Viral Infections Symptoms and Treatment Information

Viral Infections

1 Dec 2023

10 mins

World AIDS Day 2023 World AIDS Day is honored every year on December 1st. For the last 33 years, the World Health Organization (WHO) has acknowledged it as one of the eleven official global public health campaigns. Since its inception in 1988, people worldwide have united on this day to raise awareness about HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). Various organizations conduct awareness campaigns and activities, emphasizing the significance of understanding and combating HIV, as well as addressing the stigma around HIV and AIDS [https://www.mrmed.in/health-library/health-care/hiv-stigma-discrimination]. The day stands as a global moment of solidarity for those living with HIV, honoring those lost to AIDS-related diseases and rallying against the virus spread. WORLD AIDS DAY 2023 THEME This year's theme, "LET COMMUNITIES LEAD!" underscores communities' influence in responding to HIV and advancing global health. It's a call to action, recognizing the collective strength of communities in making a positive impact on the ongoing fight against HIV/AIDS. IMPORTANCE OF AIDS AWARENESS: A STATISTICAL OVERVIEW * HIV is a significant global health issue, with 40.4 million lives lost so far and ongoing transmission worldwide. * Approximately 39.0 million people were living with HIV [https://www.unaids.org/en/resources/fact-sheet#:~:text=In%202022%2C%20there%20were%2039,(0%E2%80%9314%20years).] at the end of 2022, with the number of People Living with HIV (PLHIV) estimated at around 24 lakhs in India [https://neigrihms.gov.in/Latest%20News/DDA/2023/Final%20HIV%20_%20AIDS%20Policy%202023.pdf]. * In 2022, 630,000 people died from HIV-related causes, and 1.3 million people acquired HIV. * While there's no cure for HIV, access to effective prevention, diagnosis, and treatment has turned it into a manageable chronic condition. * WHO, the Global Fund, and UNAIDS (Joint United Nations Programme on HIV/AIDS) have aligned strategies to end the HIV epidemic by 2030. DECODING HIV AND AIDS HIV is a virus that strikes our immune system, leading to the most advanced stage, known as Acquired Immune Deficiency Syndrome (AIDS). It weakens white blood cells, making the body susceptible to opportunistic diseases like tuberculosis and infections. The virus spreads through infected body fluids but not through everyday contact. It can also pass from a mother to her baby. Fortunately, HIV can be treated and prevented with anti-retroviral therapy (ART) [https://www.mrmed.in/health-library/viral-infections/hiv-medication]. If left untreated, it can develop into AIDS (advanced HIV disease) after many years. WHO identifies Advanced HIV Disease (AHD) based on CD4 cell count or WHO clinical staging. In adults and adolescents, AHD is indicated by a CD4 count below 200 cells/mm3. In addition, WHO identified WHO's clinical staging [https://www.ncbi.nlm.nih.gov/books/NBK374293/]: stages 3 and 4 as AHD. For children under five, all HIV cases are considered advanced. SIGNS AND SYMPTOMS OF AIDS * Early Stage: - Spread more easily in the first months - Many are only aware of the later stages - Initial weeks may have no symptoms or flu-like signs * Progressive Stage: - Weakening of the immune system - Symptoms include swollen lymph nodes, loss of weight, fever, diarrhea, and cough * Advanced Stage: Severe Illnesses Without Treatment leads to the development of opportunistic infections like: - Tuberculosis (TB) - Cryptococcal meningitis - Severe bacterial infections - Cancers like lymphomas and Kaposi's sarcoma - Hepatitis C - Hepatitis B - Pox infections TRANSMISSION OF AIDS AIDS can spread through body fluids: blood, breast milk, semen, and vaginal secretions. Factors increasing the risk of HIV transmission include: - Unprotected anal or vaginal sex (semen and vaginal secretions) - Presence of other sexually transmitted infections (STIs) [https://www.mrmed.in/health-library/health-care/world-sexual-health-day-2022] - Sharing contaminated needles and injecting equipment - Unsafe medical procedures, including unsterile cutting or piercing - Accidental needle stick injuries, especially among healthcare workers - Through breast milk from an HIV-infected mother to the baby. - Through Organ transplantation: Organ transplant-related HIV risk is low due to donor screening but may not detect recent exposures. AIDS TESTING AND SCREENING Although HIV tests are highly accurate, none can detect the virus immediately after infection. The timing for HIV detection depends on the test type. There are three types of HIV tests: antibody tests, antigen/antibody tests, and nucleic acid tests (NAT). HIV testing and screening [https://www.mrmed.in/health-library/viral-infections/national-hiv-testing-day-2023] is the gateway to prevention, care, and treatment. How can I self-test for HIV using home testing kits? HIV home testing kits offer rapid and convenient testing from the comfort of your home. Simply follow these steps: 1. Collect a throat swab or blood sample as per the kit instructions. 