• Dec 18, 2017
  • LastUpdated 10:33 AM, Jul 21, 2017

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Health Ministry Notification on Japanese Encephalitis
Sep 28, 2016

Health Ministry Notification on Japanese Encephalitis All confirmed Japanese encephalitis cases to be notified The Ministry of Health & Family Welfare has issued a notification (as below) on Japanese Encephalitis on Wednesday to the concerned health authorities of all the states and has requested the states of Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal where the number of JE cases has been reported to be high, to issue necessary notification under the Clinical Establishment (Registr

Health Ministry Notification on Japanese Encephalitis All confirmed Japanese encephalitis cases to be notified The Ministry of Health & Family Welfare has issued a notification (as below) on Japanese Encephalitis on Wednesday to the concerned health authorities of all the states and has requested the states of Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal where the number of JE cases has been reported to be high, to issue necessary notification under the Clinical Establishment (Registration & Regulation) Act, 2010 or relevant Act/Rules as applicable, to ensure necessary monitoring, prevention and control of the disease.

1. “Japanese Encephalitis (JE) is an important public health concern in the country accounting for substantial morbidity, mortality and disability. Early reporting of JE cases is necessary for effective implementation of preventive measures and case management.

2. In order to ensure early diagnosis & case management, reduce transmission, address the problems of emergency and spread of disease in newer geographical areas, it is essential to have complete information of all JE cases. Therefore, the healthcare providers shall notify every JE case to local authorities i.e. District Health Officer/Chief Medical Officer of the district concerned and Municipal Health Officer of the Municipal Corporation/Municipality concerned every week (daily during transmission period).

3. Accordingly, all laboratory-confirmed cases of Japanese Encephalitis should be notified as detailed below.

(A) Definition of laboratory-confirmed JE case: Patient having any one of the following:

• Presence of lgM antibodies specific to JE virus in a single sample of cerebrospinal fluid (CSF) or serum, as detected by an lgM-capture ELISA specifically for JE virus.

• Detection of a fourfold or greater rise in antibodies specific to JE virus as measured by haemagglutination inhibition (Hl) or plaque reduction neutralization assay (PRNT) in serum collected during the acute and convalescent phase of illness. The two specimens for lgG should be collected at least 14 days apart. The lgG test should be done in parallel with other confirmatory tests to eliminate the possibility of cross-reactivity.

• Isolation of JE virus in serum, plasma, blood, CSF or tissue. Detection of JE-virus antigens in tissue by immunohistochemistry;

• Detection of JE-virus genome in serum, plasma, blood, CSF or tissue by reverse transcriptase polymerase chain reaction (PCR) or an equally sensitive and specific nucleic acid amplification test.

(B) A suspected case is defined as: A person of any age, at any time of year, with the acute onset of fever, not more than 5-7 days duration and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) AND/OR new onset of seizures (excluding simple febrile seizures). Other early clinical findings can include an increase in irritability, somnolence or abnormal behaviour greater than that seen with usual febrile illness.

4. For the purpose of this notification, healthcare providers will include clinical establishment run- or managed by the Government (including local authorities), private or NGO sectors and/or individual practitioners under Clinical Establishment (Registration & Regulation) Act, 2010.

5. The doctors in Government Health Institutions and the registered medical private practitioners of the private hospitals/clinics are required to immediately inform the office of the District Health Authority of concerned district, if a suspected case of JE is reported at their health institution.

6. The blood samples of the all JE suspected cases have to be sent to the JE Sentinel surveillance Hospital (SSH), to be tested by ELISA technique. The information of the positive case should be sent to the office of the District Health Authority immediately after the diagnosis.

7. The management of the JE cases need to be done as per the guidelines issued by the Government of the India from time to time and available on the website of Directorate of National Vector Borne Disease Control programme (NVBDCP), Government of India.”

