Are we prepared for ZIKA?

I had honestly not heard of ZIKA virus till recently, when this hitherto unheard virus shot into international fame for allegedly damaging the brains of babies growing in their mother’s wombs, and having them being born in vegetative states with mental retardation. 

It is true, that ZIKA, which spreads through mosquito bites, does not seem to be dangerously fatal to the humans it stings, but the suspected havoc it causes to expecting mothers, who go on to deliver deformed mentally retarded babies, and the effect of this trauma on their families is often perceived by many to be worse than death.

Although ZIKA virus epidemic is raging in distant countries like Brazil, Mexico, Africa and other South American nations, it would be silly to adopt an “ Abhi Dilli Door Hai” stance. The same strain of mosquito that spreads ZIKA, called Aedes aegypti, is rampant in most ‘nukkars’ and ‘galis’ of India. At the moment it is fervently engaged in spreading other viruses such as Dengue and Chikungunya here. 

But when ZIKA arrives here after getting past the Indian immigration, it will find the Aedes mosquitoes eagerly waiting to carry it to a huge number of human Indian hosts living in populated towns and cities, many of who would be pregnant mothers. If swarms of Aedes mosquitoes could carry the Dengue and Chikungunya viruses, bringing governments to their knees, why would they not carry ZIKA?

Most people who catch the ZIKA infection do not show symptoms. Few (around 20%) develop fever, body aches, rash and congestion of the eyes that pass off in a few days. Hardly anyone dies. But some adults develop neurologic problems such as paralysis of muscles.

But the problem is, that unlike Dengue, there is no easy test to detect the infection. How then would an expectant mother know if she suffered the ZIKA infection during pregnancy? Or worse, how would she know that the baby growing in her womb has not been unknowingly harmed by the infection that she did not get to know about? 

This is what is making young mothers and couples in ZIKA affected areas go crazy, some even committing suicide after giving birth to deformed babies with small heads (microcephaly).

The World Health Organisation has sounded an international alarm, and the Indian government has echoed it. But in the absence of specific diagnostic tests, specific drugs to kill the virus or a vaccine to prevent the infection, how do people and nations that have swarms of mosquitoes breeding passionately face this dangerous threat?

The solution could lie beyond the virus, in its transmitter, the mosquito that carry it. And making settlements free of mosquitoes could solve the problem not just of ZIKA, but that of Dengue, Chikungunya, malaria and many more.

Civic bodies seem better positioned to solve this health problem than medical people. And we could play our little individual roles to check the mosquito-menace near our homes, schools and offices.

Plastic Bags are a Health Menace

Plastic carry bags that are so liberally doled out by grocers and store-keepers are emerging a major health hazard and killer.

They are made of polythene, a product of petroleum and can be seen littered on roadsides, drains and fields while you travel by car or train. They choke landfills and drains and have even caused floods. They block the intestines of cattle and marine animals when they are ingested mistakenly while grazing, and kill around 10, 00,000 each year by painfully strangulating their intestines or by choking.

Disposing these bags is not easy; their burning releases toxins that are harmful to environment and us. Burying them causes the landfills to choke as polythene does not breakdown and decompose easily, and when they do, release toxins into the soil that find their way into the food chain.

Sometimes plastic bag litter can cause more problems. According to Nobel Peace Prize winner, Professor Wangari Mathaai, discarded bags fill up with rainwater and become perfect breeding grounds for malaria-bearing mosquitoes. Researchers from United Nations Environment Program have recommended banning of plastic bags to check malaria and save lives in several such countries.

Social costs of plastic litter add up as well; countries lacking comprehensive waste management often sprout underground economies of ragpickers — typically children who wander refuse heaps and collect potentially recyclable materials for sale to shady businessmen operating from official dump sites.

The problem with plastic bags is that it has become the victim of its own success. It is cheap, light, impervious and convenient with around 5 trillion produced each year. Their menace can be contained by the 4-Rs — Reduce, Recycle, Re-use, Repair.

Several developed countries have concentrated on re-use. Unfortunately the disposal, collection and recycling of used plastic bags in poor countries pose logistic problems with less than 1% ever been recycled.

It is time that visionary governments impose a ban on plastic bags.

If we take our jute or cotton “jholas” when we go to the grocers, it would reduce the use of plastics. Celebrities could make it a fashion statement and the media can publicise it. Retailer chains could offer an option of jute bag carry aways, at a little extra price; many of us wouldn’t mind it.

And if we could ensure clearing of the littered bags in our vicinity, we could reduce the breeding places of mosquitoes and the harm they cause to cattle. A difference, no matter how small, is urgently worth making, and we can set examples and inspire others to join in.

