The Tribune, Chandigarh, India - Chandigarh Stories

HEALTH

Project on streptococcal infections
By Vibha Sharma
Tribune News Service

CHANDIGARH, July 9 — The PGI here has proposed epidemiological surveillance in India of Group A streptococcal infections, including pharyngitis and impetigo. The project is being supported by the Indo-US Vaccine Action Programme.

From the PGI, the principal investigators include the Head of the Department of Community Medicine, Dr Rajesh Kumar, and the Head of the Department of Experimental Medicine and Biotechnology, Dr S. Majumdar. Dr Mary Jesudasan, Head of the Department of Microbiology, and Dr Abraham Joseph, Head of the Department of Community Medicines at Christian Medical College, Vellore, will be the other principal investigators.

From the US side, Dr Richard Krause, one of the leading researchers in the field of the streptococcal infections in the world, will be part of the core team. Dr Krause was in the city on Friday to discuss the proposal and finalise the project. According to Dr Rajesh Kumar, his basic role will be as the US counterpart in this important programme for India. He is the backbone of the entire proposal.

Dr Krause is a Senior Investigator in the Laboratory of Human Bacterial Pathogenesis at the National Institute of Allergy and Infectious Diseases, Fogarty International Centre, Bethesda. He is also the author of “Emerging Infections”, an integral book for those in the field of Community Medicine.

Dr Krause, in a talk on the subject with The Tribune, said streptococcal infections in India were the basis for one of the most common heart diseases in children in the five to 15 age group. The infection, caused by Group A streptococcus bacteria, resulted in rheumatic fever in children in this age group. In some of these cases, it might eventually lead to rheumatic heart disease.

“In India there are more than 200 million children who need close medical supervision if they have had streptococcal infection,” says Dr Krause. Rheumatic fever might be due to an allergic reaction which could be hereditary. However, more often than not, it was an after-effect of streptococcal infection.

Rheumatic fever was presented in a child with migrating arthritis pain. “It may not be deforming arthritis but it could manifest in the swelling of heart muscles, tissues and the valves. One-third of any country’s entire population are children. Therefore, India has to essentially think about a primary protection programme which can eradicate the problem from its root.”

According to Dr Rajesh Kumar, who has been working in this field, “Out of 1,000 children that suffer from streptococcal sore throat, at least one will eventually suffer from rheumatic heart disorder. The heart valves get damaged. If the cardiovascular valve is replaced it would mean a burden of at least Rs 1 lakh. Kids who have once had rheumatic fever are again prone to streptococcal infection. Further damage can be controlled by the regular administration of benzathene penicillin. But to do so, regular monitoring of the child has to be carried out. In our country, where a large population is prone to the disease, it is not practically possible.”

Dr Krause agreed. “It is impossible to monitor 200 million children. One can work in close association with schools. But all along careful monitoring is required. The alternative is to develop a vaccine against the disease. It has been known since 1930 that it is only the Group A streptococcus which is responsible for the manifestation of rheumatic fever and not its other types.”

There had been many attempts in the world to produce a vaccine. However, scientists had mostly failed primarily because there were more than 100 sub-types of the Group A bacteria. “A vaccine could be effective for one sub-type and not the other,” said Dr Krause. Moreover, scientists had not been able to take out the streptococcus component that would give the immunity response.

And as Dr Kumar says, work in this field has virtually come to a standstill in the West because there was hardly any incidence of streptococcal infections there.” However, in the past decade there has been a resurgence of the infections in the West with a more virulent strain of the organism, which is why the interest has been revived.”

At present extensive experiments are being carried out in Australia, Germany and the USA to develop a vaccine. At the PGI, Dr Harpreet Vohra has been working on the vaccine development programme. “Biotechnology has made a lot of progress. Today we have a better understanding of the bacteria,” explains Dr Rajesh Kumar.

Under the first phase of the Indo-US programme, a few schools will be adopted. According to Dr Rajesh Kumar, “Vaccine Action Programme authorities will give their approval this year. Thereafter, we will monitor the adopted schools with swab organisms from the throat and culture the bacteria. We will try to find out how many infections actually take place in a year. This will give us an estimate of the burden of disease and prepare a plan for the vaccine programme.”

“The second phase will include giving vaccinations against the infections,“ explains Dr Rajesh Kumar. This will eventually help monitor whether the disease load has come down. The entire programme will take three to five years, but once the vaccine is developed it will result in a reduced burden on hospitals. “A visit to the Department of Cardiology will show that one-third of the patients there are suffering from rheumatic heart disease, which is the result of the fever caused by streptococcal infections. That is the extent of damage by the bacteria,” says Dr Rajesh Kumar.

Dr Krause agreed that it would be some time before the vaccine actually became a part of the immunisation plan for a child. “We are at the stage where it has been proven that it is effective and non-toxic in animals. The next step will be to determine its applicability to human beings. For that we require a section of the population where the disease is still quite common”.

Dr Krause said there were two possible vaccines for the phase two trial.” Phase three will be when you will actually prove that the vaccine does prevent the occurrence of the infection by the bacteria. Drug licence agencies in any country follow stringent rules and regulations. This also includes studies based on large samples.”

