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In light of the rising number of reports of monkeypox (MPX) cases in non-endemic countries, the Union Ministry of Health and Family Welfare has issued ‘Guidelines on Management of Monkeypox Disease’ today as part of a proactive and risk-based approach to Monkeypox disease management and to ensure advance preparedness across the country. These may be found on the MoHFW website:

https://main.mohfw.gov.in/sites/default/files/Guidelines%20for%20Management%20of%20Monkeypox%20Disease.pdf

Monkeypox is a viral zoonotic disease, caused by monkeypox virus, recognized as the most important orthopoxvirus infection after the eradication of smallpox.

In humans, the symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Monkeypox begins with fever, headache, muscle aches, and exhaustion. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not. The incubation period (time from infection to symptoms) for monkeypox is usually 7−14 days but can range from 5−21 days.

Human-to-human transmission is generally accomplished by respiratory droplets, which necessitate lengthy face-to-face contact because respiratory droplets may only travel a few feet. The most common way for an animal to transmit disease to humans is through damaged skin caused by a bite or scratch.

Monkeypox has been reported as endemic in several other central and western African countries such as: Cameroon, Central African Republic, Cote d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. However, caseshave been also reported in certain non-endemic countries e.g. USA, United Kingdom, Belgium, France, Germany, Italy, Netherlands, Portugal, Spain, Sweden, Australia, Canada, Austria, Israel, Switzerland etc.

Also Read: Monkeypox, unlikely to become pandemic: WHO

Latest MoHFW Guidelines on Monkeypox

• As per the Guidelines, a confirmed case is laboratory confirmed for monkeypox virus by detection of unique sequences of viral DNA either by polymerase chain reaction (PCR) and/or sequencing.All the clinical specimens should be transported to the Apex Laboratory of ICMR-NIV (Pune) routed through the Integrated Disease Surveillance Programme (IDSP) network of the respective district/state.
• The Guidelines on Management of Monkeypox Disease include epidemiology of the disease (including host, incubation period, period of communicability and mode of transmission; contact and case definitions; clinical features and its complication, diagnosis, case management, risk communication, guidance on Infection Prevention and Control (IPC) including use of personal protective equipment.
• The guidelines stresses on surveillance and rapid identification of new cases as the key public health measures for outbreak containment, mandating need to reduce the risk of human-to-human transmission. It explains the Infection Prevention and Control (IPC) measures, IPC at home, patient isolation and ambulance transfer strategies, additional precautions that needs to be taken care of and duration of isolation procedures.
• As per the Guidelines, contacts should be monitored at least daily for the onset of signs/symptoms for a period of 21 days (as per case definition) from the last contact with a patient or their contaminated materials during the infectious period.
• Raising awareness of risk factors under risk communication and preventive measures, the Guidelines further explain in detail about raising awareness and educating people about the measures for Monkeypox virus like avoiding contact with any material of the sick person, isolation of infected patient from others, practicing good hand hygiene and using appropriate personal protective equipment (PPE) when caring for patients.

International travellers to countries reporting cases of monkeypox have been advised to not come in close contact with sick persons and dead or live wild animals. They have also been asked not to consume meat of wild animals or use creams, lotions or powder made of it.

Union Ministry of Health & Family Welfare continues to maintain a close watch over the evolving situation.

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The study of how the body adapts to new motions sheds fresh information on how the nervous system learns and might serve to guide a wide range of applications, from personalised rehabilitation and sports training to wearable technologies for healthcare. The findings were published in the journal Current Biology this week.

“How does our brain figure out how to best move our body? It turns out that this can be a challenging problem for the nervous system, considering we have hundreds of muscles that can be coordinated hundreds of times per second — with more possible coordination patterns to choose from than moves on a chessboard,” says study senior author and SFU professor Max Donelan, director of SFU’s Locomotion Lab.

“We often experience changes to our body and our environment. Perhaps you enjoy a long run on a Saturday morning — your muscles may fatigue as the length of the run increases. Perhaps you choose to run on the beach on vacation — the sand may be uneven and loose in comparison to the pavement on the sidewalk. While we might register that these changes have occurred, we might not appreciate how our body adapts to these changes.”

Donelan’s team of motor learning neuroscientists cooperated with a Stanford University team of mechanical engineers who construct human-robot systems. They worked together to monitor the walking patterns of research participants wearing exoskeletons.

Findings

The nervous system tackles the difficulty of learning a new movement coordination pattern by first investigating and assessing numerous possible coordination patterns, according to the researchers. This investigation was measured as a general increase in variability throughout the entire movement, joint, and muscle levels.

With practise, the neural system adjusts to certain characteristics of movement while decreasing variability along these features. The researchers also discovered that these adaptive adjustments enhanced overall locomotion, lowering the energy cost of walking by around 25%.

“We created new contexts using exoskeletons that act to assist walking, and then studied how people explore new movements and learn more optimal ones,” says Sabrina Abram, the study lead author and former graduate student in the Locomotion Lab. Participants experienced walking in this context over six days, resulting in about 30 hours of lab time for each and an extraordinary amount of data collected by co-author Katherine Poggensee.

While the nervous system appears to benefit from first searching among many different coordination patterns, it also benefits from reducing this search space over time, Abram adds. “This is because continuing to search among coordination patterns that already reduce energy can in turn increase energy, as well as add to the already challenging problem of figuring out the best way to move.”

