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Indian scientists detect new strain of dengue

InnoHEALTH Magazine — Tue, 10 Apr 2018 08:55:07 +0000

Scientists at Pune-based National Institute of Virology (NIV) have found a new genotype of dengue virus in patients who suffered due to one of the worst epidemics in recent years in Tamil Nadu. The study shows that the strain originated in Singapore and emerged in Tamil Nadu in 2012 and Kerala in 2013.

Even a single cell bacterium has not only DNA but also cell organelles. But viruses are just bits of DNA material in a wrap, and they use cellular mechanism of the host to multiply themselves. In doing so they damage the infected cells. The immune system of the body responds with production of specific antibodies, which destroy specific viruses.

Dengue virus comes in different types and each with different flavours. There are four serotypes of dengue virus – DENV-1 to 4. Each of them has multiple genotypes. The genotype variation can be subtle either in DNA material or the envelope. For example, DENV-1 comes in as many as five genotypes – Asia, South Pacific, Thailand, Malaysia and AM/AF.

When infected first time, the patient developed a life time immunity for that serotype due to presence of antibodies produced earlier. However, if the secondary infection is by another serotype, the immune system is confused, and the infection can become life threatening.

“Dengue virus has four antigenically defined serotypes and each serotype has multiple genotypes with several clades based on phylogenetic analysis of envelope or whole genome sequences” says D Cecilia of the Dengue Group at ICMR-NIV, Pune, who is the lead author of the new study. This makes developing an effective vaccine a major challenge.

During the last five years, the National Vector Borne Disease Control Programme (NVBDCP) reported 80,725 cases of dengue per year with a fatality rate of about 0.24%. The ten-year data for Tamil Nadu, 2007–2016 show an average of 2539 cases per year with fatality of 0.21%. This is less than the national average. However, during 2012 the cases spiked to 12,826 and deaths rose to 66, which implied fatality of 0.51%. This was a clear signature of a dengue epidemic. Epidemiological studies indicated that Tirunelveli in Tamil Nadu was the epicentre of the epidemic.

Past research had shown that the emergence of new genotype was the cause of the major dengue outbreak in late 1980s in India. Taking a cue, scientists led by Dr Cecilia collected blood samples from patients in South India during the 2012 outbreak with the help of Vellore-based Christian Medical College. The genome sequence of the virus collected from the samples were compared against the GenBank library which hosts all known dengue virus samples from 1943 to 2015.

The study revealed that DENV-1 Asian genotype had replaced the AF-AM type that was hitherto dominant in Tamil Nadu. “All four serotypes were circulating but DENV-1 was dominant, present in 52% of the serotyped samples” says Cecilia. Further, the study showed that the DENV-1 Asian genotype had also developed a new phenotype in the E gene. “This is the first time after 20 years we are observing change in genotype in India,” the scientist added.

DENV-1 originated in US and Japan during 1932. However, the Asian genotype of DENV-1 that emerged in Thailand. The Indian strains that caused havoc during the 2012-15 emerged in Singapore sometime in 2005. The same strain caused an epidemic in Singapore in 2005 and later in 2009 in Sri Lanka. “Phylogenetic analysis revealed that the Asian genotype was introduced from Singapore and shared 99% similarity with viruses, associated with large outbreaks in Singapore and Sri Lanka. The movement of DENV can affect dengue outbreaks and underscores the need for close molecular monitoring of DENV,” says Dr Cecilia.

The findings are published in journal Virology. The research team included D. Cecilia, J.A. Patil, M.B. Kakade, A. Walimbe, K. Alagarasu, B. Anukumar, from National Institute of Virology and A. Abraham from Christian Medical College, Vellore.

(Article shared from India Science Wire)

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Medical tourism needs systematic structure

InnoHEALTH Magazine — Thu, 05 Apr 2018 07:21:05 +0000

The Medical Tourism Industry, poised to be a whooping USD 8-9 Billion Industry in India by the year 2020, is highly unorganized & unstructured. According to various reports of Industrial bodies, Indian Medical Travel Industry or Healthcare services is growing at a compounded rate of 20-25 per cent.

