Pakistan continues to be dealing with a polio outbreak as four fresh cases have emerged, pushing the national tally to 37 this year, according to health officials on October 19, 2024. Health officials said that the regional reference laboratory for polio eradication at the National Institute of Health in Islamabad confirmed wild poliovirus type-1 (WPV1) in two children-one from each Balochistan and Khyber-Pakhtunkhwa.

In recent cases, a girl has been affected from Pishin, and two boys from Chaman and Noshki of Balochistan, and a girl from Lakki Marwat in KP. These are the first detections of the virus within Noshki and Lakki Marwat this year; isolated cases of poliovirus were previously reported within Chaman and Pishin. The province of Balochistan was the worst hit with 20 cases, Sindh had 10, Khyber Pakhtunkhwa had five, and Punjab and Islamabad had one case each.

A gigantic fight against polio has been on going in Pakistan- especially in Balochistan and southern KP-over the last two years. Immunisation campaigns have often been suspended or delayed because of local protests, insecurity, and community boycotts. Consequently, quite a number of children did not get the necessary vaccinations, making existing patches of vulnerability for the virus to flow within those pockets.

Noshki, located near Afghanistan's border, and Lakki Marwat have also recently reported some positive environmental samples that confirm the virus is present here, said a local reference laboratory official. Samples of latest cases are currently under genetic sequencing for checking spread of virus and origin.

As the threat of polio continues to grow, Pakistan has vowed to mount a nationwide campaign against it beginning from October 28. With the zeal to tackle the menace in the most effective manner, over 45 million children under the age of five will be vaccinated across the country.

Today, Afghanistan and Pakistan remain one of the few countries where polio has not yet been eradicated. The WHO said the virus remains a potential serious public health threat in areas with low vaccination coverage and weak surveillance.

India On Alert Against Polio

The country declared itself polio-free since 2014 and has kept the disease on bay almost a decade with very robust vaccination programs; however, two cases of vaccine-derived poliovirus cases reported in recent days from Meghalaya create some amount of doubts over a possible resurgence. Experts observe that in India, despite these detections taking place, strong coverage of vaccination at 90-95% and mandatory surveillance measures keep the risk of this widespread outbreak at bay.

The experts point out, however, that such stable situation in India requires continued surveillance. "Countries like Pakistan and parts of Africa remain at a high risk because vaccination rates in those areas are much lower," Dr. Siddharth, public health expert, said. Vaccination is an indispensable act in order to avoid the spread of this incapacitating disease that manifests most importantly as a nervous system affliction leading to the paralysis of a long period.

With concerted efforts from health authorities, there is hope someday that the scourge of polio will be completely eradicated from the face of the earth and future generations will never suffer from its effects.

India’s RT-PCR testing system is capable of detecting the Bundibugyo strain of the Ebola virus, and the chances of missing a confirmed infection are very low when standardized protocols are followed, said health experts after the suspected Ebola case in Bengaluru involving a Ugandan woman tested negative.

The woman, who arrived in Bengaluru from Kampala, Uganda, on May 23, was suspected of Ebola infection after developing mild symptoms including body ache. She was shifted from a hotel to the state-run Epidemic Diseases Hospital on May 26, and her samples were sent to the National Institute of Virology (NIV), Pune. The tests today returned negative. India currently has no reported case of Ebola, the Health Ministry said.

Let’s take a look at how testing for Ebola takes place in India’s virology labs.

Speaking to HealthandMe, Dr. NK Ganguly, former Director General of ICMR, said that RT-PCR remains the confirmatory test for Ebola infection, while rapid diagnostic tests (RDTs) are mainly used for initial screening with limited sensitivity — of around 85-89 per cent.

According to him, the World Health Organization recommends that RT-PCR should only be carried out in specialized reference laboratories due to biosafety requirements. India currently has two designated Ebola reference laboratories — the National Institute of Virology (NIV), Pune, and the National Centre for Disease Control (NCDC).

"The Altona RT-PCR kit is the real star and is highly standardized. It rarely misses Ebola cases when proper protocols are followed,” Dr Ganguly said.