What does Research say about Happiness?

The secret to happiness may have to do with relatives and friends rather than money and fame, reports a recent scientific study.

The findings of a 75 years long study undertaken by Harvard University researchers to find out what makes people happy and healthy as they go through their lives, was presented by Dr Robert Waldinger, the fourth director of the long research project, in his crisp 12 minute TED talk “What makes a good Life. Lessons from the longest study on Happiness”, recently (http://ted.com/talks/robert_waldinger_what_makes_a_good_life_lessons_from_the_longest_study_on_happiness).

This unique study, the longest ever undertaken to study happiness, tracked the lives of hundreds of young people, rich and poor, starting from their teenage to their nineties.

On expected lines, most youngsters, at the time of initial interview in 1930 when the study started, had mentioned money as the most important thing they thought they needed to make them happy. Some had said they wanted fame, and several others had said that they wanted both money and fame to achieve happiness in life.

Over the 75 years, the participants were interviewed periodically and their perceptions of happiness were recorded each time to see if they changed.

By the time they were 50 years old, two types of people could be identified: those with lots of “relationships”, that is close bonds with relatives, friends and people, and another who were loners.

When followed up further till their 80s and 90s, the researchers evaluated how happy the participants were and had been in their lives, and tried to see a pattern in their lives that could correlate with their state of mind and health.

In the TED talk, Dr. Waldinger says that the research failed to show any correlation of the wealth or fame they had achieved, with their health and happiness.

What the researchers noted however was that the happy nonagenarians were far more likely to have had more relationships, often with many relatives and large families, or larger number of friends.

On trying to look back at the lives of participants, the researchers note that those who had many good strong relationships at age 50 were far more likely to be happy and healthy in their nineties.

Dr. Waldinger therefore goes on to conclude, that in order to be happy in life, investing time in relationships seem to be more important than acquiring money or fame. Building close warm bonds with relatives and friends seem to pay rich dividends later on.

Ever since I heard this talk, I am working to change my schedule to make more time for those seemingly unimportant occasions such as a cousin’s grandchild’s birthday, or a friend’s son’s marriage. Meeting people and spending time interacting with relatives and friends seem to be what we need to rediscover and get back in our increasingly busy lives.

I strongly urge you to listen to the talk and make up your minds.

Diabetes and the Liver

One could wonder why in diabetes, a condition in which the blood sugar concentration in the blood goes up, need we worry about the liver? Or for that matter, even take the blood sugar reports seriously at all.

Doctors have begun to realise that the elevated blood sugar value is only the tip of the iceberg. Patients with type 2 diabetes, the common form of the disease that occurs in adulthood, often go on to develop problems with several other organs of the body, such as kidneys, brain, blood vessels, heart, feet and the liver.

At the root of the problem in Type 2 Diabetes, is the observation that contrary to intuitive logic, the blood levels of insulin in this condition is increased!

Insulin resistance (IR) as its is called brings with it several changes in the body such as thickening of the basement membrane, the floor on which cells of all organs of the body are lined up and pushes up fatty acids in blood circulation, that then gets deposited in the liver and blood vessels.

Fatty liver is seen in two-third of diabetics. It usually has no clear symptoms in the early stages often getting recognised during investigations for abnormal readings on liver function tests (AST, ALT or GGT levels in blood) or during an ultrasound examination.

It is however not an innocuous condition. Research shows that patients with extra fat in their livers die earlier, that is, their lives are shorter than their fat-free counterparts.

What happens to people with Fatty Liver? Some of them go on to develop a state of weakness of the liver called Liver Cirrhosis. In this condition, liver cells die insidiously and are replaced by scar tissue. The organ gradually starts functioning poorly, sometimes causing swelling of feet or retention of water in the abdomen. The veins in the food pipe can get engorged and rupture, causing blood vomiting.

When the liver gets very weak due to Liver Cirrhosis, transplantation of the diseased organ is sometimes required. This condition is getting so common that it makes up around a third of all causes of liver transplantation.

Another recent finding that research has shown up is that patients with diabetes and fatty liver are at increased risk of developing liver cancer. They often come silently or are incidentally picked up on imaging tests, but progress aggressively over few months. Scientists are debating whether all type 2 diabetics with excess fat in their liver should be monitored periodically with CT scans or MRI scans to watch for early liver cancer.

Diabetes therefore is a condition of not merely increased blood levels of sugar. Although it has a genetic basis, its severity and outcome is decided by how we eat, and exercise, and get our periodic checks done to ensure our organs are keeping healthy.

Liver is a large organ with lots of reserve, but it is wise not to ignore it in diabetes.