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Epidemics and Pandemics in India throughout History: A Review Article

Authors:
  • Sree Balaji Medical College and Hospital, BIHER University

Abstract

India has encountered several epidemics and pandemics throughout history. This review article talks about such outbreaks known to have occurred in the 19th-21st century and are arranged in accordance to chronology. For this review, a variety of sources were used by searching through PubMed, NCBI and several others. Different forms of prints such as books, websites, and journals were used as references in this article. The necessity to review this title is because the information is scattered and to source them and compile them into a single article could help the medical practitioners and healthcare workers to understand what this country has been through in the past and what reforms have to be made by them, the community and the government in preventing such outbreaks in the future.
Epidemics and Pandemics in India throughout
History: A Review Article
Swetha G1, Anantha Eashwar V M2, Gopalakrishnan S2
1UG Student, 2Professor, Department of Community Medicine, SBMCH, Chrompet, Chennai
Abstract
India has encountered several epidemics and pandemics throughout history. This review article talks
about such outbreaks known to have occurred in the 19th-21st century and are arranged in accordance to
chronology. For this review, a variety of sources were used by searching through PubMed, NCBI and several
others. Different forms of prints such as books, websites, and journals were used as references in this article.
The necessity to review this title is because the information is scattered and to source them and compile
them into a single article could help the medical practitioners and healthcare workers to understand what
this country has been through in the past and what reforms have to be made by them, the community and the
government in preventing such outbreaks in the future.
Keywords: epidemics, skin deciencies
Introduction
India, being a third-world country, has encountered
a variety of epidemics and pandemics through time.
Several accounts of inuenza, cholera, dengue, smallpox
and several others have been recorded throughout
history; while we have been able to eradicate some; many
diseases still continue to pose a threat to the community.
It is not uncommon for sudden and rapid outbreaks to
occur in India and many articles direct the cause for this
in such developing countries being malnutrition, lack of
sanitation and lack of a proper public health system [1,2].
According to Park, epidemics is an unusual occurrence
in a community or region of disease, specic health-
related behavior or other health-related events clearly
in excess of expected occurrence. It is a sudden, severe
widespread outbreak of a disease pre-existing in the
community. A study by John T. Watson, et all analyses
the relationship between epidemics and natural disasters
and establishes that there is a rise in the occurrence of
epidemics post-disaster though incidence in India has not
been emphasized [3]. However, another article by Sen
Corresponding Author:
Swetha G
UG Student, Department of Community Medicine,
SBMCH, Chrompet, Chennai
states those in recent years, cholera outbreaks in India
have been due to the breakdown of sanitation during
natural disasters [4]. A study by Moore, Cristopher, and
Mark displays that the epidemic trends modify when the
transmission exceeds the threshold station the infectious
nature of it [5]. Pandemics, on the other hand, refer to the
worldwide spread of diseases. These are the global health
problems that need to be addressed and treated viciously
along with proper measures to avoid transmission to
other countries. There have been a signicant number
of pandemics throughout history and in many instances;
their control had been difcult because of the lack of
a proper, working global surveillance system [6].
These pandemics show trends of developing microbial
resistance and as a result, the death toll is usually high
in pandemics than epidemics as concluded by the study
comparing the mortality rate of inuenza pandemic and
epidemic [7]. As far as India is concerned, there have
been only two major, signicant pandemics throughout
history. While cholera had been predominant throughout
the 19th century with increasing death tolls every year,
the inuenza pandemic came later on in the early 20th
century [8,9]. The inuenza pandemic was short but
devastating and after a long time, quite recently, came
yet another u pandemic by the H1N1 strain [10].
Though, it is almost impossible to analyze all epidemics
and Pandemics throughout Indian history, effort has
been made to include most of the signicant ones.
1504 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8
19th Century:
Ist Cholera Pandemic (1817):
This is considered to be the rst major epidemic
of the 19th century in British-colonized India and was
described as probably the most terrifying of all [11]. The
rst case was reported on 23rd August 1817 by a civil
surgeon of Jessore [12].The overall estimation of the
mortality is not available as the data collection in India
began much later, probably in the late 1860s. As for the
geography, it is important to note that the year 1817
had brought a very heavy rainfall leading to ooding
which could have been the cause for such a rapid spread
[13]. While the Europeans living in India then and the
elite were not seriously affected, the slum dwellers and
people in rural poverty were hit the worst [14]. This was
probably due to the differences in living conditions,
personal hygiene and practices.
