Overview

This is a disease that is transmitted from mosquitoes to humans and affects many people in the world. Found in densely populated countries and continents, like Africa, Asia and the tropics of the Americas, this has severe symptoms. This viral disease is caused by the Chikungunya virus of the Togaviridae. First identified in the United Republic of Tanzania in 1952 and subsequently in other countries like Africa and Asia. Since 2004 the outbreak of CHIKV virus has become more widespread and caused partly due to the viral adaptations allowing the virus to be spread more easily by Aedes albopictus mosquitoes. The transmission has been noted to persist in countries where there is a large population, but interestingly, the transmission has been interrupted on islands where a high proportion of the population is infected and then immune.

Symptoms

The onset of the disease is usually in 4-8 days and after a bite of an infected mosquitoes, it is characterized by an abrupt onset of fever and then joint pain. This joint pain is severed and lasts for a few days but may prolong for months maybe even years. Other signs are joint swelling, muscle pains, headache, nausea, fatigue and rash. These symptoms also overlap with those of dengue and Zika virus and can be misdiagnosed. Most people fully recover from the infection and experience only mild and sometimes the infection even goes unrecognized. However, there have been cases of eye, heart, and neurological complications. The elderly and newborns are more susceptible to the infection and if they have any underlying conditions then they are likely to become severely ill increasing the risk of death.

Diagnosis and treatment

The diagnosis and treatment of the virus may be done by blood sampling and other tests like reverse transcriptase–polymerase chain reaction (RT–PCR). Other tests detect the activity of the antibodies. These can be detected in the first week after illness onset and can be detected for about 2 months. Many clinical measures can be taken to address fever and joint pain. But there is no specific anti-viral drug treatment for the virus.

Preventing Chikungunya

As this disease is caused by the bite of a mosquito, you must reduce the opportunities to let the mosquito breed. Mosquitoes bite during the day and night, and for people who live in risk areas like southeast Asia, Africa and tropical regions of America, many outbreaks happen each year. The best way to prevent it is to protect yourself from the mosquito's bite. You also must get vaccinated before travelling to any of these regions. Use insect repellent, and wear long-sleeved shirts and pants. You can also treat your clothes and gear with permethrin. As we all know, they tend to breed in humid places and places where they have access to water, so try to close the rooms that are air-conditioned with screens and windows. Use nets and mosquito repellents if you are sleeping outside. There are many different types of mosquito repellents like paper, liquid etc, and they are quite effective. If your job needs, you to be stationary for long hours or frequently go outside you must take the necessary precautions.

India is facing a significant and growing cancer burden, with the latest National Cancer Registry Programme study estimating that the lifetime risk of developing cancer in the country is 11% — about one in nine people.

The 2025 study also found that India ranks second in Asia and third globally in cancer incidence.

SC Directs States To Notify Cancer

Around 17 states in India have already made cancer a notifiable disease, while the Supreme Court in August directed the remaining 19 states and Union Territories to comply with the requirement, aimed at enabling early detection and proper care of patients.

The petition before the court argued that the continued non-notification of cancer, despite its alarming and escalating burden in India, amounted to a grave abdication of the state's constitutional duty under Articles 14 and 21 of the Constitution. It said this denied uniform treatment to similarly situated citizens and undermined their fundamental right to health and a life of dignity.

The Supreme Court's order is legally binding on the remaining 19 states and Union Territories, which have until November 11, 2026, to comply with the directive.

By the deadline, the concerned administrations are required to transition cancer into a notifiable disease and formally submit their progress reports to the Supreme Court. States will also need to issue official Gazette notifications requiring public and private healthcare entities to report cancer cases and related data.

Why Cancer Notification Matters

Speaking to HealthandMe, experts said making cancer notifiable could strengthen cancer surveillance, improve data collection and support research and treatment planning.

Dr Karishma Kirti, Consultant Obstetrician & Gynaecologist, Jaslok Hospital, Mumbai, said cancer should be treated as a notifiable disease, but through a system different from the traditional notification process used for infectious diseases.

How Cancer Registration Can Help

Dr Kirti told HealthandMe that mandatory registration of cancer cases could help India understand cancer trends and generate more real-world data to guide research.

“Mandatory registration of cancer cases will in the future help in understanding trends, generating real-world data early, and guiding research. Most of the evidence-based medicine and treatment that we recommend comes from Western data and mandating cancer registration will help India generate its own data and understand the inherent characteristics of Indian cancers better.”