(Source: Press Information Bureau, Ministry of Health and Family Welfare, 21st September, 2016)

Malaria Updates
Feb 08, 2016

Malaria Updates

Malaria Updates

  1. February 11, India will launch an ambitious programme that seeks to eliminate malaria by 2027.
  2. The WHO’s global target for malaria elimination is 2030.
  3. Malaria is a public health problem in several parts of the country.
  4. About 95% population in the country resides in malaria endemic areas and 80% of malaria reported in the country is confined to areas consisting 20% of population residing in tribal, hilly, difficult and inaccessible areas.
  5. Under the National Framework for Malaria Elimination, states have been divided into three categories based on their annual parasite incidence (API). Elimination will be undertaken in a phased manner, and states with low incidence rates taken first, followed by the high-incidence ones.
  6. Malaria elimination is defined as a situation where a given area — district or state — records no indigenous transmission of Plasmodium vivax and Plasmodium falciparum. Once all districts achieve that, a country is said to have eliminated malaria.
  7. 1 million malaria cases are reported annually across the country, but this is widely regarded an underestimate, as 60 to 80 per cent patients in urban areas are treated by private doctors or health establishments, most of whom do not notify cases. Although malaria is a notifiable disease, it is only voluntary notification; there are no penalties for doctors or hospitals not doing so.
  8. Under the new framework, category-1 states should have API of one (number of cases per 1,000 population annually) at both state and district levels. There are 15 such states/union territories: Goa, Haryana, Himachal Pradesh, Jammu and Kashmir, Kerala, Manipur, Punjab, Rajasthan, Sikkim, Uttarakhand, Chandigarh, Daman and Diu, Delhi, Lakshadweep, and Puducherry.
  9. In category-2 are states where overall API is less than one but in some districts it is more than one. The 11 states are Nagaland, Gujarat, Andhra Pradesh, Assam, Bihar, Karnataka, Maharashtra, Tamil Nadu, Telangana, UP and West Bengal.
  10. The last category comprises states where API is more than one at both state and district levels: Madhya Pradesh, Chhattisgarh, Arunachal Pradesh, Meghalaya, Mizoram, Odisha, Tripura, Andaman and Nicobar Islands, and Dadra and Nagar Haveli.
  11. Under the programme, accredited social health activists will be equipped with special kits for quick diagnosis of malaria. Distribution of mosquito nets will be stepped up. The current standard of insecticide spray will be brought down to one. [Indian Express)

Health Ministry issues guidelines on Zika Virus Disease
Feb 05, 2016

The Ministry of Health and Family Welfare issued guidelines on the Zika virus disease, here today. The text of the guidelines is as follows.

Background

Zika virus disease is an emerging viral disease transmitted through the bite of an infected Aedes mosquito. This is the same mosquito that is known to transmit infections like dengue and chikungunya.  Zika virus was first identified in Uganda in 1947.

World Health Organization has reported 22 countries and territories in Americas1 from where local transmission of Zika virus has been reported. Microcephaly in the newborn and other neurological syndromes (Guillain Barre Syndrome) have been found temporally associated with Zika virus infection. However, there are a number of genetic and other causes for microcephaly and neurological syndromes like Guillain Barre Syndrome.

Zika virus disease has the potential for further international spread given the wide geographical distribution of the mosquito vector, a lack of immunity among population in newly affected areas and the high volume of international travel. As of now, the disease has not been reported in India. However, the mosquito that transmits Zika virus, namely Aedes aegypti , that also transmits dengue virus,  is widely prevalent in India.

A majority of those infected with Zika virus disease either remain asymptomatic (up to 80%) or show mild symptoms of fever, rash, conjunctivitis, body ache, joint pains. Zika virus infection should be suspected in patients reporting with acute onset of fever, maculo-papular rash and arthralgia, among those individuals who travelled to areas with ongoing transmission during the two weeks preceding the onset of illness.

Based on the available information of previous outbreaks, severe forms of disease requiring hospitalization is uncommon and fatalities are rare. There is no vaccine or drug available to prevent/ treat Zika virus disease at present.

World Health Organization has declared Zika virus disease to be a Public Health Emergency of International Concern (PHEIC) on 1st February, 2016.

[1] Zika virus disease has been reported so far in the following countries; Brazil, Barbados, Bolivia, Columbia, Dominican Republic, Equador, El Salvador, French Guyana. Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, St Martin, Suriname, Virgin Island  and Venezuela. It may be noted   that this list is likely to change with time. Hence, updated information should be checked periodically. 