IInd Cholera Pandemic (1829):
The second outbreak started around 1826 from
Bengal and spread through the rivers to various parts
of northern India. After affecting the United Provinces
(UP), its impact was huge on areas around Punjab and
Delhi but most signicant is its pandemic spread to
countries like China [12,15]. Cholera spread far and
wide, all along the trade routes from China affecting
several cities and villages alike. In each place, it lasted
for a few weeks and killed hundreds of people everyday
[16].
IIIrd Cholera Pandemic (1852):
This third cholera pandemic started around 1852
and lasted till the late 1860s. It is signicant in history
because of its spread to countries that were until then not
affected. Though India was not its major area of impact,
in the later phase of pandemic, small spurts of cases
were noted in Bengal. It spread to several other countries
like Persia, Arabia and then to Russia[12,15]. This was
due to the worldwide spread of El Tor serotype of Vibrio
which was initially endemic to India [17].
IVth Cholera Pandemic (1863):
This began around 1863. While some suggest that the
major cholera epidemic in 1865 was brought to Mecca
by the Haj pilgrims from India,others disagree stating
that it was a just a recrudescence [18,15]. However, it is
agreed that it was from Mecca that the infection spread to
several countries [19,20]. The Kumbh Mela at Hardwar
in April 1867 has been considered to be responsible for
the epidemic spread of cholera in northern India [11].
The Madras Presidency in 1877 was the worst hit and
the cholera epidemic was responsible for about 10% of
the annual mortality then [21].
Vth Cholera Pandemic (1881):
The fth cholera pandemic was considerably less
fatal as compared to the previous four. It was during this
pandemic (1881-1869) that Robert Koch proved that
cholera was transmitted through the fecal-oral route,
after studying the outbreaks in Calcutta and Egypt [22].
It spread to United Provinces and Punjab after which it
spread to other countries like Afghanistan, Persia, parts
of Russia and then to Europe[23].
Bombay Plague Epidemic (1896):
This plague began in September 1896 in colonial
Bombay creating a lot of social and political frenzy. The
rapid growth of commerce in Bombay led to an increase
in population and thereby overcrowding. The anti-plague
campaign was started to battle this epidemic and it was
based on the belief that the focus of the infections was
from the slums. The plague killed thousands and many
people were forced out of the city [24].
VIth Cholera Pandemic (1899):
The sixth cholera pandemic began around 1899 and
major outbreaks were noted in Bombay, Calcutta, and
Madras [8]. While the infection throughout the 20th
century was caused by O1 serotype of Vibrio cholera
and conned mostly through the Asian subcontinent,
the sixth cholera pandemic brought about surprising
challenges. This cholera infection was caused by an
unknown, non-O1 serotype of V.cholera and spread to
many distant countries including the United States [25].
The sixth cholera pandemic lasted for about 25 years
(1899-1973)[26].
20th Century
Inuenza Pandemic (1918):
This is also known as the Spanish Flu of 1918-19.
This has been known to have caused around 20- 50 million
deaths worldwide and is considered most devastating
[27]. This was caused by the H1N1 strain of Inuenza
and was severe. The rst episode of the disease began
Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8 1505
in early 1918 and later in autumn, it began to spread all
around the world, India considered to be the foci [28].
The second wave of the attack began in Bombay in 1918
and spread to other parts of northern India and Sri Lanka
from where it spread worldwide [29]. Improvement in
the virulence and velocity of the virus strain and the
monsoon bringing humidity are considered to be the key
factors in increasing the severity and spread [28].
Polio Epidemic (1970-1990):
India was the worst affected by polio among the
developing countries until the late 1990s after which the
EPI was initiated [30]. The incidence of polio in India
was very high in both urban and rural states and the most
affected was the state of Uttar Pradesh [31]. Its worst
sequel was reported to be post-polio paralysis and in the
district of Vellore, about 6/1000 preschool children were
affected [32]. It was in 1964 in Bombay and 1965 in
Vellore that the oral polio vaccine was introduced [33].
India had a choice between Salk’s IPV and Sabin’s OPV.
Even after the introduction of the OPV in EPI there was
no improvement to be noted for 10 years [33]. But with
improvement in surveillance, the desired results were
achieved and India was declared polio-free status in
January 2011 and emphasis has been laid on maintaining
the guard to prevent resurgence [30].
Small Pox Epidemic (1974):
It is known as one of the worst small pox epidemics
of the 20th century. India contributed to about 85% of
this epidemic worldwide. This epidemic broke out in
three different villages of West Bengal, Bihar and Odissa
but it was impossible to establish a connection between
the men hence it was treated as three different epidemics.
