Tag Archives: RNA virus

COVID19 Delta variant is 60% more transmissable than Alpha variant

Citing reports, Dr Chandrashekhar T. says this mutant has been responsible for several complications cropping up among patients even after recovery.

The Delta COVID19 variant is the new villain that has taken center stage. It is believed to be 60% more transmissible than the B.1.1.7 variant (or Alpha variant) and may be associated with an increased disease severity such as hospitalization risk. Several reports from across the country indicate that this mutant has been responsible for several complications cropping up among patients even after recovery. Here is what you know about the variant.

WHAT IS THE DELTA VARIANT? Variants are mutations of the Coronavirus. Scientists say viruses constantly mutate naturally as they replicate and circulate in their hosts. Sometimes these mutants disappear; other times, they persist. The Delta variant, known as B.1.617.2, is gaining ground worldwide and is said to have contributed to the country’s recent surge. Sometimes we can see a mutation in the mutated variant; this are called as double mutation.

According to WHO and CDC, the viruses prevalent in the United States, Europe, South America, and another part of Africa and the Asian region are of different mutants. The variant prevalent in the US is called Alfa, Beta, and Theta was prevalent in South America and Africa. Theta and Gamma were prevalent in European countries. Delta was prevalent in India and Asia by large, which has now spread to other nations too. Kappa variant was prevalent in Australia. Now, people should know that the Delta wave hasn’t come in the second wave only. It was there in the first wave as well. However, Coronavirus is an RNA virus and is in constant mutation with increasing transmissibility and virulence.

HOW DANGEROUS IS THE DELTA VARIANT? To begin with, it is important to know what variants of concern (VOC) are. There is evidence of an increase in transmissibility, more severe disease, significant reduction in neutralization by antibodies generated during previous infection or vaccination, reduced effectiveness of treatments or vaccines, or diagnostic detection failures are termed as VOC.

The Delta variant was under investigation/variant of Interest (VOI) even in the first wave, as it was termed as the variant of concern by the WHO. Therefore, WHO, ICMR, and other government agencies in India are closely watching its mutations. Therefore, the Delta virus falls under the category of a variant of concern as it is more transmittable, more virulent, and causes many complications.

HOW DOES THE DELTA VIRUS IMPACT HUMAN HEALTH? Now, we all know that COVID19 can cause multiple problems in the body. First is the clotting problem causing a brain stroke or a heart attack or a particular vessel getting blocked, causing gangrene of the limbs, legs, or hands or blood clots causing pulmonary embolism or even gangrene in the intestine. 

Apart from blood clots in the arteries of limbs, heart, and brain, COVID19 patients are coming with intestinal clots that are causing gangrene of the GI. Similarly, clotting can cause pancreatitis as well.

The other problem is the inflammation problem called that Systemic Inflammatory Response Syndrome. This causes symptoms including fever or Hypothermia, Tachycardia, Tachypnoea, and a change in blood leucocyte count. Cytokine Release Syndrome (CRS) is another issue. CRS occurs when the immune system responds too aggressively to an infection. It causes a variety of symptoms, including fever, headaches, and nausea.

IS VACCINATION MY ANSWER? Yes, the vaccines available to us in our country — Covishield, Covaxin, and Sputnik put up a good defence against this variant and hold an excellent efficacy rate. So, you might wonder if vaccines work, then what is the problem. The problem is that not everybody has been vaccinated. And the variant is at its peak when the rate of vaccinations nationally has slowed down. The vaccination program will soon ramp up. Apart from this, staying at home and following all necessary COVID19 safety protocols — social distancing, wearing a mask, and hand hygiene are essential.

(Dr Chandrashekhar T. is Chief Intensivist, Fortis Hiranandani Hospital, Vashi)

Safe water means good health. Do you know why?

On World Water Day, Dr Sonali Gautam explains poor water hygiene’s impact on one’s health, especially children.  

New Delhi, March 22, 2021: On World Water Day, while we all should aim to save the most precious gift and a vital life source, we must also focus on improving water supplies and hygiene. You must be wondering why, so let me explain the impact of poor water hygiene on health. Worldwide, 2.2 billion people lack access to safely managed drinking water, and 4.2 billion people lack safe sanitation. Unsafe hygiene practices are widespread, compounding the effects on people’s health. The impact on child mortality rates is devastating, with more than 2,97,000 children under five die annually from diarrhoeal diseases due to poor sanitation, poor hygiene, or unsafe drinking water.

In India, the problem of unsafe water is a substantial public health concern. Apart from illnesses such as diarrohea, jaundice, etc., unsafe water also contributes to Hepatitis A & E. Both these diseases are associated with inadequate and unsafe water supplies, poor sanitation & hygiene, leading to infection and inflammation of the liver.

What is Hepatitis A and E? Hepatitis A and E viruses are RNA virus, which primarily infects the liver, causing inflammation of the liver (Acute Hepatitis). Infection with Hepatitis A & E is usually self-limiting.

How is the infection acquired? Hepatitis A or E is spread primarily through food or water contaminated by faeces from an infected person (feco-oral route). It enters the liver from our gut and is then excreted again by our gut into the stool, thus completing the infection cycle.

Who are at risk for Hepatitis A or E? Not everyone who’s infected will have any evidence of this disease, as it may go unnoticed (asymptomatic disease). But still, these people can excrete viruses in their stool and continue to infect others (carriers).

Asymptomatic disease: India being a developing nation with poor sanitation conditions, more than 95% of children below five years of age are usually infected with these viruses, with an asymptomatic course. Thus, in India, antibody to Hepatitis A virus is nearly universally detectable by adolescence, and antibody to HEV increases during young adulthood to reach about 40% in adults.

How does it spread? Hepatitis A is usually spread person-to-person through food or water contamination. An infected person’s hands can become the source of infection after using the bathroom. The virus then spreads by direct contact or by food, beverages or other objects that the infected person handled. An infected individual can transmit the virus to others as early as two weeks before the symptoms begin to appear.

Symptomatic disease: International travellers to India, children from high-income families are at risk of developing Hepatitis A or E infection because they do not eat much from the streets and have not developed the required antibodies resulting in fever, stomach-ache and jaundice.

What are the symptoms of Hepatitis A or E?

  • Fever
  • Tiredness
  • Stomach upset
  • Loss of appetite
  • Dark yellow urine
  • Diarrhoea
  • Yellowish eye & skin called jaundice

Why is it dangerous? Unlike Hepatitis B & C, Hepatitis A does not cause Chronic Liver Disease and is rarely fatal. But it can cause debilitating symptoms and Fulminant Hepatitis (Acute Liver Failure), which is often fatal. Fulminant Hepatic Failure leading to death is seen in 1.8 % adults, and 10% in pregnant ladies.

Most people with Hepatitis E get better within a few months. Usually, it doesn’t lead to long-term illness, or Liver damage like other forms of Hepatitis do. But Hepatitis E can be dangerous for pregnant women or anyone with weak immune systems, including the elderly or ill.

How to prevent it? The best approach is to take all precautions to avoid Hepatitis and ensure safe drinking water for all. Make sure that your water source is clean and well maintained. Apart from this, follow this:

  • Hand sanitation: Frequent handwashes before meals and after using the washroom.
  • Avoid eating outside, especially if you are pregnant.
  • Hepatitis A vaccine: Vaccinate your children below six years (consult a paediatrician about this).

If you identify any of the above symptoms, kindly meet your Gastroenterologist for timely treatment and care to resolve the infection with expected full recovery.

(Dr Sonali Gautam, Consultant-Gastroenterology, Hiranandani Hospital, Vashi, a Fortis network hospital; Image from Pixabay)