How at risk is Nepal from the Hanta virus that has swept the world?

 How at risk is Nepal from the Hanta virus that has swept the world?

Since the initial symptoms of many infectious diseases are very similar to each other, laboratory tests are helpful in distinguishing the infection.

According to the World Health Organization, 3 out of 8 people have died from Hanta virus seen on a cruise ship.

Although Hanta virus is transmitted through the feces, urine or saliva of infected rats, it has been confirmed that the 'Andean' species can be transmitted from person to person.

Nepal is at risk of Hanta virus, but even if it has not been confirmed as an outbreak, regular testing and research are necessary.

Recently, the Hanta virus seen on a cruise ship has swept the world. According to the information published by the World Health Organization a few days ago (on May 8), 3 out of 8 people have died.

That is, about 38 percent of the infected have died. This human-to-human transmission is considered very rare, but currently, dozens of cases on cruise ships have become a matter of concern and interest.

At the time of writing, the main source of infection is unknown. Information on the circumstances under which it spread from person to person is yet to be released.

Hantavirus can be transmitted to humans through contact with the feces, urine, or saliva of infected rats. Even if an infected rat does not show symptoms, it can still cause death if it infects humans.

The mortality rate of the Hantavirus strain seen in the Americas is many times higher than that of the Hantavirus strain seen in Europe and Asia, which is about 50 percent. Recently, a cruise ship has seen a mortality rate of about 38 percent. The World Health Organization has reported that the mortality rate of the Hantavirus strain seen in Europe and Asia is up to 15 percent.

Although Hantavirus is said to be transmitted only through the feces, urine, or saliva of infected rats, the ‘Andean’ strain of Hantavirus can be transmitted from person to person to some extent.

The Hantavirus strain currently circulating on cruise ships has also been confirmed by gene sequencing to be ‘Andean’. Hantavirus is mainly divided into two types based on symptoms, which also vary according to geographical location.

First, Hanta pulmonary syndrome and second, hemorrhagic fever with renal syndrome.

Hanta pulmonary syndrome is mainly seen in the Americas, while hemorrhagic fever with renal syndrome and Hantavirus are seen in Europe and Asia.

Hanta pulmonary syndrome is characterized by symptoms such as fever, chills and dizziness, muscle pain, diarrhea, nausea or vomiting, abdominal pain, and low blood pressure. If it becomes complicated, coughing, difficulty breathing, chest tightness, and pneumonia may occur.

These symptoms may appear within one to six weeks of infection.

Hemorrhagic Fever with Renal Syndrome Hanta virus causes chills, stomach pain, headache, nausea, blurred vision, red eyes, and later complications, bleeding, and there is a risk of kidney failure.

These symptoms appear one to two weeks after infection, and sometimes up to 8 weeks. This Hanta virus is seen in Asia, especially in countries like China, Korea, Japan, and Russia. Research articles have also been published that Hanta virus has been seen in neighboring India. But there is no information that it has taken the form of a major outbreak.

Is there a risk of Hanta virus in Nepal?

Hanta virus is transmitted when it comes into contact with rat feces, urine, or saliva. Rats are seen in significant numbers in all villages and cities in Nepal.

The number of people who come to Teku Hospital for treatment of rat bites is also high. Most people with such problems do not come to the hospital. There is a lot of contact between humans and rats in Nepal too.

Hundreds of scrub typhus cases are reported in Nepal every year. The main source of scrub typhus infection is the mite found in rats. This also clearly shows that the risk of any infection that can be spread by rats in Nepal is high.

Hanta virus is no exception. In 2017, a tourist fell ill and was admitted to the ICU immediately after returning to his country after visiting Nepal. A research article was published stating that the person had been diagnosed with hanta virus. This was published in an American medical journal in 2020.

This also indicates that the risk of hanta virus is present in Nepal.

However, as in India, there is no confirmation of an outbreak in Nepal yet. Since this infection is not included in routine laboratory tests, we are unaware of the status of hanta virus in Nepal.

Blood tests of tourists infected with hanta virus in Nepal show a decrease in platelet count and an increase in liver enzymes, which the author has experienced is also widely seen in fever patients in Nepal.

However, the possibility of Hantavirus seems to be overlooked when sending for diagnostic tests for limited infections. Since a large number of fever patients are still not diagnosed in Nepal, there is a need to increase the scope of testing.