The disease was introduced into different areas by
different sources. While over 15,000 people died in this
epidemic, thousands of the survived but most of them
but most ended up with disgurement and blindness
[34, 35]. Small pox was eradicated in by the WHO
small pox eradication program. It was the rst disease
to be combated globally and was declared eradicated by
WHO in 1980 [36].
Surat Plague Epidemic (1994):
Plague cases in Surat were rst reported in Sept
1994 and which it spread to other cities in India. Fewer
than 1,200 people were found positive and it lasted for
less than two weeks but it is considered important due
to its high fatality and created worldwide repercussions.
It is said to have been initially difcult for doctors to
diagnose it but when they did, all necessary precautions
are taken to contain its spread [37].
21st Century
(2001-2003)
Plague of Northern India (2002):
The Plague of Northern India broke out in Shimla
district of Himachal Pradesh in February 2002. It was
a small and less serious epidemic. Also, as soon as the
plague was detected, immediate measures were taken
like fumigation, evacuation, and chemoprophylaxis that
lead to further control of the epidemic [38].
Dengue Epidemic (2003):
In 2003 during September, there occurred an
outbreak of DF/DHF in Delhi. It reached its peak around
October-November and lasted until early December.
The mortality rate was around 3%.It became a major
outbreak in India in spite of the widespread preventive
measures taken to control DF [39].
SARS Epidemic (2003):
SARS (severe acute respiratory syndrome), is
considered as the rst serious infectious disease out
break of the twenty-rst century. It initially started in the
Guandong province of China in 2003 and spread quickly
to about 30 countries across Asia, Americas and Europe
and accounted for a total of 8,439 cases and 812 deaths,
within 7 to 8 months [40,41].
(2004-2006)
Meningococcal Meningitis Epidemic (2005):
In early 2005, a sudden surge had been noted
in meningococcemia and meningococcal meningitis
cases in India. Cases were reported from Delhi and the
surrounding states of Uttar Pradesh and Maharastra.
Around 430 cases of meningococcal meningitis were
reported as of June 2005 [42]. Case management, early
detection through surveillance was aimed at prevention
of spread [43].
Chikungunya Outbreak (2006):
Around 3.4 million cases of Chikungunya were
reported in Ahmedabad 2006 with 2,944 deaths
1506 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8
estimated. The mortality rate in 2006 epidemic was
substantially increased when compared with that
in the previous four years [44]. In December, there
occurred another epidemic in South India where the
states of Andhra Pradesh, Karnataka and Tamil Nadu
were affected. The volatile nature of this epidemic was
attributed to the herd immunity to the then isolated
genotype [45].Major efforts were taken for mosquito
control and several awareness campaigns were initiated
by the television and print media [46].
Dengue Outbreak (2006):
The outbreak began in early September of 2006
and the rst case was reported from Delhi. By the
end of September, it began to spread to other states
like Rajasthan, Kerala, Gujarat, Chandigarh and Uttar
Pradesh [47]. The ministry of health set up a control
room to monitor the outbreak and provide technical
assistance that led to the efcient management of the
disease [48].
(2007-2010)
Gujarat Jaundice epidemic (2009):
Modasa town in Gujarat witnessed the outbreak of
hepatitis B in 2009[49] This is of signicance because
almost all outbreaks of viral hepatitis in India were
considered to be due to hepatitis E which is feco-orally
transmitted [50]. It was a long-lasting epidemic and
control was achieved by mass public awareness and
health actions.
H1N1 Flu Pandemic (2009):
The H1N1 Flu pandemic began in May 2009 and
spread globally by July 2009. By August 2010, it was
declared pandemic and around 18,500 deaths were
reported from all around the world [51, 52]. Three strains
of inuenza viruses were circulating then of which the
Inf A (H1N1) and Inf A (H3N2) viruses were largely
replaced by the pdm H1N1 strain [53,54].
(2011-2014)
Odisha Jaundice Epidemic (2014):
The outbreak began in November 2014 in Kantalbai,
a remote village in Odissa. This led to a district level
investigation and it was conrmed to be jaundice
caused by the Hepatitis E virus [55]. This 2014 Odisha
Jaundice epidemic was one of the many outbreaks in
Odisha and the most common cause being HEV [56].
This is transmitted enterically and has affected several
people, especially of the low socioeconomic category.
Surveillance for clean water and sanitation was proposed
as the control measure [57].
(2015-2018)
Indian Swine Flu Outbreak (2015):
It refers to the outbreak of the 2009 H1N1 u
pandemic in India which was still present as of March
2015. This outbreak in 2015 is considered as a resurgence
of the infection and the most plausible reasons are
considered to be low temperature, decreasing host
immunity and failure of vaccination campaign after 2010
[58]. According to the NCDC data in India, Rajasthan,
Maharastra, and Gujarat were the worst affected states in
India during this pandemic [59].
