Nipah surveillance: 33 removed from contact list in Kerala as 648 remain under watch
Nipah virus contact list
across several districts in Kerala, as per a statement from the office of State Health Minister Veena George.
Of the total, 421 are from Palakkad, 110 from Malappuram, 115 from Kozhikode, and one each from Ernakulam and Thrissur districts. This also includes 17 people who remain in isolation in Palakkad.
In Malappuram, 13 people are currently under isolation. The district has so far reported 97 sample tests, all of which have returned negative.
Notably, 21 people from Malappuram and 12 from Palakkad have completed their isolation period and have been removed from the contact list, the statement read.
Across the state, 30 people are under the "highest risk surveillance" category, while 97 others have been identified as part of the high-risk group, it added.
Meanwhile, Health Minister George has also directed the One Health Centre for Nipah Research to document all matters related to the outbreak. Notably, an ICMR team visited Malappuram to assess the situation.
On July 14, Kerala's Palakkad district reported a second Nipah case after a 58-year-old man from Kumaramputhur near Mannarkkad tested positive for the virus following his demise at a private hospital in Perinthalmanna.
According to officials, field-level activities have been intensified in the area. Fever surveillance is also continuing. Further monitoring will be carried out, including the mobile tower location. The minister also directed the team to be strengthened in case another case is found.
Ten people are currently under treatment in Malappuram, of whom two are in intensive care. The state has now categorised 36 individuals as being in the highest-risk group and 128 under high-risk monitoring.
An alert has also been issued to hospitals in 6 districts in the wake of the second Nipah case.
A special alert has been issued to hospitals in Palakkad, Malappuram, Kozhikode, Kannur, Wayanad and Thrissur districts along with directions to report any case of fever or encephalitis with Nipah symptoms.
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Indian Express
14 hours ago
- Indian Express
The fault in our salt: The condiment's cultural pull in India — and why it comes at a cost to public health
In one of Hindi cinema's most iconic scenes, Kalia in Sholay swears by a pinch of salt — 'Sardaar, maine aapka namak khaaya hai' — as he pledges his loyalty to Gabbar. The ubiquitous grainy white condiment failed to save his life and in the 50 years since, a shift in consumption patterns and lifestyles has seen salt slowly eating away at Indians' health. While the permissible amount of salt consumption, as prescribed by the World Health Organisation, is 5 gm a day per person (2,000 mg of sodium or about a teaspoon of salt), several studies have pointed to how Indians consume more than double the amount, posing risks of hypertension, stroke and heart diseases. According to the Indian Council of Medical Research-National Institute of Nutrition's (ICMR-NIN) 2024 Dietary Guidelines for Indians, existing evidence reveals a 'deleterious impact of high salt intake on blood vessels and blood pressure', which in turn can cause heart attack, stroke and/or kidney problems. High amounts of salt in the body results in water retention, which further increases the pressure on the heart to pump larger volumes of fluid, causing hypertension. The primary culprit, experts agree, is ultra-processed food. According to the NIN's Dietary Guidelines, processed foods such as 'snacks, savouries, soups, sauces, ketchup, salted butter, cheese, canned foods, papads, and salted dry fish, salted nuts/dry fruits contribute to higher intake of salt. Preserved meats/vegetables and ready-to-eat foods contain a lot of sodium'. Prompted by the 'alarming' salt consumption patterns, earlier this month, ICMR-NIE (the National Institute of Epidemiology) launched Project Namak, a three-year-long community-led programme that focuses on salt reduction in individuals with hypertension. Sharan Murali, senior scientist at ICMR-NIE and the principal investigator of Project Namak, says, 'Our research team evaluated the hypertension component of the NP-NCD (National Programme for Control and Prevention of Non-Communicable Diseases) programme in 21 districts in the country and understood that 78 per cent of the individuals with hypertension who come for follow-up receive some counselling for behavioural change in the OPD. This opportunity may be used to counsel the individuals with hypertension on dietary salt reduction as an add-on along with the medications.' Over the last two decades, there have been several such studies, including those published in the Journal of Hypertension, Journal of the American Heart Association and Nutrients, among others, that