‘Global warming is the biggest challenge to infectious diseases’

From mutating viruses to bad air quality, Maharashtra has been witnessing intense public health challenges over the past few years. The State has been battling H1N1, tuberculosis and other stubborn viruses and bacteria leading to a rash of infectious diseases. As the year draws to a close, The Hindu speaks to the State health minister Dr. Deepak Sawant about the emerging health challenges, the threat of pollution, and large-scale prevention initiatives like the ongoing measles-rubella vaccination campaign:

H1N1 has killed nearly 300 people this year. What measures have been taken to avoid big outbreaks as we witnessed in 2010, 2015 and 2017?

We have set up an infection control committee consisting of the most renowned and knowledgeable doctors from the State. The committee meets once in 45 days to discuss trends and to implement new initiatives in order to aggressively tackle H1N1. We all know that global warming has resulted in changes in the characteristics of the viruses. We are currently in process of getting climate change experts and virologists together to study these patterns. We are continuously analysing if Oseltamivir, the medication that works against H1N1, is still efficient and if its dosage needs to be revised. We are checking on the efficacy of the vaccine as well. The State also widely circulated guidelines in treating H1N1 patients on a ventilator by avoiding steroids.

Tuberculosis is another infectious disease that we want to tackle aggressively. We have introduced mobile vans with digital X-ray machines and sputum testing. One of the vans also has the CB-NAAT machine ( also known as Genexpert). House-to-house TB screening is being carried out to break the chain of spread.

Bad air quality is a major health threat. Do we have a plan of action to tackle it?

We have formed a study group to research on various aspects of pollution in the State and device ways to reduce it. For this, we are constantly in conversation with the environment ministry. We don’t have an immediate solution but efforts are being taken on various fronts.

How has the response to Measles Rubella (MR) vaccination campaign been?

We aim to achieve a strong herd immunity and such preventive vaccination rounds are the key to it. Our target is to reach out to 3.37 crore children in the age group of nine months to 15 years during the six-week-long ongoing campaign. We have aggressively tackled polio earlier. Similar measures have been taken for small pox as well. Measles and rubella are among the causes of infant mortality and compromised growth of children. Our on-ground health workers face obstacles but we are turning around the situation.

Schools and communities were not completely willing to support the campaign. How are you reaching out to them?

The MR vaccination campaign is being implemented nation-wide and in 149 countries. There are many Islamic countries among these. We are taking help from the Urdu press, community doctors as well as local MLAs to debunk the rumours and myths around vaccination. There was apprehension but it is slowly disappearing. The vaccine is essential and there are only stray cases of minor side effects like rash and fever. The children who have been reported to have serious side effects, in reality, had underlying ailments.

What are the emerging health challenges faced by the State?

Global warming is the biggest challenge. It is resulting in mutations of the disease-causing pathogens. The diseases are growing, presenting with newer symptoms. We are concerned with newer challenges like the Kyasanur Forest Disease (KFD). Cases of the disease, also known as monkey fever, spread through the mites on dead monkeys, are being reported from Maharashtra, Karnataka and Goa border. Scrub typhus is another disease that we are concerned about. Several cases have been reported from the Vidarbha region during August and September. The challenge is that the classic presentation of eschar (dead tissue falling off from the skin) in scrub typhus is not seen in many cases and it has become difficult to detect. Precaution and awareness are thus necessary and so is continuous research and application of medicine to fight the diseases better.