Can India Detect The Bundibugyo Strain?

Bundibugyo is one of the strains of the Ebola virus currently linked to outbreaks in parts of Africa, including Uganda and the Democratic Republic of the Congo (DRC). The rare strain has caused over 900 cases and more than 200 deaths.

Dr. Ganguly said the incubation period for the Bundibugyo strain can range from six to seven days up to 15 days or even three weeks.

“If a person tests RT-PCR negative during this period, the chances of being infectious are lower. However, isolation is still necessary because there may be a short window period during which the infection may not be detected,” he said.

The expert added that travelers arriving from outbreak-hit countries should remain under quarantine even if their initial Ebola test is negative.

Why Ebola Testing Is Complicated

Dr. Ganguly explained that Ebola belongs to the filovirus family, which includes several strains such as Bundibugyo, Sudan, Taï Forest and Zaire viruses.

He noted that Ebola has a high fatality rate, with nearly 50 per cent of infected individuals dying from the disease. He added that the virus can spread through several body fluids including tears, saliva, milk and urine.

In the early stages, Ebola symptoms can resemble flu, malaria or other viral illnesses, including fever, cough, sore throat, headache, diarrhea, skin rashes and body ache, making early diagnosis difficult.

Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, told HealthandMe that the Bengaluru patient’s symptoms were similar to common viral infections, which is why epidemiological history and travel exposure become critical in suspecting Ebola infection.

“The symptoms of Ebola can be a little confusing because they are just like any other flu,” Dr. Gilada said, adding that travelers arriving from Ebola-affected countries should remain under observation for up to 21 days.

Are There Any Limitations In India’s Ebola PCR Testing?

Dr. Jatin Ahuja, Consultant, Infectious Diseases, Indraprastha Apollo Hospital, Delhi, told HealthandMe, there are no major loopholes in India’s Ebola PCR testing system, but there are certain limitations common to all diagnostic tests.

"One key limitation is the timing of testing. If RT-PCR is performed very early in the infection, there is a possibility of a false-negative result because the viral RNA levels may still be too low for detection," he said.

Dr. Ahuja also pointed out that test accuracy depends on whether the PCR targets are correctly aligned with the specific Ebola strain being tested. Improper alignment may reduce sensitivity.

He added that pre-analytical factors such as sample collection, storage, transport and RNA extraction also influence the final test outcome.

“Negative Ebola PCR substantially reduces concern, but interpretation always depends upon the clinical picture, travel history and exposure risk,” Dr. Ahuja said.

Hypertension is the “number one killer” in India, with nearly 1.6 million people dying from the condition every year, said Dr. Ambuj Roy, Professor of Cardiology at the All India Institute of Medical Sciences, New Delhi, today.

Speaking to media persons on hypertension, Dr. Roy said the deaths “linked to high blood pressure are five times higher than tuberculosis fatalities and exceed the combined toll of communicable diseases such as TB, malaria, dengue, and HIV”.

Calling hypertension a “silent but deadly disease,” he said most people remain unaware they have high blood pressure because symptoms are often absent.

“Ninety per cent of the time, hypertension does not cause symptoms. The only way to detect it is through regular screening,” he said.

Dr. Roy also cited the ICMR and NFHS-5 data showing that nearly 30 crore Indians are living with hypertension.

According to him, one in four adults in rural India and one in three adults in urban areas have the condition. However, “only one in three people know they are hypertensive, one in five receive treatment, and just one in twelve achieve proper blood pressure control below 140/90 mmHg”.

Lifestyle Changes Surging Hypertension Risk

Dr Roy said lifestyle changes are driving the growing burden of hypertension in India. Poor diet, obesity, physical inactivity, air pollution, stress, and poor sleep habits are major contributors, particularly among younger people.

He highlighted excessive salt intake as a key concern. While the recommended salt intake is less than 5 grams per day, average consumption in India is around 12 grams daily. He also stressed the importance of potassium-rich foods such as fruits and vegetables, noting that most Indians fail to consume the recommended 400 grams of fruits and vegetables per day.