2. Place the swab or blood sample in the provided solution or test well. 3. Wait 20 to 30 minutes for the results, indicated by single or double lines on the kit. Through these are reliable, lab testing is necessary to confirm the diagnosis. PREVENTION OF AIDS HIV is preventable through various measures, including the use of condoms during sex, regular testing for HIV and other infections, and considering circumcision for men. Harm reduction services [https://hri.global/what-is-harm-reduction/] are essential for individuals using drugs. Pre-exposure prophylaxis (PrEP) pills, special rings during sex, and injectable prophylactic antiretroviral drugs are recommended for prevention. Pregnant women at high risk receive antiretroviral drugs to protect their babies. If on treatment, maintaining control of HIV through regular testing and medication ensures non-transmission and overall health. U-Test: Youth-Friendly HIV Prevention UNICEF's U-Test [https://www.unicef.org/innovation/stories/bringing-hiv-prevention-twenty-first-century] uses AI (artificial intelligence) and social media to help young people learn about HIV in a friendly way. It lets them do a simple, private test at home using a kit. If needed, it connects them to support. In places like West Africa, over a million young people have used U-Test, with 10,000 testing themselves for HIV in just a year. It's spreading to more countries, making it easier for young people to get information and support about HIV. TREATMENT FOR AIDS HIV has no cure, but daily anti-retroviral drugs (ART) control the virus, improving overall health. ART lowers virus levels, preventing symptoms and transmission. Additionally, Complementary therapies for HIV [https://www.mrmed.in/health-library/viral-infections/complementary-therapies-hiv] can manage stress and anxiety. Pregnant women with HIV take ART to protect themselves and their babies. Medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) help prevent and manage HIV. WHO supports advanced HIV care, and ongoing research seeks more convenient treatments. Overall, ART is a lifelong commitment for a normal life, and its benefits extend beyond individual health. NACO'S HOLISTIC SUPPORT FOR HIV PATIENTS IN INDIA National AIDS Control Organization (NACO) addresses the care, support, and treatment needs of HIV-positive individuals tailored to the infection stage. NACO focuses on low-cost care for common opportunistic infections, enhancing ART accessibility for the poor, and strengthening family and community care, particularly for marginalized women and children. Community Care Centres, established in high-prevalence districts, offer counseling, nutritional support, treatment assistance, and legal services. BUSTING MYTHS Myth: I can get HIV by being around HIV-positive people. Fact: You can't catch HIV through touch, tears, sweat, saliva, or pee. It is not transmitted by inhaling the same air, using the same toilet seat or touching the door handle, drinking from a water bottle, hugging, kissing, shaking hands, sharing eating utensils, or using exercise equipment at a gym. HIV is only transmitted through infected blood, semen, vaginal fluid, or breast milk. Myth: I believe oral sex is just as risky when it comes to HIV. Fact: The risk from oral sex is almost negligible compared with other types of sex. In theory, it seems possible if your partner has HIV, but in reality, that is not the case. Myth: I believe I would show symptoms if I had HIV, and I can tell if my partner is positive. Fact: HIV can remain asymptomatic for years. Testing is the only way for you or your partner to determine positivity. Recognizing the prolonged asymptomatic phase, the CDC (Centers for Disease Control and Prevention) recommends testing for everyone between 18 and 64 as part of routine blood work. TAKE AWAY As we mark World AIDS Day, let us collectively prioritize education, dispel misconceptions, and work towards a future where HIV is no longer a global health threat. Together, we can contribute to the goal of ending the HIV epidemic by 2030. "Anti-retroviral Anthem; Let's March in Harmony Against HIV"

