Syllabus- Microbial infections; Introduction to bacterial, viral, protozoal and fungal infections. Basic knowledge of infections caused by different groups of micro- organisms- diarrhoea, dysentery, cholera, tuberculosis, malaria, viral infections like HIV, encephalitis, chikungunya, bird flu- preventive measures during out breaks.
Number of questions- Mains: 02, Prelims – 10
Mains Questions of the day-
1.Antimicrobial resistance (AMR), is now a leading cause of death worldwide, higher than HIV/AIDS or malaria. Analyze.
Introduction:
Write briefly about antimicrobial resistance (AMR).
Body:
Mention the data and causes on why antimicrobial resistance (AMR) is the leading cause of deaths worldwide.
Conclusion:
- A multi-stakeholder approach, involving private industry, philanthropic groups and citizen activists is needed.
- Private pharmaceutical industries must take it upon themselves to distribute drugs in a responsible manner.
- Philanthropic charities must fund the development of new antibiotics, while citizen activists must drive awareness.
- These stakeholders must appreciate that the only way to postpone resistance is through improved hygiene and vaccinations.
- Increasing public awareness and understanding is therefore the most crucial pillar towards tackling antimicrobial resistance.
- AMR is an increasingly serious threat to the global public health that requires action across all government sectors and societies.
Content:
Antimicrobial Resistance:
- Antimicrobial resistance is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics) that are used to treat infections.
- As a result, standard treatments become ineffective, infections persist and may spread to others.
- Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
- The World Health Organization (WHO) has identified AMR as one of the top ten threats to global health.
- A comprehensive estimate of the global impact of antimicrobial resistance (AMR) has found that 1.27 million people died in 2019 as a direct result of AMR, which is now a leading cause of death worldwide, higher than HIV/AIDS or malaria.
The analysis: Global Research on Antimicrobial Resistance (GRAM) report:
- The Global Research on Antimicrobial Resistance (GRAM) report used statistical modelling to estimate deaths linked to 23 pathogens and 88 pathogen-drug combinations.
- Apart from 7 lakh deaths caused directly by AMR (these would not have occurred had the infections been drug-susceptible), another 49.5 lakh deaths were associated with AMR (a drug-resistant infection was implicated, but resistance itself may or may not have been the direct cause of death).
- HIV/AIDS and malaria were estimated to have caused 8.6 lakh and 6.4 lakh deaths respectively in 2019.
- Of the 23 pathogens studied, drug resistance in six (E coli, S aureus, K pneumoniae, S pneumoniae, A baumannii, and P aeruginosa) led directly to 9.29 lakh deaths and was associated with 3.57 million.
- One pathogen-drug combination – methicillin-resistant S aureus, or MRSA – directly caused more than 1 lakh deaths.
- Resistance to two classes of antibiotics often considered the first line of defence against severe infections – fluoroquinolones and beta-lactam antibiotics – accounted for more than 70% of deaths caused by AMR.
Antimicrobial Resistance in India:
- India is among the nations with the highest burden of bacterial infections.
- India, with its combination of large population, rising incomes that facilitate purchase of antibiotics, high burden of infectious diseases and easy over-the-counter access to antibiotics, is an important cause for the generation of resistance genes (such genes help bacteria in surviving on being exposed to antibiotics).
- In India, over 56,000 newborn deaths each year due to sepsis are caused by organisms that are resistant to first line antibiotics.
- A study reported by ICMR (Indian Council of Medical Research) from 10 hospitals showed that when Covid patients acquire drug-resistant infections in hospitals, the mortality(death) is almost 50-60%.
- An estimated 4,10,000 children aged five or less die from pneumonia in India annually; with pneumonia accounting for almost 25 % of all child deaths.
- The mortality from infectious diseases in India today is 417 per 1,00,000 persons.
- The Food Safety and Standards Authority of India (FSSAI) banned the use of antibiotics in agriculture and allied sector.
- There is no regulation in the poultry industry where antibiotics added to food of animals and feed them for profit.
Reasons for Spread of AMR:
- The misuse of antimicrobials in medicine and inappropriate use in agriculture.
- Contamination around pharmaceutical manufacturing sites where untreated waste releases large amounts of active antimicrobials into the environment.
- Overuse, misuse, and improper use (e.g., taking antibiotics to treat viral diseases!) of antimicrobials.
- Greater access to over-the-counter antibiotic drugs in developing countries.
- Using broad-spectrum antibiotics over narrow-spectrum antibiotics (targeting specific microbes only).
- Dumping of inadequately treated effluents from the pharmaceutical industry.
- Antibiotic use in livestock feed at low doses for growth promotion is industrialized countries.
- Poor sanitation and hygiene that forces the extended use of antimicrobials.