Nipah Outbreak (2018):
The virus was rst noted in the late 1990s in
Singapore and Malaysia. The natural host for this
disease is the fruit bat and transmission is from direct
person to person contact [60]. This Nipah virus outbreak
began in May 2018 in Kozhikode District, Kerala. This
is the rst Nipah virus outbreak reported in Kerala and
the third known to have occurred in India, with the most
recent previous outbreak being in 2007 [61]. Spread of
awareness about this infection, isolation of the infected
and post-outbreak surveillance led to the control of this
outbreak [62].
Conclusion
India has stood strong through several epidemics
and pandemics. Good medical care and efcient
researches have made it possible to ght every infection
and luckily, we have been able to even eradicate a few. It
can be established that throughout time, many infectious
diseases have become widespread due to the mere lack
of sanitation and crowded environment. The tropical
climate and the seasonal rains in India is yet another
important factor contributing to several vector-borne
infections outbreaks in the past and many more to come.
Though it has been difcult to compile all the epidemics
and pandemics due to lack of sufciently available data
and errors in data preservation, sincere efforts have been
put into including most of the important, notable ones.
This is written with a hope that it may help medical
Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8 1507
professionals understand where they had gone wrong in
controlling an outbreak in the past or how they succeeded
to lead by example. It is also a sad truth that India will
have to face several more such outbreaks in the days
to come but preparedness has to be given immense
importance and control of spread should be the number
one priority of the doctors and other health care workers.
Ethical Clearance- No ethical clearance was
necessary for this research work
Source of Funding- Self funded project
Conict of Interest – Nil
References
1. Rice AL, Sacco L, Hyder A, Black RE. Malnutrition
as an underlying cause of childhood deaths
associated with infectious diseases in developing
countries. Bulletin of the World Health organization.
2000;78:1207-21.
2. John TJ, Dandona L, Sharma VP, Kakkar M.
Continuing challenge of infectious diseases in India.
The Lancet. 201115; 377(9761):252-69.
3. Watson, John T., Michelle Gayer, and Maire
A. Connolly. Epidemics after natural disasters.
Emerging infectious diseases 13.1 (2007):1.
4. Sen S, Srabani. Indian cholera: A Myth. Indian
Journal of History of Science 47.3 (2012): 345-374.
5. Moore, Cristopher, and Mark EJ Newman.
Epidemics and percolation in small-world networks.
Physical Review E 61.5 (2000):5678.
6. Hughes JM, Wilson ME, Pike BL, Saylors KE,
Fair JN, LeBreton M, Tamoufe U, Djoko CF,
Rimoin AW, Wolfe ND. The origin and prevention
of pandemics. Clinical Infectious Diseases. 2010
Jun15; 50(12):1636-40.
7. Simonsen L, Clarke MJ, Schonberger LB, Arden
NH, Cox NJ, Fukuda K. Pandemic versus epidemic
inuenza mortality: a pattern of changing age
distribution. Journal of infectious diseases. 1981;
178 (1):53-60.
8. Ramamurthy T, Sharma NC. Cholera outbreaks
in India. In Cholera Outbreaks 2014 (pp. 49-85).
Springer, Berlin, Heidelberg.
9. Mills, Ian D. “The 1918-1919 inuenza pandemic—
the Indian experience.” The Indian Economic &
Social History Review23.1 (1986):1-40.
10. Mishra B. 2015 resurgence of inuenza a (H1N1)
09: Smoldering pandemic in India?. Journal of
global infectious diseases. 2015;7(2):56.
11. Arnold, David.”Cholera and colonialism in British
India.”Past & Present 113(1986):118- 151.
12. Pollitzer, Robert.”Cholerastudies:1. History of the
disease.”Bulletin of the World Health Organization
10.3 (1954):421.
13. Collins, A. E. “The geography of cholera.” Cholera
and the Ecology of Vibrio cholerae. Springer,
Dordrecht, 1996. 255-294.
14. Pollitzer R, Swaroop S, Burrows W. History of
the disease. Cholera. World Health Organization,
Geneva, Switzerland.1959:11-50.
15. Barua, Dhiman. “History of cholera.” Cholera.
Springer, Boston, MA, 1992.1-36.
16. Macnamara, Nottidge Charles. A history of Asiatic
cholera. MacMillan,1876.
