A scientific temper; and brain-eating bacteria

This week in health, we read about brain-eating bacteria, confusion over the NEET- Undergraduate exam, Zika virus infection cases in Pune and more.

Updated - July 10, 2024 11:28 am IST

Published - July 09, 2024 04:48 pm IST

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying thereYou can subscribe here to get the newsletter in your inbox.)

Hello! Are we taller in the morning than when we go to bed? The beauty of science is that you can ask this with a straight face, and there will also be a perfectly reasonable explanation, based in science, fact and actual historical data. That is the joy of being in science, watching it grow, answer all our questions without dissing them as silly or a whim or a fantasy. And yes, if you want to know the answer to the question, yes, we all are indeed taller when we wake in the morning than when we go to bed at night. There are two components to this, you’ll learn if you click on the link: In a growing child, the growth hormone is secreted in pulses overnight. This acts through several intermediary steps to cause lengthening of the bones at the end-plates (epiphyses). Accurate measurements of the forearm or lower leg using specialised apparatus or X-rays can record this night-time growth.

The most marked effect, however, which occurs even after growth has ceased, is caused by postural compression of the spine under the effect of gravity. Another factor concerns the inherent curvatures of the spinal column. This has a convexity backwards in the thoracic or chest region, called a kyphosis, and a concavity in the lumbar region or base of the back called a lordosis. These curves vary with body weight and position. As a result, the spinal column tends to press downwards when in an upright position, altering these curvatures, and hence shortening the spinal length. When lying down, the reverse happens and the column lengthens again.

Like we said, Science takes its questions seriously.

Now that we’ve lobbed that curveball at you, it’s time to move on to the major health events of the past week, not least what has gained popularity in media as the ‘brain-eating bacteria’. The index case involved the death of a five-year-old girl from Malappuram district in Kerala who had been undergoing treatment for amoebic meningoencephalitis at the Government Medical College Hospital, on May 21. Another 13-year-old girl from Kannur died of the infection, within a month, and a 12-year-old boy died in Kozhikode of PAM on July 4. As news of this spread, so did fear in the community The detection of a total of four cases in the State so far, raised the profile of Primary Amoebic Meningoencephalitis (PAM), and neighbouring States sent out warnings to their residents, though the disease causing vector Naegleria folweri cannot spread from person to person. Director of Public Health in Tamil Nadu, issued an advisory on amoebic meningoencephalitis, warning the public of bathing or swimming in pools, lakes and waterbodies that had not been cleaned, as they might contain the disease causing pathogen. For a full-length explainer on what PAM is, do read this explainer by A.S. Jayanth Rare and fatal brain-eating amoeba infection.

We are tracking that story, but meanwhile, here’s an update on the recent Zika infection in the country. Six Zika virus infection cases in Pune; two are pregnant women. Since Zika in pregnancy can cause birth defects including microcephaly, a smaller head, disproportionate to the body, there is much concern about controlling this epidemic. Since it is known to be spread by infected mosquitoes of the Aedes genus, mosquito and larval control programmes are the need of the hour, particularly at a time when the monsoon showers leave puddles prone to harbouring mosquito larvae.  

From infectious diseases, it makes sense to segue into vaccines. We have been reporting hope emerging in the research on a HIV vaccine. Linda-Gail Bekker and Nadine Dreyer  report here on another breakthrough: researchers find new pre-exposure prophylaxis is 100% effective in trial. A large clinical trial in South Africa and Uganda has shown that a twice-yearly injection of a new pre-exposure prophylaxis drug gives young women total protection from HIV infection. The trial tested whether the six-month injection of lenacapavir would provide better protection against HIV infection than two other drugs, both daily pills. All three medications are pre-exposure prophylaxis (or PrEP) drugs, explained Bekker, principal investigator for the South African part of the study. For more on what this means, and what to expect next, do click on the link above. 

There was a bit of kerfuffle last week about the effectiveness and vaccine induced intussusceptions with Rotovac, and we bring you here, both sides of the argument: R Prasad says the Increased cases of Rotavac-induced intussusceptions after the third dose can be explained by background rates, while Brian Hooker and Jacob Puliyal justify their conclusion that there were Increased cases of Rotavac-induced intussusceptions.