In the light of the current disease trend, and its possible association with adverse pregnancy outcomes, the Directorate General of Health Services, Ministry of Health and Family Welfare advises on the following:

1.            Enhanced Surveillance

1.1.      Community based Surveillance

·         Integrated Disease Surveillance Programme (IDSP) through its community and hospital based data gathering mechanism would track clustering of acute febrile illness   and seek  primary case, if any,  among those who travelled to areas with ongoing transmission in the 2 weeks preceding the onset of illness.

·         IDSP would also advise its State and District level units to look for clustering of cases of microcephaly among newborns and reporting of Gullian Barre Syndrome.

·         The Maternal and Child Health Division (under NHM) would also advise its field units to look for clustering of cases of microcephaly among new borns.

1.2       International Airports/ Ports

·         All the International Airports / Ports will display billboards/ signage providing information to travelers on Zika virus disease and to report to Custom authorities if they are returning from affected countries and suffering from febrile illness.

·         The Airport / Port Health Organization (APHO / PHO) would have quarantine / isolation facility in identified Airports.

·         Directorate General of Civil Aviation, Ministry of Civil Aviation  will be asked to instruct all international airlines to follow the recommended aircraft disinsection guidelines

·         The APHOs shall circulate guidelines for aircraft disinsection (as per International Health Regulations) to all the international airlines and monitor appropriate vector control measures with the assistance from NVBDCP in airport premises and in the defined perimeter.  

1.3       Rapid Response Teams

·         Rapid Response Teams (RRTs) shall be activated at Central and State surveillance units. Each team would comprise an epidemiologist / public health specialist, microbiologist and a medical / paediatric specialist and other experts (entomologist  etc) to travel at short notice  to investigate suspected outbreak.

·         National Centre for Disease Control (NCDC), Delhi would be the nodal agency for investigation of outbreak in any part of the country.

1.4       Laboratory Diagnosis

·         NCDC, Delhi and National Institute of Virology (NIV), Pune, have the capacity to provide laboratory diagnosis of Zika virus disease in acute febrile stage. These two institutions would be the apex laboratories to support the outbreak investigation and for confirmation of laboratory diagnosis.  Ten additional laboratories  would be strengthened by ICMR to expand the scope of laboratory diagnosis.

·         RT- PCR test would remain the standard test. As of now there is no commercially available test for Zika virus disease. Serological tests are not recommended.

2.         Risk Communication

·         The States/ UT Administrations would create increased awareness among clinicians including obstetricians, paediatricians and neurologists about Zika virus disease and its possible link with adverse pregnancy outcome (foetal loss, microcephaly etc). There should be enhanced vigilance to take note of travel history to the affected countries in the preceding two weeks.

·         The public needs to be reassured that there is no cause for undue concern. The Central/ State Government shall take all necessary steps to address the challenge of this infection working closely with technical institutions, professionals and global health partners.

3.         Vector Control

·         There would be enhanced integrated vector management. The measures undertaken for control of dengue/ dengue hemorrhagic fever will be further augmented. The guidelines for the integrated vector control will stress on vector surveillance (both for adult and larvae), vector management through environmental modification/ manipulation; personal protection, biological and chemical control at household, community and institutional levels. Details are at Annexure-I.

·         States where dengue transmission is going on currently due to conducive weather conditions (Kerala, Tamil Nadu etc) should ensure extra vigil. 

4.         Travel Advisory

·         Non-essential travel to the affected countries to be deferred/ cancelled2.

·         Pregnant women or women who are trying to become pregnant should defer/ cancel their travel to the affected areas.

·         All travelers to the affected countries/ areas should strictly follow individual protective measures, especially during day time, to prevent mosquito bites (use of mosquito repellant cream, electronic mosquito repellants, use of bed nets, and dress that appropriately covers most of the body parts).

·         Persons with co-morbid conditions (diabetes, hypertension, chronic respiratory illness, Immune disorders etc) should seek advice from the nearest health facility, prior to travel to an affected country.

·         Travelers having febrile illness within two weeks of return from an affected country should report to the nearest health facility.

·         Pregnant women who have travelled to areas with Zika virus transmission should mention about their travel during ante-natal visits in order to be assessed and monitored appropriately.

5.         Non-Governmental Organizations

·         Ministry of Health &FW / State Health Departments would work closely with Non-Governmental organizations such as Indian / State Medical Associations, Professional bodies etc to sensitize clinicians both in Government and private sector about Zika virus disease.