point to high salt intake among Indians. According to India Salt Market Report and Forecast 2025-2034 by Claight Corporation published this year, the India salt market reached around USD 2.32 billion in 2024. The market is projected to grow at a compounded annual growth rate of 6.20% between 2025 and 2034, reaching almost USD 4.23 billion by 2034. With experts also warning against too little salt — Dr Vivekanand Jha of the George Institute of Global Health says 'physiologically, at least 500 mg of sodium is compatible with good health' — how does one strike a balance with something as ubiquitous as salt? Historians say that the earliest evidence of salt production in India can be traced to the Indus Valley Civilization, although consumption would date even further back, 'particularly 11,000 years ago or a little later when they realised that they need to add salt to their diet,' notes Kurush Dalal, archaeologist and culinary anthropologist. 'Salt is indispensable to all mammals. As a rule, hunter gatherers used to get all the salt they needed from the food they ate. They didn't need to add anything at all. It's only when we became farmers that we started adding salt,' he says. 'On every continent', notes Mark Kurlansky in his book Salt: A World History, 'once human beings began cultivating crops, they began to look for salt to add to their diet. How they learned of this need is a mystery… however, most people choose to eat far more salt than they need, and perhaps this urge — the simple fact that we like the taste of salt — is a natural defense.' With that, salt became one of the most valuable commodities of trade. Kurlansky notes, 'Where people ate a diet consisting largely of grains and vegetables, supplemented by the meat of slaughtered domestic farm animals, procuring salt became a necessity of life, giving it great symbolic importance and economic value. Salt was one of the first international commodities of trade; its production was one of the first industries and, inevitably, the first state monopoly.' In India, salt holds a deeply symbolic value given how Mahatma Gandhi shook an empire with a fistful of salt with his Salt Satyagraha. While the origins of salt consumption are global, Indians took to salt more organically. In the absence of any recorded evidence, SubbaRao M Gavaravarapu, scientist and Head of Nutrition Information, Communication and Health Education at NIN, cites 'traditional knowledge' to explain Indians' tendency to consume higher amounts of salt. 'We are a tropical nation and many of our people would work outdoors and perhaps to compensate for the sodium loss through sweat, sodium was incorporated through food,' he says. To understand the detrimental effect of this condiment, however, it is important to know that salt (NaCl, with sodium and chloride ions in a 1:1 ratio) is only as harmful as its sodium content. And that, given our shifting eating patterns, sodium comes from more than just the salt we consume. While, as the NIN guidelines say, 'a major amount of sodium does come from the visible addition of salt', there are also innocuous ways sodium makes its way into our bloodstream. For instance, there is sodium bicarbonate or baking soda, the indispensable ingredient in bakery products. There's also monosodium glutamate or MSG which gives food its umami or savoury flavour and is commonly present in canned food. Then there's sodium nitrite, which is commonly used by commercial meat processing units to preserve meat, and sodium benzoate, which gives acidic foods and beverages such as colas, soft drinks, pickles, salad dressings and jams and preserves their shelf life. And for those into carbonated drinks such as diet soda, there's sodium saccharin to reckon with — all of which add to our sodium intake without any real addition of salt itself or table salt as we know it. Food critic and historian Pushpesh Pant reiterates the need for broadening the understanding of salt to manage one's sodium consumption. 'In Sanskrit, the word for salt is lavana, which does not necessarily mean sodium chloride, which we know as table salt. It could mean potassium chloride, sodium bicarbonate. It could be anything which is alkali,' he says. Khar, the alkali ash that is commonly used in food in the Northeast, is sodium carbonate, he explains. Experts broadly agree that among the easiest ways to combat this excessive supply of sodium to our bodies is to consume less table salt — and achieve a better balance of flavours. In his seminal 1998 work, A Historical Dictionary of Indian Food, the late food historian K T Achaya notes that there are six 'pure' tastes: madhura (sweet), amla (sour), lavana (salty), katu (pungent), tikta (bitter) and kasaya (astringent). 