In the case of a new infection or a first-time infection, testing for that infection should also be included in routine testing. Since the initial symptoms of many infectious diseases are very similar to each other, laboratory testing is helpful in distinguishing infections. Only if the infection is diagnosed can treatment, prevention, and counseling be correct.

Currently, the World Health Organization has stated that the risk of further spread of this virus is low. However, the number of infections on a cruise ship at the same time is so high. And as the problem becomes more complicated and the mortality rate is higher, it cannot be ruled out that the contagiousness and lethality of this virus has increased compared to the past.

Nepal cannot completely ignore the risk of the virus, given the confirmed research on this virus and the frequent contact with rats, which is considered the source of the virus.

If national guidelines were developed in Nepal, prioritizing research on Hanta virus, it would be useful for health workers in diagnosis, treatment, and prevention.

Latest information on Corona-virus

6 million 54 thousand infected worldwide from Corona, 2.562 million more cured (how many in which country)

The global pandemic corona virus (Covid-19) has so far infected 6 million 54 thousand 187 people worldwide. According to Johns Hopkins University, 2.562 million of those infected have recovered.

The most contagious cases have been reported in the United States. As of Sunday morning, 1,769,776 infections had been confirmed in the United States. Similarly, 4 lakh 16 thousand 461 have been cured.

The death toll in the United States is also high. So far, 133,758 people have lost their lives in the United States. Similarly, 500,000 people have been found infected in Brazil. So far, 4,98,440 infected people have been found in Brazil. Of them, 2 lakh 892 have recovered and 28 thousand 834 have died.

After Brazil, Russia has seen many infections. So far, 396,575 people have been found infected in Russia. Of those infected, 4,555 have died and 1,67,469 have been cured. A recent decline in infection rates has so far confirmed 274,219 cases of the virus in the UK. Of them, 1,173 have recovered and 38,458 have lost their lives. Corona, which has been rampant since late December, has so far affected 188 countries. So far, 368,711 lives have been lost in these countries.

Figures for the ten most infected countries

America

Infected: 17,69,776

Deaths: 1,03,758

Healing: 4,16,461

Brazil

Infected: 4,98,440

Deaths: 28,834

Healing: 2,00,892

Russia

Infected: 3,96,575

Deaths: 4,555

Healing: 1,67,469

United Kingdom

Infected: 2,74,219

Deaths: 38,458

Healing: 1,173

Spain

Infected: 2,39,228

Deaths: 27,125

Healing: 1,50,376

Italy

Infected: 2,32,664

Deaths: 33,340

Healing: 1,55,633

France

Infected: 1,88,752

Deaths: 28,774

Healing: 68,386

Germany

Infected: 1,83,189

Deaths: 8,530

Healing: 1,64,908

India

Infected: 1,81,827

Deaths: 5,185

Healing: 86,936

Turkey

Infected: 1,63,103

Deaths: 4,515

Healing: 1,26,984

(Source: Johns Hopkins University)

Corona outbreak: This is the latest epidemic in the world

As of this writing, 371,006 people have died and 6,160,295 have been infected in the world due to the corona virus epidemic, which has become a major challenge for the world in the field of health.

Similarly, 27 lakh 38 thousand 284 people have recovered after health treatment while the health condition of 53 thousand 515 people in the world is critical. Outbreaks of the corona virus, which has spread to 213 countries, have killed 15,557 people in the United States and infected 1,816,820.

There, 5 lakh 35 thousand 238 people have recovered after health treatment and 17 thousand 163 people are in critical condition.

In Brazil, 4,99,966 people have been infected so far and 28,849 people have died. Similarly, 15 people have died and 1,526 new infections have been added today. In Brazil, 25,371 people have recovered after receiving medical treatment, while 8,318 are in critical condition.

In Russia, 4,555 people have died and 3,96,575 have been infected with the corona virus.

There, 1,67,469 people have recovered after health treatment and 2,300 are in critical condition.

In Spain, 27,125 people have died and 2,86,308 have been infected with the corona virus.

There, 196,958 people have recovered after receiving medical treatment while the health condition of 617 people is critical.

In the UK, the corona virus has so far killed 38,376 people and infected 272,826. The health condition of 1,559 people there is critical.

In Italy, 33,340 people have died and 232,664 have been infected with the corona virus. There, 155,633 people have recovered after receiving medical treatment while the health condition of 450 people is critical.