17. Blake, Paul A. Historical perspectives on pandemic
cholera. Vibrio cholerae and Cholera. American
Society of Microbiology, 1994.293-295.
18. Omar W. The Mecca Pilgrimage: Its Epidemiological
Signicance and Control. Postgraduate medical
journal. 1952;28(319):269.
19. Bryceson, AD. Cholera, the ickering ame.
(1977):363-365.
20. Lacey, Stephen W. Cholera: calamitous past,
ominous future. Clinical Infectious Diseases 20.5
(1995):1409-1419.
21. Whitcombe E, Famine mortality. Economic and
Political Weekly (1993):1169-1179.
22. Howard-Jones, Norman. Robert Koch and the
cholera vibrio: a centenary. British medical journal
(Clinical research ed.)288.6414 (1984):379.
23. Rogers L. The Incidence and Spread of Cholera
in India; Forecasting and Control of Epidemics.
The Incidence and Spread of Cholera in India;
Forecasting and Control of Epidemics.1928 (9).
24.
25. Kidambi P. ‘An infection of locality’: plague,
pythogenesis and the poor in Bombay, c. 1896–
1905. Urban History. 2004;31(2):249-67.
26. Kaper JB, Morris JG, Levine MM. Cholera. Clinical
microbiology reviews. 1995 1;8(1):48-86.
1508 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8
27. Colwell, Rita R. “Global climate and infectious
disease: the cholera paradigm.” Science 274.5295
(1996):2025-2031.
28. Johnson NPAS, Mueller J. Updating the accounts:
global mortality of the 1918-1920” Spanish”
inuenza pandemic. Bull Hist Med. 2002; 76:105–
115.
29. Chandra S, Kassens-Noor E. The evolution of
pandemic inuenza: evidence from India, 1918–19.
BMC infectious diseases. 2014; 14(1):510.
30. Patterson KD,PyleGF.The geography and mortality
of the 1918 inuenza pandemic. Bull Hist Med.
1991;65:4–21.
31. John, T. Jacob, and Vipin M. Vashishtha. Eradicating
poliomyelitis: India’s journey from hyperendemic
to polio-free status. The Indian journal of medical
research 137.5 (2013): 881.
32. Chaturvedi UC, Mathur A, Singh UK, Khushwaha
MRS, Mehrotra RML, Kapoor AK, et al. The
problem of paralytic poliomyelitis in the urban and
rural population around Lucknow, India. J Hyg
Camb. 1978;81:179–87.
33. Pabhakar N, Srilatha V, Mukarji D, John A,
Rajarathnam A, John TJ. The epidemiology and
prevention of poliomyelitis in a rural community in
South India. Indian Pediatr.1981; 18:527–32.
34. John TJ. Understanding the scientic basis of
preventing polio by immunization. Pioneering
contributions from India. Proc Indian Natl Sci
Acad.2003; B69:393–422.
35. The control and eradication of smallpox in South
Asia, Internet Archive, 2018, Available from:
https://web.archive.org/web/20081019023043/
http://www.smallpoxhistory.ucl.ac.uk/, Accessed on
18 July,2006
36. Greenough P. Intimidation, coercion and
resistance in the nal stages of the South Asian
smallpoxeradicationcampaign,1973–1975.
Socialscience&medicine.19951;41(5):633- 45.
37. FennerF.Globaleradicationofsmallpox.
Reviewsonfectiousdiseases.19821;4(5):916- 30.
38. Dutt, Ashok K., Rais Akhtar, and Melinda McVeigh.
Surat plague of 1994 re- examined. Southeast Asian
journal of tropical medicine and public health 37.
4(2006):755.
39. Gupta, Manohar Lal, and Anuradha Sharma.
Pneumonic plague, northern India, 2002. Emerging
Infectious Diseases13.4 (2007):664.
40. Singh N P, Jhamb R, Agarwal S K, Gaiha M, Dewan
R, Daga M K, Chakravarti A, Kumar S. The 2003
outbreak of dengue fever in Delhi, India. Headache.
2005 1; 114:61-.
41. Dikid,T.Emerging & re-emerging infections in
India : An overview .The Indian journal of medical
research 138.1 (2013): 19.
42. Geneva: World Health Organization; 2003. Summary
table of SARS cases by country, 1 November 2002
2007 August. Available from: https://www.who.
int/csr/sars/country/2003_08_15/en/, Accessed on:
December 11, 2006
43. Manchanda V, Gupta S, Bhalla P. Meningococcal
disease: History, epidemiology, pathogenesis,
clinical manifestations, diagnosis, antimicrobial
susceptibility and prevention. Indian J Med
Microbiol 2006;24:7-19
44. WHO, Global Alert and Response, Meningococcal
disease in India, Available from: https://www.
who.int/csr/don/2005_05_09/en/, Accessed on: 9
May2005
45. Mavalankar D, Shastri P, Bandyopadhyay T, Parmar
J, Ramani KV. Increased mortality rate associated
with chikungunya epidemic, Ahmedabad, India.