Notifying Cancer Could Strengthen Cancer Care

Dr Harit K Chaturvedi, CEO & Clinical Head, Apollo Oncology Network, said making cancer a notifiable disease could help improve cancer care and research as the country's cancer burden rises.

“No two cancers are the same and the disease cannot be fought in silos. As the burden of cancer cases is increasing, wherein India is projected to record 1.5 million cases in 2026, declaring cancer as a notifiable disease can enable better cancer care and research across India,” he told HealthandMe.

Chaturvedi said notification of cancer would also give impetus to the decades-old National Cancer Registry Program and enable proper and mandatory record-keeping of cancer cases, as seen in many developed nations.

“By making cancer a notifiable disease, we can ensure that all cancer cases are reported and documented accurately, enabling us to track cancer incidence, mortality, and survival rates.”

Importantly, he said, notification would also enable policymakers, healthcare providers and researchers to work with real-time data, which could help bring more awareness, strengthen prevention and early detection, and improve treatment outcomes and quality of life.

Recurring abdominal pain is often dismissed as acidity or indigestion. This becomes a matter of concern when persistent pain reaches the back and causes vomiting and weight loss. These are symptoms of a more serious disease such as chronic pancreatitis.

A recent case highlights the importance of recognizing the condition early. A 35-year-old mother of two had been living with severe upper abdominal pain for nearly three years. She experienced episodes that required hospital admission. Upon detailed investigations, it was confirmed to be a case of chronic idiopathic calcific pancreatitis. Long-standing inflammation had caused stones to develop within the pancreatic duct, which blocked the normal flow of digestive juices and triggered repeated attacks of pain. The underlying problem remained unresolved. To the patient, the mental toll of being a daily-wage worker came with loss of income and disruption to family life.

Chronic pancreatitis is when repeated inflammation causes permanent damage to the pancreas. Gradually, the gland becomes scarred, the pancreatic duct narrows, and stones develop. Pressure within the pancreas increases, thereby causing recurrent abdominal pain. As the disease advances, patients may also develop difficulty digesting food, unintended weight loss, nutritional deficiencies, and diabetes due to loss of pancreatic function. There exist multiple causes of chronic pancreatitis such as alcohol, gallstones, smoking, genetic disorders, autoimmune diseases and certain metabolic conditions. In a proportion of patients, no definite cause can be identified despite extensive evaluation.

Diagnosis is made on clinical grounds and imaging modalities such as ultrasound, CT scan, or MRI, which are helpful in identifying changes in the pancreas and detecting ductal stones. Early diagnosis is essential to prevent further complications and long-term outcomes. Treatment is modified according to the severity of the illness and the patient's signs and symptoms. Initial management is done in the form of dietary modifications, enzyme supplementation, and avoidance of substances such as alcohol and tobacco. However, when pain persists despite medical treatment, surgery may be required to relieve the obstruction and restore pancreatic drainage. This also occurs when stones obstruct the pancreatic duct,

In this patient's case, the severity of the case warranted surgery in order to ensure the best chance of lasting relief. Prior to the surgery, the patient consulted multiple hospitals before treatment. She underwent a minimally invasive robotic-assisted procedure to remove the pancreatic duct stones and create a new drainage pathway for pancreatic secretions. She had been advised open surgery but delayed it because she feared the large incision and long recovery; before this, she was admitted every 2-3 months for severe pain. The surgery was performed through small incisions with reduced tissue trauma as compared to conventional open surgery. The recovery was unsuccessful, and the patient was discharged with pancreatic enzyme supplementation.

Three months later, she was free from the disabling pain that had dominated her life. She had returned to work and was able to resume her daily routine.

Available treatment options have increased due to minimally invasive and robotic techniques for selected patients, but they may not be suitable for everyone. The choice of treatment is dependent on multiple factors such as the stage of the disease, the anatomy of the pancreas, and the patient's overall condition.

The more important message, however, extends beyond surgery. Persistent pain should never be ignored or considered a common passing occurrence; neither should it be repeatedly treated with painkillers without identifying the cause.

Earlier diagnosis and timely referral can be encouraged by raising awareness amongst the general public to prevent recurring hospital visits. Awareness can make the difference between years of repeated hospitalizations and a return to a healthier, more productive life.