Dr Archana Gupta

Viral Infections

24 Oct 2023

8 mins

World Polio Day 2023"From Awareness to Action: Polio Ends Here!" Imagine entering a vibrant global celebration where people from all corners unite to mark October 24th as World Polio Day. It is not just any ordinary day but a day pulsating with energy and purpose, dedicated to a cause that can transform lives. Picture this: a world where the word "polio" is just a distant memory, where children can run and play freely without fear. This vision is what world polio day is all about. Created by Rotary International [https://www.rotary.org/en/how-rotary-clubs-are-celebrating-world-polio-day], it is a day that lights up the calendar to honor the birthday of Jonas Salk [https://en.wikipedia.org/wiki/Jonas_Salk], the brilliant mind behind the first polio vaccine. Step beyond mere celebrations; let us unravel the mystery of polio. Discover its secrets, recognize its signs, and learn how to shield ourselves. On this world polio day, let's not just mark the occasion; let's embark on a journey to a polio-free world. Together, we can make history and ensure a healthier future for future generations! WHAT IS POLIOMYELITIS? Poliomyelitis, according to the World Health Organization (WHO), commonly shortened as polio, is a highly contagious viral disease mainly caused by the poliovirus. This virus is transmitted mostly from person to person through the fecal-oral route or contaminated water and food. It invades the central nervous system and can result in paralysis (unable to make voluntary muscle movements). It primarily affects individuals with compromised immune systems, pregnant women, and children under five. POLIO UNCOVERED: 7 KEY FACTS! 1. Polio primarily impacts children under five years old, leading to irreversible paralysis in one out of every 200 infections. Tragically, 5-10% of those paralyzed die [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512932/] due to immobilized breathing muscles. 2. Cases caused by the wild poliovirus have decreased by more than 99% since 1988, dropping from an estimated 3,50,000 cases to just six reported cases [https://www.who.int/health-topics/poliomyelitis#tab=tab_1] in 2021. 3. The risk remains global: as long as a single child is infected, all countries' children are vulnerable to polio. Failing to eradicate polio from these last strongholds could trigger a worldwide disease recurrence. 4. In contrast to many diseases, polio has the potential for complete eradication. Three strains of wild poliovirus exist, none of which can endure outside the human body for extended periods. If the virus cannot locate an unvaccinated individual to infect, it will naturally extinguish. Notably, type 2 wild poliovirus was eradicated in 1999, and type 3 cases of wild poliovirus have not been reported anywhere globally since 2012. 5. The global effort against polio has strengthened capacities in numerous countries, enhancing their ability to combat various infectious diseases. This progress has been achieved by establishing effective surveillance and immunization systems. 6. Only three countries have never halted polio transmission—Afghanistan, Nigeria, and Pakistan. These nations confront various obstacles, including insecurity, fragile healthcare infrastructures, and inadequate sanitation. The risk persists as polio can spread from these endemic countries, infecting children in other nations lacking sufficient vaccination coverage. 7. In 2011, the last child was paralyzed by polio in India. By 2014, the country achieved a historic milestone by not reporting any Wild Poliovirus (WPV) cases for three consecutive years. Consequently, India was certified as a "polio-free country [https://main.mohfw.gov.in/sites/default/files/5628564789562315.pdf]," along with other nations in the South East Asia Region (SEAR) of the WHO. WATCH OUT FOR THE FOLLOWING SYMPTOMS OF POLIO * Asymptomatic Infections Most poliovirus carriers show no symptoms of the disease. * Mild Polio (Abortive Polio) Approximately 5% of infected individuals experience mild symptoms resembling the flu, lasting 2 to 3 days. Symptoms include fever, headache, muscle aches, sore throat, stomachache, loss of appetite, nausea, and vomiting. * Moderate