2.Global Health Estimates (GHE) released by World Health Organization estimates that all non-communicable diseases together accounted for 74% of deaths globally in 2019.Discuss.
Introduction:
Write briefly about the GHE findings released by WHO.
Body:
- Define the NCD
- Mention the factors responsible for NCD and measures to control them.
Conclusion:
Way forward-
- Monitoring progress and trends of NCDs and their risk.
- Investing in better management of NCDs is critical. Management of NCDs includes detecting, screening and treating these diseases and providing access to preventive care for people in need.
- High impact essential NCD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment
- A comprehensive approach is needed requiring all sectors including health, finance, transport, education, agriculture, planning and others, to collaborate to reduce the risks associated with NCDs and promote interventions to prevent and control them.
Content:
- WHO provide a comprehensive and comparable assessment of mortality and loss of health due to diseases and injuries for all regions of the world.
- Non-communicable diseases make up 7 of the world’s top 10 causes of death, an increase from 4 of the 10 leading causes in 2000(The new data cover the period from 2000 to 2019).
- Heart disease now represents 16% of total deaths from all causes.
- Life spans have increased over the years, with a global average of more than 73 years (in 2019) compared to nearly 67 (in 2000).
Non-Communicable Diseases:
- NCDs are medical conditions or diseases that are not caused by infectious agents. These are chronic diseases of long duration, and generally slow progression.
- Main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases, Chronic neurologic disorders (Alzheimer’s, dementias), diabetes etc.
Factors contributing to the NCDs:
- Genetic Factor:
In major NCDs including cancer, diabetes, cardiovascular diseases, mental health and asthma.
- Behavioural Factors:
Physical inactivity, unhealthy diets (diets low in fruit, vegetables, and whole grains, but high in salt and fat), tobacco use (smoking, secondhand smoke, and smokeless tobacco), and the harmful use of alcohol
- Socio-economic factors:
Poverty is closely linked with NCDs. Nearly 30% of NCD-related deaths in low-income countries occur under the age of 60, whereas in high-income countries the proportion is only 13%.
- Urbanization and urban development policy:
- Encouraged mechanized transport and discourages physical activity. The nature of work available in urban areas may require less energy expenditure than rural areas.
- Also, Children living in unfavourable social conditions, poor housing and no access to parks and recreation centres were likely to be overweight or obese.
- Cultural norms:
Beliefs and norms amongst some social groups include preferences for foods high in animal fat which are socially acceptable but can result in obesity, hypertension etc.
Global Measures to control NCDs:
- NCDs are recognized as a major global challenge in the United Nation’s 2030 Agenda for sustainable development.
- As part of the Agenda, Heads of State and Government committed to develop ambitious national responses, by 2030, to reduce by one-third premature mortality from NCDs through prevention and treatment (SDG target 3.4).
- WHO has developed a Global action plan for the prevention and control of NCDs 2013-2020, which includes nine global targets that have the greatest impact on global NCD mortality. These targets address prevention and management of NCDs.
- India is the first country to develop specific national targets and indicators aimed at reducing the number of global premature deaths from NCDs by 25% by 2025.
Measures taken by India to control NCDs:
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010.
- Ayushman Bharat which would help to deal with NCDs and injuries along with communicable diseases.
- Food Safety and Standards Authority of India (FSSAI) proposed a tax and advertisement ban on unhealthy foods.
- FSSAI has launched ‘Eat Right India’ movement and a mass media campaign ‘Heart Attack Rewind’.
- Pradhan Mantri Ujjwala Yojana helps to reduce indoor air pollution which is also responsible for a significant number of acute respiratory illnesses.
Prelims Questions of the day:
1.Which of the following international organization launched the Global Antimicrobial Surveillance System (GLASS)?
- WHO
- FAO
- GISAID
- Global Forum for Health Research
Answer: A
Explanation:
- In 2015, WHO launched the Global Antimicrobial Surveillance System (GLASS) to work closely with WHO collaborating centers and existing antimicrobial resistance surveillance networks.
- As members of GLASS, countries are encouraged to implement the surveillance standards and indicators gradually based on their national priorities and available resources.
2.Which of the following potential causes of Antibiotic Resistance?
- Over-prescribing of antibiotics
- Patients not finishinf their treatment
- Over-use of antibioticsin livestock and fish farming
- All the above
Answer: D
Explanation:
Antimicrobial resistance:
- Antimicrobial resistance is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as anti-biotics, anti-fungals, anti-virals, anti-malarials, and anthelmintics) that are used to treat infections.
- As a result, standard treatments become ineffective, infections persist and may spread to others.
- Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
- The World Health Organization (WHO) has identified AMR as one of the top ten threats to global health.
Causes of Antibiotic Resistance:
- The misuse of antimicrobials in medicine and inappropriate use in agriculture.