(Dr. Sreedhara V., Surgical Gastroenterologist, Apollo Hospitals Bannerghatta Road, Bengaluru)

Liver cancer rarely announces itself. It creeps in without warning, and by the time symptoms surface, the disease has often progressed to a stage where treatment options shrink, and outcomes worsen. That's why doctors have long called it a "silent killer."

In India, the threat is growing. Rising rates of hepatitis infection, fatty liver disease, and lifestyle-driven risk factors are pushing the numbers up.

Data from the World Health Organization's International Agency for Research on Cancer (IARC) shows more than 40,000 new liver cancer cases reported in India, a figure that underscores a mounting public health challenge. The disease also carries a high mortality rate, largely because most cases surface only once treatment options have narrowed.

This fits into a much larger global picture: WHO's newly released Global Status Report on Cancer 2026 warns that annual cancer cases worldwide could climb from 20.6 million today to nearly 35 million by 2050 without urgent intervention, with infections like hepatitis B and C among the preventable risk factors driving a significant share of the burden.

Why Does Liver Cancer Stay Hidden?

The liver is a workhorse organ, filtering toxins, storing nutrients, and keeping the body running, and it can keep functioning almost normally even after cancer takes hold. That resilience is precisely what makes early detection so difficult. When symptoms do appear, they're vague enough to be mistaken for something else entirely:

• Unexplained weight loss
• Persistent fatigue and weakness
• Upper abdominal pain
• Loss of appetite
• Yellowing of the skin and eyes
• Abdominal swelling

Because these signs surface late, patients often delay seeking care, which is exactly why regular health checkups matter most for high-risk groups, including people with chronic liver disease, hepatitis infection, or fatty liver.

What's Driving the Risk?

Liver cancer doesn't appear overnight; it's the result of years of accumulated damage. Key contributors include:

• Chronic Hepatitis B and C infections, among the leading causes worldwide
• Liver cirrhosis, where scar tissue replaces healthy liver tissue
• Fatty liver disease, increasingly common in India amid rising obesity and diabetes
• Excessive alcohol consumption, which steadily damages liver cells
• Family history of liver disease or cancer
• Exposure to toxins through contaminated food
• Smoking, which raises overall cancer risk

India's shifting disease landscape, sedentary routines, poor dietary habits, and metabolic disorders like obesity and diabetes, means liver cancer is no longer just an infectious-disease concern. It's increasingly a lifestyle disease too.

Can It Be Prevented?

The good news: much of this risk is manageable.

• Get vaccinated against Hepatitis B to block the long-term viral infection that often leads to cirrhosis
• Maintain a healthy weight through diet and regular activity, as obesity is closely tied to fatty liver disease
• Manage diabetes and metabolic health, since insulin resistance accelerates liver damage
• Limit or avoid alcohol, a leading cause of cirrhosis
• Avoid tobacco, which compounds cancer risk
• Stay on top of routine screening if you're at risk; this is one of the most critical preventive steps and includes:
  • Liver function tests (LFTs) to catch early signs of inflammation or damage
  • Ultrasound scans every 6 months for those with cirrhosis, chronic hepatitis B or C, or advanced fatty liver disease
  • Alpha-fetoprotein (AFP) blood tests, used alongside imaging to flag early tumour changes
  • Advanced imaging (CT or MRI) for more detailed evaluation in high-risk cases

Paired with lifestyle changes and timely medical care, these steps can meaningfully lower the risk of developing liver cancer and support long-term liver health.

Know When to Seek Medical Help

Because liver cancer tends to progress silently, early detection is everything when it comes to improving outcomes. Doctors typically rely on a combination of diagnostic tools, ultrasound scans, AFP blood tests, CT or MRI imaging, and in some cases a liver biopsy, to catch the disease at a more treatable stage.

When caught early, treatment can significantly improve survival odds. The right approach depends on the stage of disease, liver function, and the patient's overall health:

• Liver resection, surgically removing only the cancerous portion of the liver, when the disease is localized
• Liver transplant, replacing the entire diseased liver with a healthy donor liver, in select cases
• Ablation, using radiofrequency or microwave energy to destroy cancer cells with heat
• Targeted therapy, drugs designed to attack specific cancer cells while sparing healthy ones
• Immunotherapy, strengthening the body's own immune system to identify and fight cancer cells

Liver cancer is serious and life-threatening, but early diagnosis through screening, paired with timely medical intervention, can meaningfully improve treatment success and survival rates.

(By Dr. Kundan, Consultant - Surgical Oncology, Manipal Hospital, Ghaziabad_