Outbreak

Epidemics in connected world

By National Council of Science Museums

Nehru Science Centre, Mumbai

All it takes is one plane ride for few localized cases of a disease to become an epidemic. Therefore, understanding what happened during this major health crisis is important. Particularly in the current connected world and an era of humanity’s growing population and its ever-continuing migration to greener pastures-crowded cities-across the globe and the resulting cohabitation of limited space with animal kingdom.

Outbreak In IndiaNational Council of Science Museums

A Brief History of Outbreaks In India

A total of 553 outbreaks were reported in 2008, 799 outbreaks in 2009, 990 outbreaks in 2010, 1675 outbreaks in 2011, 1584 outbreaks in 2012, 1964 outbreaks in 2013, 1562 in 2014 and 1935 in 2015,2679 in 2016 and 1714 have been reported in 2017.   

Majority of the reported outbreaks included those of Acute Diarrhoeal Diseases, Food Poisoning and Measles. The weekly outbreak report generated by the CSU is shared with all key stakeholders including the Prime Minister’s Office.

Outbreak In India, From the collection of: National Council of Science Museums
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Outbreak in India, From the collection of: National Council of Science Museums
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The weekly reporting of outbreaks is significant, because it indicates the paradigm shift in the outbreak reporting attitude enabled by IDSP, from the traditional reluctance to report outbreaks to one that encourages outbreak reporting and response. Data analysis, action and feedback are undertaken by the respective reporting districts/states and also at CSU.  A Unique code (outbreak ID) is assigned from 1st week of January 2016 to each outbreak in the Weekly outbreak Report

Spanish FluNational Council of Science Museums

Spanish Flu

The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. It is estimated that about 500 million people or one-third of the world’s population became infected with this virus.


Spanish FluNational Council of Science Museums

 The number of deaths was estimated to be at least 50 million worldwide. Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20–40-year age group, was a unique feature of this pandemic.

Small PoxNational Council of Science Museums

Small Pox

Smallpox was an infectious disease caused by one of two virus variants, Variola major and Variola minor. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980. 

By Lynn PelhamLIFE Photo Collection

The risk of death after contracting the disease was about 30%, with higher rates among babies. Often those who survived had extensive scarring of their skin, and some were left blind. 

By Lynn PelhamLIFE Photo Collection

Smallpox was caused by infection with Variola virus, which belongs to the family Poxviridae, subfamily Chordopoxvirinae, and genus Orthopoxvirus.

PlagueNational Council of Science Museums

Plague

 Plague is an infectious disease caused by the bacterium Yersinia pestis. Symptoms include fever, weakness and headache. Usually this begins one to seven days after exposure. In the bubonic form there is also swelling of lymph nodes, while in the septicaemic form tissues may turn black and die, and in the pneumonic form shortness of breath, cough and chest pain may occur. 

Bubonic Plague (1950-11) by Joe ScherschelLIFE Photo Collection

Bubonic and septicaemic plague are generally spread by flea bites or handling an infected animal. The pneumonic form is generally spread between people through the air via infectious droplets. 


Diagnosis is typically by finding the bacterium in fluid from a lymph node, blood or sputum. 

Introduction: What is vaccination?National Council of Science Museums

Those at high risk may be vaccinated. Those exposed to a case of pneumonic plague may be treated with preventive medication. If infected, treatment is with antibiotics and supportive care. 


Typically, antibiotics include a combination of gentamicin and a fluoroquinolone. The risk of death with treatment is about 10% while without it is about 70%.

Mass Migration, India (1947-10) by Margaret Bourke-WhiteLIFE Photo Collection

Cholera

Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhoea that lasts a few days. Vomiting and muscle cramps may also occur. 


Diarrhoea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance. This may result in sunken eyes, cold skin, decreased skin elasticity, and wrinkling of the hands and feet. Dehydration can cause the skin to turn bluish. 

CholeraNational Council of Science Museums

Cholera is caused by a number of types of Vibrio cholerae, with some types producing more severe disease than others. It is spread mostly by unsafe water and unsafe food that has been contaminated with human faeces containing the bacteria. 


Undercooked seafood is a common source. Humans are the only animal affected. Risk factors for the disease include poor sanitation, not enough clean drinking water, and poverty.

LIFE Photo Collection

The World Health Organization (WHO) recommends focusing on prevention, preparedness, and response to combat the spread of cholera.