Emerging infectious diseases. 2008;14(3):412.
46. KaurP,PonniahM,MurhekarMV,etal.
Chikungunyaoutbreak,SouthIndia,2006.Emerg
Infect Dis. 2008;14(10):1623–1625.doi:10.3201/
eid1410.07056
47. Mavalankar, Dileep, PriyaShastri and Parvathy
Raman.”Chikungunya epidemic in India: a major
public-health disaster.” The Lancet infectious
diseases 7.5 (2007):306-307.
48. More dengue, chikungunya cases reported, NDTV
Web Version, Accessed on: 9 October 2006
49. “Nationwide data on outbreak, The Hindu”.Chennai,
India. 9 October 2006.Archived from the original on
17 May 2009. Retrieved2006-10-09.
50. Patel DA, Gupta PA, Kinariwala DM, Shah HS,
Trivedi GR, Vegad MM. Aninvestigation of an
outbreak of viral hepatitis B in Modasa town,
Gujarat, India. Journal of global infectious diseases.
2012;4(1):55.
51. Naik SR, Aggarwal R, Salunke PN, Mehrotra NN.
Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8 1509
A large waterborne viral hepatitis E epidemic in
Kanpur, India. Bull World Health Organ. 1992;
70:597–604.
52. Pandemic (H1N1) 2009-Weekly update 112.
2010. Available from: http://www.who.int/csr/
don/2010_08_06/en/index.html
53. Galwankar S, Clem A. Swine inuenza A (H1N1)
strikes a potential for global disaster.J Emerg
Trauma Shock. 2009;2:99–105.
54. Broor S, Krishnan A, Roy DS, Dhakad S, Kaushik S,
Mir MA, Singh Y, Moen A, Chadha M, Mishra AC,
Lal RB. Dynamic patterns of circulating seasonal
and pandemic A (H1N1) pdm09 inuenza viruses
from 2007–2010 in and around Delhi, India. PloS
one. 2012 3;7(1):e29129.
55. Dangi T, Jain B, Singh AK, Mohan M, Dwivedi M,
Singh JV, et al. Inuenza virus genotypes circulating
in and around Lucknow, Uttar Pradesh, India, during
post pandemic period, August 2010-September
2012. Indian J Med Res. 2014;139:418–26
56. Integrated Disease Surveillance Programme
(IDSP). National Center for Disease Control,
DGHS,MOH&FW,GovernmentofIndia.
DiseaseOutbreakReportedandRespondedby States.
2012. Available from:http://www.idsp.nic.in
57. Kelly R. India Weekly Outbreak Reports 2013.
Emerging Disease and Other Health Threats Winnter
Park, Florida: Flutrakers.com, Inc. 2015.
Available from: https://utrackers.com/forum/
forum/india/india-emerging-diseases-and-other-
health- threats/158406-india-weekly-outbreak-
reports-2014.
58. Paul, Sourabh, et al. “Investigation of jaundice
outbreak in a rural area of Odisha, India: Lessons
learned and the way forward.” Community Acquired
Infection 2.4 (2015):131.
59.
60. Mishra B. 2015 resurgence of inuenza a (H1N1)
09: Smoldering pandemic in India? Journal of global
infectious diseases. 2015;7(2):56.
61. NCDC, Ministry of Health (2019), H1N1 Swine
Flu- number of cases and deaths from 2012-2019
Data. Available from: https://ncdc.gov.in/showle.
php?lid=280, Accessed on:18 June2019
62. Chatterjee P. Nipah virus outbreak in India. The
Lancet 391.10136 (2018):2200.
63. WHO, Disease Outbreak News, Nipah Virus-India.
Available from: https://www.who.int/csr/don/31-
may-2018-nipah-virus-india/en/, Accessed on: 31
May 2018
64. Kumar AA, Kumar AA. Deadly Nipah outbreak
in Kerala: Lessons learned for the future. Indian
journal of critical care medicine: peer-reviewed,
ofcial publication of Indian Society of Critical
Care Medicine. 2018;22(7):475.