Source: Simon Fraser University

The World Health Organization (WHO) has released fresh data on the extent to which tobacco harms both the environment and human health, and has called for measures to hold the tobacco industry more responsible for the damage it does.

The tobacco business costs the globe more than 8 million human lives, 600 million trees, 200 000 hectares of land, 22 billion tonnes of water, and 84 million tonnes of CO2 per year. The bulk of tobacco is cultivated in low- and middle-income nations, where water and cropland are frequently in short supply to meet the region’s food needs. Instead, they are being exploited to cultivate lethal tobacco plants, while forests are being removed at an increasing rate.

The WHO report “Tobacco: Poisoning our planet” highlights that the industry’s carbon footprint from production, processing and transporting tobacco is equivalent to one-fifth of the CO2 produced by the commercial airline industry each year, further contributing to global warming.

“Tobacco products are the most littered item on the planet, containing over 7000 toxic chemicals, which leech into our environment when discarded. Roughly 4.5 trillion cigarette filters pollute our oceans, rivers, city sidewalks, parks, soil and beaches every year,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

Cigarettes, smokeless tobacco, and e-cigarettes all contribute to the accumulation of plastic pollution. Cigarette filters are the second most common source of microplastic contamination in the world.

There is no proof that filters have any demonstrated health advantages, notwithstanding tobacco industry propaganda. To preserve public health and the environment, WHO recommends that policymakers approach cigarette filters like single-use plastics and consider banning them.

Rather than the tobacco business causing the problem, taxpayers bear the cost of cleaning up littered tobacco products. This costs China around US$ 2.6 billion per year and India approximately US$ 766 million each year. Brazil and Germany will pay more than $200 million each (see table below for further estimates).

France and Spain, as well as towns in the United States such as San Francisco, have taken a stance. They have successfully adopted “extended producer responsibility law,” which holds the tobacco industry liable for cleaning up the damage it generates, based on the Polluter Pays Principle.

WHO encourages nations and cities to follow this lead by supporting tobacco growers in their transition to sustainable crops, enacting significant tobacco levies (which may include an environmental tax), and providing support services to assist people quit smoking.

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Scientists have uncovered a new condition that might aid individuals with unexplained liver and kidney issues.
TULP3-related ciliopathy is a hereditary disorder that causes kidney and liver failure in children and adults, according to researchers at Newcastle University in the United Kingdom. There are a variety of causes for kidney and liver organ failure, which can be life-threatening if left untreated, but patients frequently do not receive a specific diagnosis, making the optimal course of therapy uncertain.

A defective gene, according to research published in the American Journal of Human Genetics, is the catalyst for increasing fibrosis in the liver and kidney, which commonly necessitates a transplant.

Professor John Sayer, Deputy Dean of Clinical Medicine at Newcastle University, said: “Our finding has a huge implication for better diagnosis and management of kidney and liver disease in some patients.”

“What we are now able to do is give some patients a precise diagnosis, which allows their treatment to be tailored to their needs for the best possible outcome.”

Experts assessed clinical symptoms, obtained liver samples, and performed genetic sequencing on scores of participants in the research, identifying 15 people from eight families as having this new disease.

Urine samples from these individuals were utilised to culture cells in the lab, and the defect causing TULP3-related ciliopathy was then studied.

Because their condition had deteriorated severely, more than half of the participants in the research required a liver or kidney transplant. Until the investigation, the initial cause of these individuals’ organ failure remained unclear.

Professor Sayer, who is a consultant nephrologist at Newcastle upon Tyne Hospitals NHS Foundation Trust, said: “We were surprised at how many patients we were able to identify with TULP3-related ciliopathy and this would suggest that the condition is prevalent within those with liver and kidney failure.”

“We hope to provide a proper diagnosis for many more families in the future. This work is a reminder that it is always worth investigating the underlying reasons for kidney or liver failure to get to the bottom of the condition.”

“Finding a genetic cause of liver or kidney failure has huge implications for other family members, especially if they are wishing to donate a kidney to the patient.”

The research, which was co-funded by Kidney Research UK and the Northern Counties Kidney Research Fund, was made possible by the Genomics England 100,000 Genomes initiative, in which Professor Sayer played a key role in the project’s local success.

Newcastle researchers will now use patient-derived cell lines to explore the disease process in greater depth and evaluate possible therapies for TULP3-related ciliopathy.

Case study of a patient

Linda Turnbull, a liver transplant recipient, has lived a long and busy life since receiving her new organ over 30 years ago.

The lawyer, from Stocksfield, Northumberland, UK, was one of 15 patients identified as having the new ailment, TULP3-related ciliopathy, as part of a Newcastle University research.

Linda, who is in her 60s, was always an unwell child and things became worse when she started vomiting blood where, at the age of 11, tests diagnosed her with liver failure.

She was treated successfully, but gradually her liver failed completely resulting in the need for a transplant in 1994. More recently she was noted to also have kidney failure.

Linda provided urine samples for the study so her cells could be grown in the laboratory for the new disease to be understood more. Her involvement has helped patients locally, nationally and internationally.

She said: “It is brilliant to finally have an answer to my life-long questions: Why has this happened to me and why do I have this condition.

“It’s fantastic that this research has been led in Newcastle and it means that people in the future will have information regarding their condition and how best to treat it.”