The Medical and Wellness Industry in India, being a highly unorganized and unstructured industry, is currently driven by limited market players and requires a systematic structural presentation, according to an in-depth study titled “Medical Tourism Opportunities and Challenges”.

The study, conducted in Delhi and National Capital Region (NCR), found if structural development of the sector is ensured, it will facilitate creation of a level playing field for the medical & ancillary service providers which in turn will put the country as one of the most premier Medical Travel destination in the world.

Jitin Kapoor, Joint Secretary at International India Medical Tourism Congress (IIMTC), who spearheaded the study along with a team of researchers, told “Inno Health” in an exclusive interview that the Medical Tourism Industry is undoubtedly one of the most promising sector for the country’s economy, and shall be one of the major source of revenue generation, as well as job creation in near future.

The study finds positioning India in the world market as a bigger and valued prospect for medical travelers from around the world. Mr Kapoor, also a chartered accountant, recommended that there is a dire need to improve the local travel and accommodation facilities for the medical tourists. The available ancillary services need to be adequately marketed and showcased for the medical travelers as a lot of difficulty is faced by them due to lack of awareness.

According to him, the payment security for service providers as well as medical travelers needs to be developed through a dedicated digital payment platform.

A common organizing platform, integrating all the medical service providers, along with the related service providers is highly desirable. They are required to be brought on single digital platform which will assist in providing transparent and conducive environment leading to a positive feedback and in turn help the industry to flourish.

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Medical Tourism, also known as Health & Wellness tourism, in recent years, has been coined as a term to represent the movement of people from one place to another for their medical treatment care, and wellness needs. People from across the world travel to other countries for their surgical, medical, dental requirements, etc.

And at the same time make some time for family vacations, tours & travels to experience the local attractions of the destinations. Such movement has in itself evolved as one of the most rapidly growing industry integrating travel & tourism sector with healthcare and wellness sector; both being the most revenue generating sectors for an economy.

India, Thailand, Singapore, Malaysia, Greece, Peru, to name a few are some of the major Medical Travel destinations. This phenomenon has been actively prevalent in the healthcare sector across the globe for last one and half decade and is growing tremendously.

With high cost of treatment in the West, to the long waiting time for treatment in the EU Countries, the people from developed and industrialized nations are looking for destinations that have a ready availability for treatments with the facilities that are at par with their own country. The countries like Africa, Oman, Afghanistan, etc. are also looking for better healthcare infrastructure as compared to their own.

India can serve as an enormous potential destination for all the international medical travelers owing to its healthcare facilities that match the best in the world, along with a vast number of West trained medical practitioners. Another major factor is the cost effectiveness the Indian Healthcare sector provides viz-a-viz the International healthcare costs. People travelling for medical processes can get the treatment readily available and that too with a 5-Star Hospitality (in a fraction of the cost they incur in their own countries). Travelers also have an option to explore the country with amazing picturesque destinations, backed with rich heritage culture.

This exceptional combination has already made the Medical Tourism Industry worth 2.5 Billion USD in India, growing at a compounded rate of 20-25 per cent, as per various reports of Industrial Bodies.

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INNOVATING CARE: HEALTHCARE TO WELLCARE

InnoHEALTH Magazine — Wed, 12 Apr 2017 05:54:54 +0000

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Innovating Care: Healthcare to Wellcare
Steven Yeo, Founder & CEO, TalentGrid Ventures Pte. Ltd. has more than 25 years of international business and management experience working with government, multi-national corporations and non-profit organisations. He specialises in healthcare, advanced technology and life sciences practice group for both multinationals and local companies. Prior to starting up TalentGrid Ventures Pte Ltd, Steven was the EVP for DHR International a global-retained search firm covering Asia Pacific. He was also the Vice President and Executive Director for HIMSS (Healthcare Information and Management Systems Society – the largest Healthcare IT society in the world). Steven was also the Director of Intel Corporation managing its e-Business Group and Digital Health Group from 1999-2008 in the Asia Pacific region.

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Healthcare today is in a truly interesting state of transition from traditional to wellcare models, powered by technology and disruptive innovation. To address the prevailing healthcare challenges and also leverage on the opportunities, there needs to be a coordinated effort across multiple stakeholders in order to deliver innovation that can improve outcomes, expand access and increase affordability of healthcare in Asia Pacific and beyond.