In France, the corona virus has so far killed 28,771 people and infected 188,625. There, 68 thousand 268 people have recovered after health treatment and 1 thousand 325 people are in critical condition.

In Germany, the corona virus has killed 8,600 people and infected 183,294 so far. There, 1,64,900 people have recovered after receiving medical treatment while the health condition of 720 people is critical.

Similarly, 5,185 people have died and 182,143 have been infected with the corona virus in neighboring India so far. There are 316 new infections today. In India, 86,984 people have recovered after receiving medical treatment, while 8,944 are in critical condition.

According to WorldDometer, 4,515 people have died and 1,63,103 have been infected with the corona virus in Turkey. Similarly, 126,984 people have recovered after receiving medical treatment while the health condition of 649 people is critical.

In Peru, 4,371 people have died so far due to the corona virus epidemic

A total of 155,671 people have been infected. There, 66,447 people have recovered after receiving medical treatment while the health condition of 960 people is critical.

In Iran, 7,734 people have died and 148,950 have been infected with the corona virus. There, 116,827 people have recovered after medical treatment and 2,533 people are in critical condition.

In Canada, 7,073 people have died and 90,190 have been infected. There, 48,103 people have recovered after medical treatment and 1,618 people are in critical condition.

In Mexico, the corona virus has so far killed 9,779 people and infected 87,512. There have been 364 deaths so far today and 2,885 new infections have been added today. In Mexico, 61,871 people have recovered and 378 are in critical condition.

Similarly, two more corona infections have been confirmed in China today. There have been 4,634 deaths and 83,001 infections. There, 78,304 people have recovered after health treatment and the health condition of 3 people is critical.

Similarly, 1,483 people have died and 69,496 have been infected in Pakistan so far. Today alone, 88 people have died and 3,039 new infections have been added. There, 25,271 people have recovered after receiving medical treatment while the health condition of 111 people is critical.

In Belgium, 9,453 people have died so far and 58,186 have been infected. There, 15,769 people have recovered after receiving medical treatment while the health condition of 73 people is critical.

In the Netherlands, 5,951 people have died so far and 46,257 have been infected. The health condition of 170 people there is critical.

In the last 24 hours, 500 people have died worldwide and 9,812 new infections have been added.

Get latest information on Corona-virus.

Should Nepalese be worried about the coronavirus?

The outbreak of the 2019 novel coronavirus in China, also known as the Wuhan Coronavirus, has now affected 17 countries.

There are approximately 6,000 cases in China with the majority being diagnosed. Total casualties have crossed 130, most of them in Wuhan, in Hubei Province. Nepal has recorded its first confirmed case: a student studying in China who went to Nepal when diagnosed. Coronavirus family viruses have historically caused respiratory infections in human populations worldwide.

The most recent outbreaks include acute acute respiratory syndrome (SARS) in 2002 and Middle Eastern respiratory syndrome (MERS) in 2012.

Both have affected thousands of people and in some cases can be fatal. SARS killed 10% of infected people, while MERS was fatal in 37% of the infected population. The current death rate due to Wuhan coronavirus is 2.2%. If we reverse this number, 98 percent of people infected with this virus will not die. Given the low mortality rate compared to previous coronavirus outbreaks, why is there so much concern about this outbreak?

The first reason is that the Wuhan Coronavirus is a ‘novel’.

The term is used to refer to a new species in viral epidemiology that has never been found in the population. Therefore, scientists do not know enough about the symptoms of the virus and provide public health indications about treatment.

Second, unlike SARS and MERS, the incubation period of the virus is up to 14 days, and asymptomatic individuals can spread the disease to others.

Infected individuals who show development may also continue to spread the virus. The R0 (n r naught ') value of this virus is estimated to be 3, which means that the infected person transmits on average three more people. It is believed to have a high infectivity number, but it is still lower than SARS or MERS. Chinese authorities have taken tough steps in Wuhan to stop the spread of the virus. However, this may not be enough as most infected people may be out of the city until they take action. Wuhan's population is 10 million, and many begin this week's Chinese New Year. According to experts at Imperial College in London, the number of infected populations is less than about 100,000. Therefore, we can expect more cases around the world as infected people spread and transmit the disease.

However, the question has arisen once again about how many people have been infected so far.

The virus may be spreading, but not the cause of many deaths?