Sterilization: Proper disposal and treatment of all materials that may have come into contact with cholera victims' faeces (e.g., clothing, bedding, etc.) are essential. 


Water purification: All water used for drinking, washing, or cooking should be sterilized by either boiling, chlorination, ozone water treatment, ultraviolet light sterilization, etc.

Preventions and Control MeasuresNational Council of Science Museums

Prevention and Control Measures

Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from healthcare into a component in public health, known as "infection protection". 

It is an essential part of the infrastructure of health care. Hand hygiene is one of the basic, yet most important steps in IPC (Infection Prevention and Control).

Arno Brasch's Lab And Capacitron (Throws Beam Of Electrons Used For Sterilization Of Raw Foods) (1947-02) by Fritz GoroLIFE Photo Collection

Sterilization is a process intended to kill all microorganisms and is the highest level of microbial kill that is possible. Sterilizers may be heat only, steam, or liquid chemical.

India's Caste System (1946) by Margaret Bourke-WhiteLIFE Photo Collection

Infections can be prevented from occurring in homes as well. In order to reduce their chances to contract an infection, individuals are recommended to maintain a good hygiene by washing their hands after every contact with questionable areas or bodily fluids and by disposing of garbage at regular intervals to prevent germs from growing.

By Cornell CapaLIFE Photo Collection

Health care workers may be exposed to certain infections in the course of their work. Vaccines are available to provide some protection to workers in a healthcare setting. 


Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for hepatitis B; influenza; measles, mumps and rubella; Tetanus, diphtheria, pertussis; N. meningitidis; and varicella.

Pradhan Mantri Jan Arogya YojnaNational Council of Science Museums

Pradhan Mantri Jan Arogya Yojana

Pradhan Mantri Jan Arogya Yojana of the Government of India aims to provide free access to healthcare for 50 crore people in the country. People using the program access their own primary care services from a family doctor. 

When anyone needs additional care, then PM-JAY provides free secondary health care for those needing specialist treatment and tertiary health care for those requiring hospitalization. 

Pradhan Mantri Jan Arogya YojnaNational Council of Science Museums

The programme is part of the Indian government's National Health Policy. It was launched in September 2018 by the Ministry of Health and Family Welfare. That ministry later established the National Health Authority as an organization to administer the program.

It is a centrally sponsored scheme and is jointly funded by both the federal government and the states. By offering services to 50 crore (500 million) people it is the world's largest government sponsored healthcare program. 

The program is a poverty alleviation programme as its users are people with low income in India.

Polio EradicationNational Council of Science Museums

Polio Eradication

Eradicating polio in India was a feat of dedication, commitment and simply doubling down on immunization activities.  

Given India’s vast population, tropical climate in many parts of the country, and other environmental challenges, it would be easy to imagine that if polio couldn’t be stopped, India would be the place to fail.

After all, India constituted over 60% of all global polio cases as recently as 2009.

Polio EradicationNational Council of Science Museums

However, in 2014, India was officially declared polio-free, along with the rest of the South-East Asia Region. 

Thanks to the singular commitment of the Indian Government at all levels, partners of the Global Polio Eradication Initiative, notably WHO, Rotary International and UNICEF, polio was tackled head-on. India has not had a case single case of wild polio virus since 2011.

IDSPNational Council of Science Museums

Integrated Disease Surveillance Project (IDSP)

Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period up to March 2010. The project was restructured and extended up to March 2012. 


The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.

A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT headquarters and District Surveillance Units (DSU) at all Districts in the country have been established.

IDSPNational Council of Science Museums

The objective is to strengthen/maintain decentralized laboratory-based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs).

Healthcare WorkersNational Council of Science Museums

In 2006, the Public Health Foundation of India was started by the Prime Minister of India as both a private and public initiative. The goal of this organisation is to incorporate more public health policies and diverse professionals into web the healthcare sphere.

Healthcare WorkersNational Council of Science Museums

It also collaborates with international public health organisations to gather more knowledge and direct discussions around needs and improvements to the current system. 

 Oftentimes officials in policy making positions have a gap in their education about public health, and MPH and PhD programs in public health are lacking in their number of students and resources. 


The Public Health Foundation aims to further these programs and educate more people in this field. The research discovered would be made transparent to the Indian public at large, so that the entire nation is aware of health standards in the country

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