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We are at the turning point of a new generation of healthcare: The transition from healthcare to wellcare, facilitated by technology and innovation that can help improve individual patient outcomes and elevate the standard of care. The transition is, however, not always a smooth one. In Asia, which is considered to be the fastest-growing and most dynamic region in the world today, there still exists a huge disparity in access to high quality and cost-effective healthcare for millions of people. In fact, the need in some Asian countries is particularly acute, especially with the rapid growth of the ageing population.

Lack of patient awareness, infrastructure, proper training for healthcare professionals, and in some cases, lack of healthcare manpower itself, are just some of the barriers to effective healthcare and recovery. On the other hand, there are also empowered and engaged healthcare consumers who may have a different set of needs to satisfy. In order to address these barriers while at the same time pushing down costs, healthcare experts collectively agree on one thing – innovation. Disruptive innovation, according to some, because current healthcare systems in place are ailing and they need help.

By definition, disruptive innovation is one that creates a new market and value network by disrupting an existing market either through a brand new solution or a perhaps a creative spin on something that already exists in order to deliver better results. Healthcare today is in a truly disruptive state, opening up doors for opportunities for different healthcare stakeholders.

Innovating Care Asia Pacific (ICAP) 2016 conference is an event platform that aims to build a community of highly influential, knowledgeable, and very well connected healthcare professionals, decision makers, thought leaders and influencers who are passionate about transforming healthcare, for the greater good of the patients and other healthcare consumers. There is a great need to address prevailing challenges and leverage on the opportunities – and these require a coordinated effort across multiple stakeholders in order to deliver innovation that can improve outcomes, expand access and increase affordability of healthcare in Asia Pacific.

The Silver Tsunami

Considering that most of the countries in Asia Pacific are rapidly ageing, with a vast majority of those above 60 yrs requiring treatments and assisted care, governments and concerned institutions are therefore hard-pressed to establish and implement measures that would help the seniors age-in-place and continue living fulfilled lives.

Singapore is one of the fastest ageing countries in the world. According to the Long-Term Care in Singapore Challenges and Learning Points presentation by the Ministry of Health (Singapore), the estimated number of Singaporeans aged 65 and above who may require assistance with mobility and other activities of daily living is expected to nearly triple between 2010 and 2030. Which means that by 2030, one in five Singaporeans will be aged 65 and older and there will be nearly a million elderly, most of whom will be afflicted with at least one chronic disease, resulting in reduced autonomy and lower quality of life.

To ensure good quality of life for the seniors even as they grow frail, the Singapore government is now looking into a more patient-centric view of long-term care focusing on accessibility, quality and affordability. Meanwhile, innovators from the private sector continuously churn out innovative solutions and re-engineering care models to help the elderly cope with ageing, whether in the confines of their own home or in nursing homes. These innovations may come in the form of health kiosks, ILTC subsidies, augmentation of manpower with the use of technology and more. In other developed countries like Japan, said to be the world’s most ageing society, more radical solutions have been devised to meet this challenge. In less developed countries in the region, you might be surprised to see unexpected forms of innovation that deliver tremendous results as what the Indian hospitals that became the subjects of Vijay Govindarajan and Ravi Ramamurti’s Harvard Business Review-published study called Delivering World-Class Healthcare, Affodably, have shown.

Taking off from the discussion and knowledge exchange that had transpired during the ICAP 2016 Conference, Innovating Care Asia Pacific is launching a vertical spin-off forum focusing mainly on Elderly and Home Care where decision makers, practitioners, researchers, service providers, and community members can share their experiences to support and empower rapidly ageing populations worldwide through the integration of healthcare, social participation and community.

As the healthcare sector slowly but steadily moves away from physician-centred to patient-centric health, patients are now encouraged and empowered to take charge of their health and treatment. And with the help of technology and innovation, patients are now also redefining the very borders of healthcare. As someone who has spent many years entrenched in the healthcare and healthcare IT sectors, I am happy to take part in this new revolution that will see more and more patients owning their health, as we slowly transit from traditional healthcare models to wellcare.

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