Nepal has a common outbreak of respiratory diseases such as seasonal influenza, 'avian influenza' and 'swine flu'. Nepali media often report cases of ‘unknown viral disease’. The Nepalese government set up screening centers for coronaviruses at airports and border posts before the first infected person was diagnosed in Tibet. The National Public Health Laboratory is working with private hospitals and laboratories and technical assistance from the World Health Organization (WHO) to make timely and accurate diagnosis of Wuhan coronaviruses. These cases are referred to the Sukhraj Tropical Infectious Diseases Hospital and are monitored by the Department of Epidemiology and Disease Control in the country.

The Ministry of Health and Population has ordered all private hospitals in the country to be on standby if ventilator-supported ICUs are needed. The state mechanism seems to have learned from the vulnerabilities previously seen during the SARS and H1N1 (swine flu) outbreaks. However, the exact clinical diagnosis of the disease is a challenge, as people who are infected with non-symptomatic phosphoses are more likely to be infected with other viruses, such screening is the only way to identify the maximum number of cases entering the country and prevent the population from getting infected.

There have been no cases of coronavirus infection since January 25 in Nepal.

The first case has only been reported to date. The global media reporting of the outbreak is more focused on malignancy than recovery, and the WHO fails to note that the Wuhan coronavirus outbreak with its expertise and access to data has not yet declared a public health emergency. The experience of making a 'premature and hasty' decision to end the 2009 influenza A (or H1N1) - or swine flu - is still a pandemic, at which point the

WHO decided to take a close look at the situation. 

WHO is focusing on China as a priority over the action, while observing the rest of the world. This does not mean that we can be complacent, because the risk of mutation in the more severe form of the virus is real. However, this also does not help to be afraid. We need to look at the numbers, listen to the experts in this field and move on accordingly. After the end of the week, several high-level coordination committees, led by Deputy Prime Minister and Defense Minister Ishwar Pokharel, made several important decisions aimed at limiting the spread of

Travelers from more than 50 countries in Nepal, Europe, Britain, the Gulf and West Asia have been banned; Nationwide secondary education exams are postponed; Asked to close all gyms, health clubs, movie theaters, and dance bars; And all meetings of more than 25 people are banned.

Civil Aviation Minister Yogesh Bhattarai told the Post on Wednesday, "These strong measures have been taken based on the global impact of the coronavirus, the fear it has created and While these measures are welcomed, many public health officials fear they may not be enough and the public is not sure that the government is doing enough. Sundar Mani Dixit's video has criticized the government's response that the government is not conducting enough tests as the test kit is not viral. Despite a conspiracy theorist signaling for Dikshit, especially the claim that the test kits are being saved for 'VIPs', the video is taken aback by Nepal's lack of confidence in the dense urban development, poor security measures and health infrastructure. As of March 20, only 546 Nepalis were tested for Kovid-19, excluding adverse cases in January, according to the Ministry of Health and Population.

Current screening procedures include assessing whether patients have a fever with severe respiratory symptoms or have a surgical condition; And then they are assessing whether Kovid-19 may be in the 14 days they are performing, or in the affected country.

Fever is being tested for those who arrive in Nepal, and when they show no symptoms, they are asked to self-confine. If there is fever, they are left alone and sent to a designated hospital. But the airport has suffered long-term institutional and infrastructure failures. On March 9, the Diplomat reported that 13 health workers at the Tribhuvan airport were inadequate to check passengers coming from China, South Korea, Hong Kong, Thailand, Malaysia, Japan. Some travelers skip the screening process due to the limited number of health workers," one passenger told the publication.

On March 18, The Himalayan Times reported that incoming travelers were not being properly investigated and many were not being asked to remain in self-restraint. Nepal's hospitals and laboratories are also pre-equipped, first to screen potential patients, then to isolate them, and then to provide adequate care. Nepal Public Health Laboratory officials told the Post that they had only 1,000 test kits.

As of March 20, more than half of them were used and it is unclear whether they received the 5,000 kits they sought from the WHO.

On March 19, the Medical Council of Nepal urged all hospitals, private and public, to set up more than 100 beds with special fever clinics, and urged everyone to conserve resources for the outbreak, with health workers postponing elective surgery to ensure safety. Decrease. Unnecessary congestion in hospitals and treatment centers.

Kathmandu is one of the most densely populated cities in the region and the spread of it will increase health care facilities quickly. The Covid-19 mortality rate is not very high - revised from the initial estimate of 3.4 percent to less than 1 percent - but when coronavirus patients come to hospitals, those who need immediate medical care do not need care. .