 Based on available evidence, World Health Organization  is not recommending any  travel or trade restrictions.

6.         Co-ordination with International Agencies

·         National Centre for Disease Control, Delhi, the Focal Point for International Health Regulations (IHR), would seek/ share information with the IHR focal points of the affected countries and be in constant touch with World Health Organization for updates on the evolving epidemic.

7.         Research

·         Indian Council of Medical Research would identify the research priorities and take appropriate action.

8.         Monitoring

·         The situation would be monitored by the Joint Monitoring group under Director General of Health Services on regular basis. The guidelines will be updated from time to time as the emerging situation demands.

Invitation to Web seminars: LMG's 3-Part Governance Webinar and Seminar Series
Mar 07, 2015

Sanjay Bedi, invites you to join a series of events on the Web using WebEx.

EVENT 1 SUMMARY

Topic: LMG’s Unleash the power of good governance in provincial health systems, public hospitals, and multi-sector governing bodies
Date and Time:
Wednesday, March 11, 2015 8:00 am, Eastern Daylight Time (New York, GMT-04:00)
Registration password: This event does not require a password for registration
Event URL: https://mshmeetings.webex.com/mshmeetings/onstage/g.php?d=730123368&t=a&SourceId=drsanjaybedi%40gmail.com
Host name: Dr. Mahesh Shukla
Phone No.: 1--
Host Email address: mshukla@msh.org

EVENT 2 SUMMARY

Topic: LMG’s Unleash the power of good governance in CSOs working for vulnerable populations, reproductive health and HIV and AIDS
Date and Time:
Wednesday, April 15, 2015 8:00 am, Eastern Daylight Time (New York, GMT-04:00)
Registration password: This event does not require a password for registration
Event URL: https://mshmeetings.webex.com/mshmeetings/onstage/g.php?d=731150315&t=a&SourceId=drsanjaybedi%40gmail.com
Host name: Dr. Mahesh Shukla
Phone No.: 1--
Host Email address: mshukla@msh.org
 

Prohibition of Use of Polyethylene Terephthalate or Plastic Containers
Feb 23, 2015

MOH notification regarding Prohibition of Use of Polyethylene Terephthalate or Plastic containers for primary packaging of drug formulations for using in certain cases

MINISTRY OF HEALTH AND FAMILY WELEFARE

(Department of Health and Family Welfare)

NOTIFICATION

New Delhi, the 29th September, 2014

 

G.S.R. 701(E).—The following draft rules which the Central Government proposes to make, in exercise of the powers conferred by clause (i) of sub-section (2) of section 33 read with section 26A of the Drugs and Cosmetics Act, 1940 (23 of 1940), on the recommendation of the Drugs Technical Advisory Board, is hereby published for the information of all persons likely to be affected thereby; and notice is hereby given that the said draft rules shall be taken into consideration on or after the expiry of a period of forty-five days from the date on which the copies of the Gazette of India containing this notification is made available to the public;

The objections and suggestions, if any, received from any person with respect to the said draft notification within the period so specified shall be taken into consideration by the Central Government;

The objections and suggestions, if any, may be addressed to the Under Secretary (Drugs), Room No. 523-A, Ministry of Health and Family Welfare, Government of India, Nirman Bhawan, New Delhi – 110011.

Draft Rules

1. Short title and commencement.

(1) These rules may be called the Prohibition of Use of Polyethylene Terephthalate or Plastic containers for primary packaging of drug formulations for using in certain cases Rules, 2014.

(2) They shall come into force after a period of one hundred and eighty days from the date of its final

publication in the Official Gazette.

2. Prohibition of use of Polyethylene Terephthalate in liquid oral formulations for primary packaging of drug formulations.—No manufacturer shall use the Polyethylene Terephthalate or Plastic containers in liquid oral formulations for primary packaging of drug formulations for paediatric use, geriatric use and for use in case of pregnant women and women of reproductive age group.

3. Penalty for contravention.—Any manufacturer who contravenes the provisions contained in rule 2 shall be liable to penalty under the provisions of the Drugs and Cosmetics Act, 1940.

 

 

K. L. SHARMA,

Jt. Secy

MINISTRY OF HEALTH AND FAMILY WELEFARE

 

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