Pollution: An Emerging Concern

Further, the Cardiologist linked pollution exposure to rising hypertension rates. Referring to studies conducted by AIIMS in collaboration with IIT Delhi, Dr. Roy said areas exposed to crop burning showed a 15 per cent higher prevalence of hypertension.

Another study found that every 10 microgram increase in PM2.5 levels was associated with a 5 per cent higher risk of hypertension.

How To Reduce Hypertension

Dr. Roy said reducing blood pressure by just 10 mmHg can significantly lower the risk of

• cardiovascular mortality by 20 per cent,
• stroke 28 per cent,
• heart failure by 28 per cent,
• coronary artery disease by 17 per cent,
• mortality by 13 per cent.

He also referred to the “TOPSPIN trial,” a large Indian hypertension study, which found that a single-pill combination therapy using two medicines reduced blood pressure by 30–40 mmHg and helped nearly 70 per cent of patients achieve blood pressure control.

The expert stated that around 70 per cent of patients may require long-term treatment or may need it lifelong. However, for nearly 30 per cent of people, hypertension can be reduced by stopping medication through:

• sustained lifestyle changes
• weight loss,
• low-sodium diets,
• exercise,
• better sleep.

‘Do Not Stop BP Medicines Abruptly’

Importantly, Dr Roy cautioned people against stopping blood pressure medicines abruptly once readings improve.

“Blood pressure is controlled because of the medicine. If you stop it suddenly, BP can rise sharply and may trigger a brain stroke or hemorrhage,” he said.

Dr. Roy also dismissed fears around side effects of antihypertensive medicines, calling them among the safest long-term drugs available. “The only side effect they have is benefits,” he remarked, adding that these medicines reduce the risk of heart attack, stroke, and kidney failure.

To reduce blood pressure naturally, the expert advised people to

• remain physically active for at least 150 minutes per week,
• reduce processed and salty foods,
• maintain hydration during heatwaves,
• adopt DASH-style diets rich in fruits and vegetables.

The American Cancer Society (ACS) has updated its colorectal cancer testing guidelines, which bring new screening options for colorectal cancer. This will give the Americans two new options of stool-based tests and blood-based screening tests.

The ACS recommended colorectal cancer screening for citizens as the risk of the disease starts at the age of 45 and continues through age 75 for those with a life expectancy of 10 more years. Thus, to make colorectal cancer tests more accessible to the masses, the new guideline gives nod to blood-based screening tests and FDA-approved new stool sample kits.

Blood-based screening tests must be done in a doctor's office, while one can use stool sample kits for testing at home. Notably, colonoscopy is still the most accurate option for detecting colorectal cancer.

The new guidelines acknowledged the fact that people are likely to choose the most effective colorectal cancer screening test. But still about 20 million eligible Americans remained untested, according to the ACS.

ACS mentions that 1 in 5 colorectal cancer cases is seen in young adults; the new guidelines were a direct result of this huge problem. Though the one who will choose colonoscopy would only have to go through screening every 10 years, on the other hand, the gap between screenings will be every one, three, or five years, depending on the specific method of testing selected.

Early Symptoms Of Colorectal Cancer

Some of the most commonly missed early signs include:

• Persistent changes in bowel habits, especially if they last more than a few days, must be taken seriously. Narrow or ribbon-shaped stools may indicate a tumor partially blocking the colon.
• Blood in the stool is one of the most common and concerning signs. While it might be due to hemorrhoids or fissures, it’s important not to assume. A proper evaluation is critical.
• Unexplained weight loss: Especially when unintentional.
• Abdominal cramps or bloating: Misinterpreted as common digestive issues.

Ignoring such a red flag delays diagnosis and drastically reduces treatment success rates. A timely visit to a healthcare provider can change outcomes.

How To Prevent Colorectal Cancer?

• Diet: More fibre-rich fruits, vegetables, and whole grains; less processed food and red meat.
• Physical activity: “Even 30 minutes of daily walking helps.”
• Screenings: Especially vital for those over 45 or with a family history.