Confusion over the NEET- Undergraduate exam continues like a nuclear chain reaction. SC to hear batch of pleas related to irregularities in exam todayKrishnadas Rajagopal writes that Cancellation of NEET-UG 2024 in its entirety is an ‘extreme last resort’, says Supreme Court. And relatedly, with allegations of cheating and fraud in common entrance exams vitiating the results of NEET- UG, Maitri Porecha reports on the Health Ministry’s statement that the Foreign Medical Graduate Examination was being conducted amidst tight security.

Let’s move on to the burning topic of our times: climate change. 

Jacob Koshy reports on a study that says Death rates from air pollution spikes vary across cities. A spike in air pollution in Indian cities that have clean air may raise death rates higher than in cities that have higher pollution loads. Thus, the same increase in air pollution in, say, Bengaluru, can raise death rates more than in Delhi, which has much higher background levels of air pollution.

Overall, however, cities that had high pollution loads saw a greater fraction of annual deaths attributable to air pollution, with 11.5% of Delhi’s annual deaths attributable to air pollution, and 4.8% in Bengaluru. The latter’s population had 30% the exposure to daily air pollution than the average Delhi resident, says a first-of-its kind multi-city analysis in India that studied the health effects of short-term exposure to air pollution published in the peer-reviewed Lancet Planet Health recently. 

On another note, staying on the subject, a US based study claimed that the usage of dirty cooking fuels threaten infants in India. While outdoor air pollution gets a lot of attention, the Environmental Protection Agency and other organisations suggest that poor indoor air quality is much deadlier because people spend the majority of their time at home. The researchers used the household survey data from 1992 to 2016 to determine the human cost of reliance on dirty cooking fuels, and found that the largest effect was shown in infants under a month old. “That’s an age group where lungs are not fully developed and when infants are most closely stuck to their mothers, who are often the primary home cooks,” a researcher said. 

Meanwhile, experts suspect that India is likely undercounting heat deaths, thereby affecting its response to harsher heat waves.  

Do not forget to read this very important article by Dinesh S. Thakur, where this medical professional who has been a whistleblower himself argues that in India, the primary guardrails that are supposed to be a check on the abuse of medical ethics do not function. Given the context of medical trials, the recent controversy about Covaxin’s safety and efficacy, and the near certainty that our future will be filled with ethical questions too, he makes some pertinent points, for both the research community and government regulators. To read more: Trials, medical ethics and the orbit of power.

For this week’s tail piece, we enter the gender segment, but in a slightly unique fashion. Did you know that pain-sensor cells in the human body are either male or female? Oh, yes, they are. Sanjukta Mondal reports here. A study led by University of Arizona Health Sciences researchers, recently published in the journal Brain, demonstrated for the first time functional sexual dimorphism in nociceptors, the nerve cells responsible for perceiving pain. Do check out the details on the link.

Since we take our explainers very seriously, here’s a selection for you:

Arun Panchapakesan writes a detailed note on the two vaccines that brought us to the brink of eradicating polio

It’s always better to be prepared for unpleasant events in the future. P. Venkatachalam and Guy Garty here explain all about Radiation Biodosimetry: the ABCs of responding to a mass radiological event 

Education remains the most effective contraceptive, says Zubeda Hamid, quoting experts in the field.

For an in-depth assessment of the current discourse on the HPV vaccine, read this article by P. Omkar Nadh and Y. Madhavi Indigenous HPV vaccine, the rhetoric and the reality. 

Justin Stebbing explains the radical CAR-T procedure now rolled out as cancer therapy, and argues that the its risk of causing cancer is small.

If you have a few spare minutes and want to catch up with other health stories, do stop by at the following links: 

Afshan Yasmeen reports: The Clinical Psychology Society of India opposes new proposed nomenclature for clinical psychology training

Multi-disciplinary study highlights need for specialised rehabilitation services for patients with young-onset dementia

Sam Paul A. writes: In a first, Alappuzha district panchayat launches ‘Palliative Sena’ to care for bedridden patients

Study brings lifestyle of enigmatic extinct humans into focus

Sridhar Sivasubbu and Vinod Scaria on How jumping genes and RNA bridges promise to shake up biomedicine.

For many more health stories, head to our health page.

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