... The population affected by these diseases was quite enormous but they did not take the shape of the ongoing pandemic wherein all the continents have come under the clutches of this deadly virus. When it comes to India, she has also faced the wrath of deadly diseases such as Dengue Epidemic (2003), SARS Epidemic (2003), Meningococcal Meningitis Epidemic (2005, Chikungunya Outbreak (2006), H1N1 Flu Pandemic (2009), Indian Swine Flu Outbreak (2015 and Nipah Outbreak (2018) (Swetha G, 2019).Politics is an integral part of the entire process starting from an outbreak to finding a cure, reviving the economy and to prepare our societies for the next one. The current political system of India was an outcome of 'modernity' and has undergone several changes, both in terms of 'ideology' and in terms of its 'functioning'. ...
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The Covid-19 health crisis has thrown a number of challenges at human kind in general but it has also given significant amount of opportunities for India. It has shown the fault lines in our economic policies and revealed our strengths and weaknesses. When identities get deconstructed strong and powerful ideas take birth. Anthony Pagden while describing the ‘Idea of Europe’ mentions that identities are constructed over time and history gives legitimacy to it. Similarly, Benedict Anderson in his Imagined Communities (1983) argues history is constructed and so is nationalism. Therefore, it is time to carve out a new ‘Idea of India’ in the post Covid-19 world order. The paper defines society during and after the crisis is over which the authors consider as the new normal and the impact that such changes already have or further might have on peoples’ lives and industries. An alternative approach has been looked at while defining ‘power’ and theories that govern international relations. Further, an attempt has been made to problematise issues faced because of the health crisis and some suggestions to tackle them. The central argument of the article is that the three pillars of inclusive and sustainable development are ‘Education’, ‘Health Care’ and ‘Research and Development’ of any country. Keywords: International Relations, Indian Foreign Policy, International Politics, Education, Healthcare, Research and Development, Idea of India, Pax Indica, Covid-19 and India, Challenges and Way Forward
... India's history is replete with previous records of pandemic, which our nation withstood and overcome, notable among them was the Cholera outbreak in 19th century followed by Influenza pandemic around 20th century which played havoc, though it lasted for short-interval. 1 More recent was the H1N1 flu pandemic (2009), which resulted in the loss of 18,500 people globally. ...
... The economic loss due to respiratory infections caused by influenza viruses was estimated to be between US$71 and US$167 billion annually (6). The potential of influenza viruses to cause public health emergencies in society, evidenced by several incidents in the past, such as the Spanish flu of 1918, the Asian influenza of 1957, the Hong Kong influenza of 1968 and the H1N1 pandemic of 2009, cannot be overstated (7)(8)(9)(10). ...
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The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country’s capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.
... While the Indian health-care was able to eliminate some, many diseases continue to be a threat to Indian-society. Unusual health-emergencies in India are rare but many articles point to the causes for usual health-emergencies in developing countries such as malnutrition, poor sanitation, and the lack of a proper public health system (Murhekar, 2009;Swetha, 2019). Pandemic is an outbreak of a sudden, serious illness in different parts of world that already exists in some specific countries. ...
... Along with these communicable diseases which are compressed in times, many non-communicable diseases with a shifted epidemic time scale from several days or weeks to years are also included in epidemics. (Swetha et al., 2019) However, newly infectious diseases like COVID-19 are emerging day by day affecting humans &animal's lives & also having high costs to society. Several contributing factors like climate changes, globalisation, urbanisation, malnutrition,poverty, lack of sanitation, lack of a proper public health system and prolonged use of immune suppressant drugs, allow more natural transmission of viral diseases in the community. ...
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Review article about concept of janapadodhwamsa & its correlation with pandemic Covid 19
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Since March 2020, India has seen the surge in COVID-19 infection throughout the various sections of the society across all states and union territory. The COVID-19 pandemic has affected all sectors in India. During the lockdown, migrant laborers went back to their own native places resulting in stoppage of manufacturing, assembling, trading and construction activities. The pandemic affected educational sector also. Many of the academic establishments and universities faced the problem of completing their teaching sessions. Due to wide spread of the corona virus in the society, government at center and at state took a decision of lockdown in the regular activities with a purpose of breaking the chain of spreading the virus. The educational establishments and universities forced to look into new ways to complete their remaining term. Purpose of the Study: The purpose of the study is to understand the effectiveness of usingDigital Learning Resources during the COVID-19 pandemic situation at the University level programs of Maharashtra State. This research paper tries to relate the significant aspects of digital mode as against the traditional mode of teaching-learning process. This paper also studies the challenges and opportunities of adopting the digital mode as a new method of teaching-learning process in the affiliated institutes and universities of Maharashtra. Methodology: The researcher adopted descriptive research method for this research paper. Literature review was carried out to understand the history of pandemic in India and the developments in the area of digital learning resources and its use in India. The secondary data was collected through various articles and research papers published in journals. The primary data was collected through a structured questionnaire online. The questionnaire was circulated amongst the students and faculty members by using Google Forms. The sample size of 100 students and 120 faculty members were taken for drawing objective related findings. The researcher used statistical tools such as MS excel and SPSS 21 for analyzing the collected data. Findings: Upon carrying out data analysis, the observations and finding were drawn. The major finding of the research indicates that most of the institutes affiliated to various universities have adopted digital mode for completing their remaining term. At the same time it is observed that, the institutes gone with digital mode have faced lot of challenges in smooth conduct of the sessions. The main challenge listed is unavailability of infrastructural support in the rural part of the state along with connectivity issues. It is also observed that students and faculty members still feel that traditional mode of teaching-learning process is more effective than digital mode.