Dr Rajesh Kumar says that the Department of Community Medicine along with the departments of Cardiology and Experimental Medicine of the PGI has been carrying out investigations in the Raipur Rani block development area for the past decade. “We have seen that a child may have six throat infections in a year. Remember, here we are talking of averages. There may be a child who has had 12 infections and there may be one who has not had a single one. Out of these, one will be a streptococcal infection.

SPORT

Banta Singh bags two gold medals
By Our Sports Reporter

CHANDIGARH, July 9 — Banta Singh bagged two gold medals in the 100 mt and 200 mt race in the above 70 years category in the Chandigarh State Veterans Athletic Meet held today. In the men category, Ram Murti Kalia won the 100 mt, 200 mt and 5 km walk by securing first position in each. Another reputed athlete of yesteryears, Dharambir Sharma bagged first place in the above 80 years category in the 100 mt, 200 mt and long jump section.

Earlier, the patron of the Veterans Amateur Athletic Association of Chandigarh and renowned athlete, Brig G.S. Sandhu, inaugurated the meet.

Results:

Women category — above 35 yrs: 5 km walk: Kiran Bala 1; Paramjit Kaur 2; 800 mt: Amarjit Kaur 1,

Shot-put: Rajbir Kaur 1; Sandhya Devi 2.

Above 55 yrs: Beantjit Kaur 1. Above 70 yrs (100& 200 mt): Banta Singh 1.

Men category: Above 40 yrs —200 mt: Buta Singh 1; Charanpreet 2; Sukhwinder Singh 3. Javelin throw: Karnail Singh 1; Pritpal Singh 2.

High jump and 110 mt hurdles: Sampuran Singh 1; 400 mt, 1500 mt, 10 km and 5 km: Jatinder Singh 1.

Above 45 yrs:100 mt and 200 mt: Sukhdev Singh Passi 1.

Above 50 yrs: 400 mt, 1500 and 10 km: Jasmer Singh 1. 100 mt, 200 mt and 400 mt: ML Garg 1.

Above 55 yrs: 400 mt, 800 mt and long jump: Sardar Chand 1. Above 60 yrs: long jump and triple jump: OP Shukla 1.

Above 65 yrs: 800 mt, 1500 mt and 5 km: Jatinder Marwaha 1.

Above 75 yrs: 100 mt, 200 mt and 5 km walk: Nihal Chand Garg 1.

Football academy trials today
By Our Sports Reporter

CHANDIGARH, July 9 — The final selection trials for the Chandigarh Football Academy will begin here tomorrow at the Sector 7 sports complex. According to Mr JPS Sidhu, Joint Director, Sports UT Administration, the preliminary trials were held at Amritsar, Hoshiarpur, Ambala, Yamunanagar, Dharamsala and Mahilpur, where in all 55 boys in the age group of 9-10 were finalised for the final trials. Now these boys will undergo physical tests in standing broad jumps, vertical jumps, shuttle run and others.

Experts in sports medicine, scientific officer and orthopaedics surgeon, besides others will form part of these trials to assess the young aspirants. Mr Sidhu told that the newly made football ground in the Sector 42 complex was ready and 24 boys will be selected in academy — the first of its kind in the region where free boarding, lodging and other educational facilities will be provided. They will be lodged at the sports complex 42 hostel. He said a few boys will also be kept in the waiting list.

Mr Sidhu said that in the sports complex, Sector 42, where the UT Sports Department will be shifting from the existing Sector 9 office will also house an exhaustive sports library catering to all requirements of the players. They will also go in for sports sciences centre, which will be expanded in due course of time.

Various associations of the city have already been given space to house their offices at the sport complex, 42. It will become a full-fledged sports complex and an all-weather swimming pool at the same centre is also on the anvil. He also said that the hockey turf of polypropylene material to be laid will replace the nylon made astro-turf, which was not in good playing condition.

Population Day race on July 11
Tribune News Service

CHANDIGARH, July 9 — The local Sports Authority of India(SAI) Training Centre, in association with the Department of Social Welfare, Chandigarh Administration, will organise a Population Day race on July 11. The race is being held to mark the World Population Day which falls on the same day.

According to the Regional Director (North), Dr P.C. Kashyap, the event would cover an age group of six to 60. The 3-km race will start and finish at the SAI Training Centre in Sector 18. Those interested in participating in the race can contact the coordinator of the event, Mrs Ritu Pathik, Assistant Director of the centre.

“Our aim is to spread the message that increase in the population is the root cause of all problems in the country,” says Dr Kashyap. “We need to make a conscious effort to stop the menace from spreading further and when there is still some hope. It is with this view that the SAI is organising such races all over India.”

For Punjab the venue for the race is Amritsar. In Haryana the run will be held in Bhiwani. Shimla is the venue for Himachal Pradesh. In Jammu and Kashmir the race will be held in both the summer as well as the winter capital.

According to Dr Kashyap, nearly 1,000 persons are expected to participate in the race. The Department of Social Welfare is bringing 200 children from the slum areas in the city. Moreover, there will be 200 children from the National Open School, Sector 11. The Department of Health will provide the medical support for the race.

On the day of the event all participants will be given a T-shirt and refreshments. Besides this, all those who finishes the race will also get a certificate.

A slogan competition based on “Small family, happy family” is also being organised for the children on the same day. Each participating youngsters will have to bring a placard with slogan about the benefits of a small family. The best slogan will get a cash prize of Rs 1,000.