays, WHO now collaborates with Gavi to implement the program in 2024;
providing technical guidance to countries in developing and implementing their national rabies elimination plans, focusing on strengthening surveillance and reporting;encouraging countries to build the capacity of their One Health workforce by using rabies elimination programs as a platform for multisectoral collaborations; and
encouraging the use of United Against Rabies (UAR) multi-stakeholder forum, which was launched in collaboration with WHO, Food and Agriculture Organization (FAO) and World Organisation for Animal Health (WOAH, formerly OIE), to advocate for action and investment in rabies control.

Website: International Conference on Infectious Diseases

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Thursday, January 2, 2025

Stop germs in their tracks: 6 essential hygiene tips

1. Hand Sanitation: The Initial Line of Protection

Children are more likely to be exposed to pathogens during the monsoon because of damp surfaces, tainted water and an increased frequency of indoor activities. Establish a routine where you and your child wash your hands together. Show them the right way to scrub: use soap and water for at least 20 seconds, being sure to get under the nails and in between the fingers. Make the most of this time by having lively, instructive discussions or even by joining in on a handwashing song. Parent-friendly applications that monitor and remind users of their hygiene habits can help them stick to their routines by providing daily reminders and instructive information. This not only strengthens the habit but also transforms a routine activity into a bonding experience.

2. Bathing: More Than Just Cleanliness

Monsoon humidity can lead to excessive sweating, making the skin a breeding ground for bacteria and fungi. Regular bathing helps prevent skin infections and keeps your child feeling fresh and comfortable. Make bath time a fun and relaxing experience. Let your child choose their bath toys or favorite bath products, and educate them on the importance of thoroughly cleaning areas prone to sweat, such as armpits, groin, and feet. Modern apps can help parents track their child's hygiene habits and schedule bath times. These apps may also remind you when it's time to switch out bath products or book a grooming appointment, making it easier for parents to integrate these routines into daily life.

3. Foot Care: Fighting the Fungi

Children love to splash in puddles during the monsoon, but this increases the risk of fungal infections like athlete's foot. Wet feet, if not dried properly, can lead to discomfort and infections. Teach your child the importance of drying their feet thoroughly, especially between the toes, after coming in from outside. Make it a point to inspect their feet regularly for any signs of infection, like redness or itchiness.

4. Diet and Hydration: Internal Hygiene

A strong immune system is vital during the monsoon when infections are rampant. A balanced diet rich in vitamins and minerals, along with proper hydration, helps maintain overall health and resilience against illnesses. Involve your child in meal planning and preparation. Several apps offer individualised meal plans that are kid-friendly and nutrient-dense. These apps can also engage your child in the meal preparation process, allowing you to choose dishes that meet their nutritional needs and preferences while strengthening your bond. Turn cooking into a fun activity where you both can experiment with new recipes, especially those rich in immunity-boosting ingredients like ginger, turmeric and citrus fruits.

5. Clothing: Dressing for the Season

Wearing the wrong clothing during the monsoon can lead to discomfort and increase the risk of infections. Teach your child the importance of wearing appropriate clothing during the monsoon. Ensure they change out of wet clothes immediately after getting drenched.

6. Maintaining Clean Nails and Hair

Regular grooming, particularly during the monsoon, is essential for maintaining hygiene. Set up routine grooming times for your kids, teaching them the proper way to comb their hair and trim their nails. This is a great way to spend quality time together and emphasize the importance of personal grooming. Apps can turn grooming chores into fun, rewarding tasks for kids, helping them take charge of their hygiene. This approach not only makes grooming enjoyable but also strengthens parent-child bonds and encourages healthy habits.

Website: International Conference on Infectious Diseases

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