With each passing year, the frequency and intensity of epidemics have been increasing.
For instance, 2003 saw the SARS outbreak; the swine flu pandemic occurred in 2009; the Ebola virus outbreak happened in 2014-2016; the chikungunya outbreak in late 2014; Zika in 2015; Covid-19 in 2019 and monkeypox occurred in 2022.
Given the frequency of these disease outbreaks, the need for routine testing and surveillance can hardly be overstated.
Take the example of hMPV. In February 2022-April 2022, scientists from the Indian Council of Medical Research (ICMR) in eastern Uttar Pradesh conducted a study on respiratory infections.
They collected nasal and throat swabs from 100 sick children under the age of five, and tested the samples for pathogens including viruses such as influenza A and B, SARS-CoV2, RSV-A and B, parainfluenza virus-1,2,3 and 4, adenovirus and human rhinovirus.
They found hMPV to be an important cause of acute respiratory infections — out of 100 sick children, four tested positive for hMPV. One among them died.
Though respiratory infections are quite common among children, there’s very low reporting — and thus, awareness — of hMPV among children under five years of age in India.
As in other populations, in eastern Uttar Pradesh too, hMPV contributes significantly to bronchiolitis and pneumonia in children.
In some cases, it is significantly associated with pneumonia, difficulty in breathing and wheezing, which is an indicator of severe pneumonia in young children.
The virus was also identified in Chennai in a study conducted in April 2016 – August 2018. Here, 14 children — out of a total of 350 sick children — were found to be affected by hMPV.
Studies in other states also found similar numbers for those affected by the virus — 5 percent in Pondicherry, 3.6 percent in Lucknow and 3 percent in Kolkata. In these studies, though, the children were older than five years.
The virus has been identified in other countries as well — the positivity rate of hMPV was found to be 16.5 percent in Pakistan in 2015.
According to surveillance data from the Centre for Disease Control and Prevention in the United States, hMPV is most active in temperate areas in the late winter and early spring.
The study from eastern Uttar Pradesh also shows the same seasonal patterns. However, as India has a diverse climate, hMPV circulation patterns may differ in different regions of the country.
Thus, routine testing of viruses in laboratories helps monitor viral seasons and circulation patterns.
Learnings from a pandemic:
Viral outbreaks, epidemics and pandemics such as Covid-19 teach us many lessons, even as they expose the fault lines in the health systems.
In India, various government initiatives are attempting to boost health infrastructure, particularly by setting up virology research institutes and laboratories across the country.
For instance, during Covid-19, the country’s premier virology institute in Pune with a biosafety laboratory for testing dangerous pathogens, became the nodal laboratory.
To reduce the load on a single institution and expedite testing of new viruses, laboratory infrastructure had to be enhanced – from the one laboratory in 2020, over 3,000 laboratories were made functional by the Indian Council of Medical Research in 2021.
Mobile biosafety labs have also been created for quick diagnosis of new pathogens.
Once identified, genome sequencing techniques have to be deployed to look for new mutations in viruses. This helps to understand super-spreader events and outbreaks and strengthen public health interventions.
Indigenous production of protective gear, masks, reagents and kits also helps save costs of diagnosis.
This is all being done in the backdrop of India’s plans to implement Universal Health Coverage — ensuring healthcare is available, affordable and accessible to the last mile.
One of the most crucial pillars of pandemic or outbreak preparedness is effective risk communication — dissemination of timely, evidence-based communication to tackle misinformation, fake news and confusion.
About author: Dr Rajni Kant is Indian Council of Medical Research (ICMR)-Chair, Disease Elimination.
This is an abridged version. Originally published under Creative Commons by 360info™.