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This study is interdisciplinary in nature and brings in its fold dissemination of social science research on health. In the light of the recent Covid 19 crisis, there has been an increasing interest towards epidemiology and to understand the concept of epidemics or pandemics. Intermittent outbreaks of infectious diseases have had profound effect on societies throughout history. Historical perspective helps in understanding the extent to which panic, connected with social stigma, threat, prejudice, frustrated public health efforts can control the spread of disease. The intensity of the spread of a pandemic and the number of people affected in country and specific regions depend a lot on the measures of state control at the local and centre-level. However, the severity of an epidemic which slowly pervades into a pandemic depends on the spatio-temporal frame of a region. The research poses a basic question, how do members of the society respond to the threat of pandemic and to the hygiene, social isolation and other measures proposed by public health, over time and selects the case of Bengal which has witnessed three pandemics since the 18thcentury.. The study follows a mixed-method approach and the discussion provided a few general observations which however are not exhaustive to pandemic reaction, for the study area like threat Perception, emergence of leadership, science communication etc.
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The incidence of emerging infectious diseases in humans has increased within the recent past or threatens to increase in the near future. Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin. Developing countries such as India suffer disproportionately from the burden of infectious diseases given the confluence of existing environmental, socio-economic, and demographic factors. In the recent past, India has seen outbreaks of eight organisms of emerging and re-emerging diseases in various parts of the country, six of these are of zoonotic origin. Prevention and control of emerging infectious diseases will increasingly require the application of sophisticated epidemiologic and molecular biologic technologies, changes in human behaviour, a national policy on early detection of and rapid response to emerging infections and a plan of action. WHO has made several recommendations for national response mechanisms. Many of these are in various stages of implementation in India. However, for a country of size and population of India, the emerging infections remain a real and present danger. A meaningful response must approach the problem at the systems level. A comprehensive national strategy on infectious diseases cutting across all relevant sectors with emphasis on strengthened surveillance, rapid response, partnership building and research to guide public policy is needed.
Chapter
What is cholera? How and where did it start? How did and does it spread? There is a lack of agreement about the early history of cholera. Confusion arose because it was difficult to define cholera precisely (which has a broad clinical spectrum) and to distinguish it from many other diseases associated with diarrhea and vomiting.
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Cholera is a global health problem as several thousands of cases and deaths occur each year. The unique epidemiologic attribute of the disease is its propensity to occur as outbreaks that may flare-up into epidemics, if not controlled. The causative bacterial pathogen Vibrio cholerae prevails in the environment and infects humans whenever there is a breakdown in the public health component. The Indian subcontinent is vulnerable to this disease due its vast coastlines with areas of poor sanitation, unsafe drinking water, and overcrowding. Recently, it was shown that climatic conditions also play a major role in the persistence and spread of cholera. Constant change in the biotypes and serotypes of V. cholerae are also important aspects that changes virulence and survival of the pathogen. Such continuous changes increase the infection ability of the pathogen affecting the susceptible population including the children. The short-term carrier status of V. cholerae has been studied well at community level and this facet significantly contributes to the recurrence of cholera. Several molecular tools recognized altering clonality of V. cholerae in relation with the advent of a serogroup or serotype. Rapid identification systems were formulated for the timely detection of the pathogen so as to identify and control the outbreak and institute proper treatment of the patients. The antimicrobials used in the past are no longer useful in the treatment of cholera as V. cholerae has acquired several mechanisms for multiple antimicrobial resistanceantimicrobial resistance . This upsurge in antimicrobial resistance directly influences the management of the disease. This chapter provides an overview of cholera prevalence in India, possible sources of infection, and molecular epidemiology along with antimicrobial resistance of V. cholerae.
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