Polio (Nonparalytic Polio) About 1% of those infected suffer from nonparalytic polio, enduring intensified flu-like symptoms and additional discomfort such as neck stiffness, limb aches, and severe headaches. Later stages might include spine and neck stiffness, decreased reflexes, and muscle weakness. * Severe Polio (Paralytic Polio) This rare and severe form initially exhibits symptoms akin to nonparalytic polio. Still, it progresses to intense pain, heightened sensitivity, tingling sensations, muscle spasms, and eventual limb paralysis. Various limbs can be affected, with leg paralysis being the most common, followed by arm paralysis. Breathing muscle paralysis and swallowing difficulties are also possible, depending on the disease's severity. * Post-Polio Syndrome Occurring decades after the initial infection, this syndrome introduces new or worsened symptoms, including progressive muscle or joint weakness, fatigue, muscle wasting, breathing or swallowing problems, and increased sensitivity to cold temperatures. TRANSMISSION OF POLIO Polio is transmitted by coughing, sneezing, or contact with an infected person's feces (fecal-oral route). It has the potential to spread through: * Leaving your hands unwashed after using the restroom or changing diapers. * Droplets from an infected person's coughing or sneezing. * Being in close contact with a polio patient. * Touching infected objects or surfaces. * Consuming contaminated water or food * Swimming in contaminated water POLIO DIAGNOSIS Polio infection is diagnosed by performing a physical examination, obtaining a detailed medical history, including recent vaccinations and travel information, collecting samples (throat swab, stool, urine, blood, and spinal fluid), and getting an MRI to examine the spinal cord. Poliovirus is most likely to be found in stool samples. POLIO PREVENTION: EMPOWERING LIVES THROUGH VACCINATION Still, there is no known cure or treatment for polio. Physical or occupational therapy can treat polio-related arm or leg weakness, which may also enhance long-term effectiveness. If your breathing muscles are weakened or paralyzed due to polio, you will require mechanical ventilation, a machine that assists you in breathing. HOW CAN I PREVENT POLIO? The most reliable way to prevent polio is through polio vaccination [https://www.cdc.gov/vaccines/vpd/polio/public/index.html]. Usually, vaccinations are given to children. There are two polio vaccines: inactivated and oral (live-attenuated). Inactivated poliovirus vaccine (IPV) is injected into the leg or arm based on the patient's age. Since the year 2000, IPV only has been used in the United States. The oral poliovirus vaccine (OPV) is still widely used in many parts of the world. "Vaccinate to Annihilate: Polio's Endgame Starts with You!" Recommended polio vaccination schedule: Children receive their first dose of the polio vaccine at two months old, their second dose at four months, their third dose between six and eighteen months, and their booster dose between four and six years old. Children who have not completed their polio vaccine or received all recommended doses should begin as soon as possible. Adults who have never had the polio vaccine should get three doses of IPV. The first dose can be taken whenever you like, the second dose is given one to two months later, and the third dose is given six to twelve months following the second dose. NATIONAL IMMUNIZATION SCHEDULE (NIS) FOR POLIO IN INDIA Vaccine & its presentation Protection Route Number of doses Vaccine Schedule OPV (Oral Polio Vaccine) - Liquid vaccine Poliomyelitis Oral 5 Birth dose for institutional deliveries, Primary three doses at 6, 10 & 14 weeks, and one booster dose at 16-24 months of age. Given orally. VACCINATE, LET'S END POLIO On this world polio day 2023, spread the word to learn about polio, its transmission, symptoms, diagnosis, treatment, and prevention. Educate your friends and family about the importance of polio vaccination because there is no cure or treatment for Poliomyelitis. Remember, vaccination is our strongest weapon against polio. On this International Polio Day, vaccinate your kids and make our nation polio-free. "Get A Drop, Stop The Strop!"

Dr Archana Gupta