news Tuesday, June 23, 2015 - 05:30
  Doctors have diagnosed ‘Kala Azar’ or black fever in one person in Thrissur district of Kerala. “Kala Azar has been confirmed in one patient admitted at the hospital, two more are under observation. This disease is mainly found among migrant labourers in Kerala. Since they go back to their place when they are infected we did not yet get a chance to confirm or research on it. Five years ago, this fever had been identified in five or six patients, It is a dangerous parasitic killer and shows symptoms only after 45 to 50 days of infection,” said Dr.M.A.Raveendran, Head of Medicine Department at the Thrissur Medical College. A vector-borne disease mainly found in states like Bihar and Uttar Pradesh, there have been rare times in the past when the disease has been confirmed in Kerala.  Kala azar or black fever in medical lexicon is known as Visceral leishmaniasis (VL), and is prevalent in central India and parts of north India, but not in Southern India. One of the patients currently being monitored for the disease is from Jharkhand What is Kala Azar? Doctors Without Borders or MSF calls it one of the most dangerous, neglected tropical diseases (NTDs). Leishmaniasis is also said to be the second largest parasitic killer in the world after malaria. It is a disease spread by sandflies, just like mosquitoes spread malaria. Kala azar is caused by bites from female phlebotomine sandflies—the vector (or transmitter) of the leishmania parasite. “If blood containing leishmania parasites is drawn from an animal or human, the next person to receive a bite will then become infected and develop leishmaniasis. Months after this initial infection the disease can progress into a more severe form, called visceral leishmaniasis or kala azar,” says MSF. Symptoms of Kala Azar Kala Azar affects the internal organs such as spleen, liver and the bone marrow and can be fatal if left untreated. Common systems include irregular bouts of fever and weight loss. The parasites can cause skin sores or ulcers at the site of the bite.   According to the National Vector Borne Disease Control Programme of India(NVBDCP), these are the symptoms of black fever.   Recurrent fever intermittent or remittent with often double rise  loss of appetite, pallor and weight loss with progressive emaciation  weakness   Splenomegaly - spleen enlarges rapidly to massive enlargement, usually soft and non-tender   Liver - enlargement not to the extent of spleen, soft, smooth surface, sharp edge   Lymphadenopathy – a  disease affecting the lymph nodes, not very common in India  Skin - dry, thin and scaly and hair may be lost. Light coloured persons show grayish discolouration of the skin of hands, feet, abdomen and face which gives the Indian name Kala-azar meaning "Black fever" Anaemia - develops rapidly Treating Kala Azar The treatment options are individualised depending on the form of the Leishmania species that has caused the infection and the severity of the case. While some cases of cutaneous leishmaniasis(skin ulcers) are left to heal on their own, severe cases of visceral lesihaniasis(that affects spleen,liver) are sometimes fatal. While several medications are available, some include antimony-containing compounds Intermuscular injections are the first course of treatment available. According to the NVBDCP, there is a national health programme built in 2010 to tackle the disease. However, both diagnosis and treatment has been difficult since apart from the expensive costs for treatment and prolonged time, the diagnosis for visceral leishmaniasis itself involves sampling tissues of the bone marrow, lymphnodes and spleen. However, procedures carry a risk of bleeding in the case of splenic aspiration.   First line of treatment involves receiving Sodium Stibo Gluconate . The second line of treatment which is more toxic than the first involves usage of Amphotericin B . Miltefosine is used as an oral drug originally studied as an anti-tumour agent, says the website.  Treatment is usually provided as a Directly Observed Therapy and the patient is told to report for treatment routinely.  (Image for representational purpose: Doctors Without Borders website)  
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