Zika in India

Ahmedabad health officials found out about Zika cases in their city from WHO website on Friday

The Union health ministry and the Gujarat government were told about three Zika cases, but the information was not passed on to the local authorities.

The Indian Council of Medical Research told the Ministry of Health and Family Welfare and the Gujarat government about the three cases of Zika virus infections in Ahmedabad as soon as they were confirmed positive, said Dr Soumya Swaminathan, director-general of the apex body for medical research in the country. The first case was confirmed on January 4.

However, the government appears not to have passed this information to the local authorities in charge of disease prevention and control measures. Said Dr Vijay Kohli, entomologist, Ahmedabad Municipal Corporation: “We got to know about Zika cases in Ahmedabad after reading about it on the WHO website.”

Local health authorities under city corporations conduct disease control activities such as controlling the spread of the mosquitoes, informing the public and treating the infected people.

Within the Indian Council of Medical Research, the information remained within a “core group” that deals with virology, said Swaminathan. More than 50 laboratories have been trained to test for the Zika virus in India. Asked whether they were alerted that the disease had entered India, Swaminathan said they were not.

A new disease enters India

In March 2015, Brazil began to report a spurt in cases of microcephaly, where babies are born with abnormally small heads. The scientific consensus is that the microcephaly cases were caused by the Zika virus. The virus is mainly transmitted by the bite of the Aedes aegypti mosquito. People with the disease can have symptoms including mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache.

India began surveillance for the Zika virus in July 2016. So far, 34,233 human samples and 12,647 mosquito samples have been tested for the presence of Zika virus. No mosquito samples tested so far have shown the presence of the virus.

In March 2017, the Minister of State for Health and Family Welfare Anupriya Patel, in answer to a question in the Lok Sabha, said: “So far only one case of laboratory positive zika virus disease has been detected in Ahmedabad, India as part of routine laboratory surveillance in January, 2017.”

But the information did not become widely known until the World Health Organisation published an update on May 26, saying it had received information from India about three cases of Zika infections.

All three cases – a 64-year-old man, a 34-year-old new mother and a 22-year-old pregnant woman – have been reported from the Bapunagar locality of Ahmedabad. The cases were first detected in BJ Medical College in Ahmedabad. The three cases were re-confirmed as positive by National Institute of Virology.

The 34-year old woman was detected with Zika in January, when she was still pregnant. The other two cases were confirmed by end of March, said Swaminathan. However, Indian government sent the information to the WHO only on May 15.

Union health ministry officials have been unavailable for comment and have not issued an official statement at the time that this story was published.

Timeline of Zika in India: What we know so far

  • July-August 2016: Surveillance of Zika virus begins. Indian Council of Medical Research assigns about 50 laboratories the task of testing for Zika in cases of acute ferbile illness where dengue and chikungunya tests are negative.
  • November 2016: 34-year-old woman who delivers baby in BJ Medical college in Ahmedabad tests positive for Zika.   
  • January 4, 2017: The 34-year-old woman’s positive test results are confirmed by the National Institute of Virology. This is the first confirmed case of Zika in the country.
  • February 2017: During surveillance of acute febrile illness between February 10 to February 16, the blood sample from a 64-year old man in Ahmedabad is found positive for Zika. During the same surveillance period, another 22-year-old woman who is 37 weeks  pregnant tests positive for Zika. Both samples are sent for re-confirmation to National Institute of Virology
  • March 17, 2017: Responding to a question in Parliament, Minister of State for Health and Family Welfare Anupriya Patel says that one laboratory positive case of Zika has been found in India.
  • March 2017: Around the end of March, the National Institute of Virology re-confirmed the other two cases of Zika virus in Ahmedabad. 
  • May 15: The Ministry of Health and Family Welfare informs World Health Organisation about the confirmed Zika cases.
  • May 26: The WHO releases a statement about the confirmed Zika cases
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Changing the conversation around mental health in rural India

Insights that emerged from discussions around mental health at a village this World Mental Health Day.

Questioning is the art of learning. For an illness as debilitating as depression, asking the right questions is an important step in social acceptance and understanding. How do I open-up about my depression to my parents? Can meditation be counted as a treatment for depression? Should heartbreak be considered as a trigger for deep depression? These were some of the questions addressed by a panel consisting of the trustees and the founder of The Live Love Lough Foundation (TLLLF), a platform that seeks to champion the cause of mental health. The panel discussion was a part of an event organised by TLLLF to commemorate World Mental Health Day.

According to a National Mental Health Survey of India 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS), common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. The survey reported a huge treatment gap, a problem that is spread far and wide across urban and rural parts of the country.

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During the visit, the TLLLF team met patients and their families to gain insights into the program’s effectiveness and impact. Basavaraja, a beneficiary of the program, spoke about the issues he faced because of his illness. He shared how people used to call him mad and would threaten to beat him up. Other patients expressed their difficulty in getting access to medical aid for which they had to travel to the next biggest city, Shivmoga which is about 2 hours away from Davangere. A marked difference from when TLLLF joined the project two years ago was the level of openness and awareness present amongst the villagers. Individuals and families were more expressive about their issues and challenges leading to a more evolved and helpful conversation.

The process of de-stigmatizing mental illnesses in a community and providing treatment to those who are suffering requires a strong nexus of partners to make progress in a holistic manner. Initially, getting different stakeholders together was difficult because of the lack of awareness and resources in the field of mental healthcare. But the project found its footing once it established a network of support from NIMHANS doctors who treated the patients at health camps, Primary Healthcare Centre doctors and the ASHA workers. On their visit, the TLLLF team along with APD and the project partners discussed the impact that was made by the program. Were beneficiaries able to access the free psychiatric drugs? Did the program help in reducing the distance patients had to travel to get treatment? During these discussions, the TLLLF team observed that even amongst the partners, there was an increased sense of support and responsiveness towards mental health aid.

The next leg of the visit took the TLLLF team to the village of Bilichodu where they met a support group that included 15 patients and caregivers. Ujjala Padukone, Deepika Padukone’s mother, being a caregiver herself, was also present in the discussion to share her experiences with the group and encouraged others to share their stories and concerns about their family members. While the discussion revolved around the importance of opening up and seeking help, the team brought about a forward-looking attitude within the group by discussing future possibilities in employment and livelihood options available for the patients.

As the TLLLF team honoured World Mental Health day, 2017 by visiting families, engaging with support groups and reviewing the successes and the challenges in rural mental healthcare, they noticed how the conversation, that was once difficult to start, now had characteristics of support, openness and a positive outlook towards the future. To continue this momentum, the organisation charted out the next steps that will further enrich the dialogue surrounding mental health, in both urban and rural areas. The steps include increasing research on mental health, enhancing the role of social media to drive awareness and decrease stigma and expanding their current programs. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.