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With love, from animals


DHANVANTARI by BUDDHA BASNYAT, MD


BIKRAM RAI
As we bid farewell to the festival of animal sacrifice and get ready to worship our beloved pets, it's a good time to ponder over the potential diseases and infections that our four legged friends pass onto us.

From Japanese encephalitis, rabies, malaria, brucellosis, swine flu, leptospirosis, rickettsial illnesses (for example the different varieties of typhus infections) are some of the common Zoonotic infections prevalent in Nepal.

Amazingly, typhoid, a frequent problem in Nepal has no connection with the animal kingdom, as the bacterium (salmonella typhi and paratyphi) responsible for this illness are restricted to humans beings. Lucky dogs. Otherwise all our street canines would be dead of typhoid fever in Kathmandu, which has the dubious distinction of being the typhoid capital of the world.

Zoonotic infections are so widespread that they actually make up nearly two-thirds of human infectious diseases. The three recent worldwide viral outbreaks, namely SARS (severe acute respiratory syndrome), bird flu (H5N1), and swine flu (H1N1) are all examples of infections passed from animals to humans. Even the HIV virus was transferred from chimpanzees to humans in the last century.

In countries like Nepal it's extremely challenging to make a proper diagnosis of these seemingly new illnesses. In fact, we have problems diagnosing even well-established, old bacterial diseases most of the time.

For example if you talk to clinicians around the Valley, they will say that brucellosis, a bacterial disease which is transmitted by eating infected meat or unsterilised milk may be important to consider in patients with long-running fever. But we are hardly ever able to make a clear microbiological diagnosis which is vital because clinical assessment alone is never enough.

So the diagnosis of brucellosis remains a hunch because we lack specific testing techniques with properly spaced blood collections. We then treat the disease 'empirically' to the best of our ability. Such an approach to treatment is not restricted to brucellosis, but is almost standard practice for a host of other infections. Indeed whenever there is an outbreak in Nepal, the laboratory set up is often inadequate.

We need to have reliable microbiological laboratories which can make definitive diagnosis of these zoonotic illnesses. Although private and government laboratories have mushroomed in Nepal in the last decade, microbiological methodology requires great deal of skills and meticulous work which these clinics cannot provide. Without this kind of medical support we will be completely unprepared to handle zoonotic illnesses and face a major crisis when a pandemic strikes.



1. Ramprasad
The laboratories in Nepal needs to be revamped...government must emphasize and subsidize to bring more specific testing methods for accurate diagnosis of infectious/ malignant conditions.. PCR machines, Flow cytometry machines, T-SPOT testing methods among others must be introduced as routine to improve the overall health sector of our country...

LATEST ISSUE
638
(11 JAN 2013 - 17 JAN 2013)


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