- Contamination around pharmaceutical manufacturing sites where untreated waste releases large amounts of active antimicrobials into the environment.
- Overuse, misuse, and improper use (e.g., taking antibiotics to treat viral diseases!) of antimicrobials.
- Greater access to over-the-counter antibiotic drugs in developing countries.
- Using broad-spectrum antibiotics over narrow-spectrum antibiotics (targeting specific microbes only).
- Dumping of inadequately treated effluents from the pharmaceutical industry.
- Antibiotic use in livestock feed at low doses for growth promotion is industrialized countries.
- Poor sanitation and hygiene that forces the extended use of antimicrobials.
3.Which of the following is a diseases caused by microbes?
- Tuberculosis
- Polio
- hepatitis A
- smallpox
Answer: A
Explanation:
Diseases Caused by Microbes:
- A few harmful microorganisms can enter the body and cause infectious diseases.
- They can also spoil clothing, leather, and food.
- They are responsible for diseases such as flu, measles, chickenpox and tuberculosis, etc.
- Scientific research has also found and provided evidence that microbes may play a factor in
many non–infectious chronic diseases such as some forms of cancer and coronary heart disease.
- The invasion and multiplication of pathogens inside an individual are called infections.
- When the infection causes harmful effects on the individual’s body functions, the condition is known as disease.
- To cause an infection, microorganisms must enter our bodies.
- The site through which these enter the body is known as the portal of entry.
- The portals of entry can be the respiratory tract, gastrointestinal tract, urogenital tract, and skin.
4.Which of the following is a disease caused by fungi?
- Ringworm
- Small pox
- Hepatitis A
- Polio
Answer: A
Explanation:
Diseases caused by fungi:
- Fungi develop on the bodies in moist and humid areas.
- It is responsible for causing diseases such as ringworm and athlete’s foot.
5.Which of the following infections can be caused by the Microbes?
- Acute infections
- Chronic infections
- Latent infections
- All the above
Answer: D
Explanation:
- Microbes are organisms that are too small to be seen without using a microscope, so they include things like bacteria, archaea, and single cell eukaryotes — cells that have a nucleus, like an amoeba or a paramecium. Sometimes we call viruses microbes too.
- Current estimates suggest there could be at least 1 billion different species of microbe on Earth, possibly more.
- Microbial diversity is truly staggering, yet all these microbes can be grouped into five major types: Viruses, Bacteria, Archaea, Fungi, and Protists.
Microbes can also cause:
- Acute infections, which are short-lived.
- Chronic infections, which can last for weeks, months, or a lifetime.
- Latent infections, which may not cause symptoms at first but can reactivate over a period of months and years.
6.Which of the following statement(s) is/are correct about Aspergillosis?
- It is an infection.
- It is an allergic reaction
- It is a fungal growth.
- All the above
Answer: D
Explanation:
- Aspergillosis is an infection, allergic reaction, or fungal growth caused by the Aspergillus fungus.
- After black, white, and yellow, cases of a new fungal infection named aspergillosis were reported in the country.
7. Which of the following statement is/are correct about Favipiravir?
- Favipiravir is an antiviral COVID-19 drug.
- Glenmark Pharmaceuticals under the brand name FabiFlu has launched an antiviral drug Favipiravir.
- It is India’s first COVID-19 drug launched.
- All the above are correct
Answer: D
Explanation: Favipiravir is an antiviral COVID-19 drug. Glenmark Pharmaceuticals under the brand name FabiFlu has launched an antiviral drug Favipiravir. It is India’s first COVID-19 drug launched, priced at Rs 103 per tablet.
8. In which of the following cells are found in COVID-19 patients ‘bode well’ for long-term immunity?
- P-cell
- D-Cell
- T-Cell
- Endothelial Cell
Answer: C
Explanation: T cells are known as immune warriors that help us fight some viruses, but their importance for battling SARS-CoV-2, the virus that causes COVID-19, has been unclear. Research is going on and maybe it can be fruitful.
9.which of the following represent a clinical trial in which blood is transfused from recovered COVID-19 patients to a coronavirus patient who is in critical condition?
- Plasma Therapy
- Solidarity
- Remdesivi
- Hydroxychloroquin
Answer:A
Explanation: Plasma Therapy or Convalescent Plasma Therapy is a clinical trial in which blood is transfused from recovered COVID-19 patients to a coronavirus patient who is in critical condition.
10. Which of the following is related to the Coronavirus?
- It is a large family of viruses.
- It belongs to the family of Nidovirus.
- Both A and B are correct
- none.
Answer: C
Explanation: Coronaviruses are a large family of viruses and belong to the Nidovirus family or Nidovirales order, which includes Coronaviridae, Arteriviridae, and Roniviridae families.