'Every meal was expected to include all the six tastes, and in the order just listed, according to Sushrutha (ancient Indian physician and doctor),' the book says. Traditionally, the use of salt in cooking has been in tandem with the other five tastes, Pant explains, while saying that different regional cuisines in India have their own equation with salt. 'If you are a coastal person, most of your salt would come from sea water fish. The pungency of mustard oil, which is used generously in Bengali cuisine, ensures a limited requirement of salt…Now, if you are a Maratha living away from the coast line, and you are eating millets, which are not very palatable on their own, you will increase the levels of salt and chillies. Or if you are having preserved foods like papad or bari, salt content is higher,' Pant says. Concerns of excessive salt intake and its detrimental effects on public health have prompted a host of studies and small-scale interventions to produce 'low-sodium' salt. This involves replacing a part of the sodium in sodium chloride with other additives, primarily potassium. But so far, these experiments haven't achieved the required scale in India. 'The concern in salt is the sodium. To reduce sodium, other kinds of salts are added. Mostly, it is replaced with potassium but there are issues with low-sodium salts — it is expensive and its supply is short,' says NIN's Gavaravarapu. The practice of adding potassium to packaged common salt, however, is yet to take off on a mass scale in the country given the lack of India-specific studies and with little clarity around its potential benefits or perceived risks. Dr K Srinath Reddy, founder president of the Public Health Foundation of India (PHFI) who formerly headed the Department of Cardiology at AIIMS, says that following initial trials across the world, where part of the sodium in salt was replaced with either potassium or magnesium, there were concerns over whether it could 'cause harm to people with reduced renal and kidney function'. 'Potassium is a bit corrosive, so we would have to use it in concentrations that won't damage the lining of the stomach and intestines. There were also concerns over whether low-sodium salt would cause hyperkalemia (excess potassium levels in the blood) in the elderly with renal function though there were successful trials in the US that said it was safe for them. But the findings weren't accepted because the trials were small,' Reddy says, while pointing to a study conducted in China by the George Institute for Global Health. With a 'fairly large' sample size of over 20,000 participants from 600 rural villages in five provinces in the country, the China Salt Substitute and Stroke Study (SSaSS), published in 2023 and conducted over five years, found that 'replacing salt with a reduced-sodium added-potassium 'salt substitute' significantly lowers the risk of stroke, heart disease, and death'. The institute has submitted a funding request to ICMR to conduct a similar study in India, said Dr Vivekananda Jha, Executive Director at The George Institute for Global Health, India. 'The study in China proves the point that lower than usual levels of dietary sodium can be tolerated without ill-effects, and a certain amount of potassium is required to balance the sodium. But whether that's going to become public policy in India, whether people are going to accept the altered tastes, we will have to see,' says Dr Reddy, emphasising that 'ideally', potassium, which negates the effects of sodium, should be consumed in the form of fruits and vegetables rich in the mineral. 'One can consume bananas and coconut water. But everybody may not be able to take all of it all through the year. So introducing a salt substitute like in the China trial is something we should maybe consider… Do some pilots to see what the response is, what the safety is, and what the popular acceptance is,' he adds. The last time a population-level health intervention in salt was carried out was in 1962, when common salt was fortified with iodine under the National Goitre Control Programme. Presently, all packaged salt sold in India, from common salt to rock salt, is iodised. NIN's Gavaravarapu flags another, largely behavioural, concern regarding low-sodium substitutes not being 'salty enough'. 'People think that because it is low-sodium, they can have more of it. Ideally, you should use it even less than usual so that the benefit of replacing it with potassium is passed on,' he says. While we wait for more research and consensus on reducing the sodium component in common salt, experts advocate the need to create awareness among consumers. Dr Reddy and NIN's Gavaravarapu reveal that the Food Safety and Standards Authority of India (FSSAI), a statutory body under the Ministry of Health and Family Welfare, is looking at the feasibility of 'front of the package labeling' that would explicitly warn customers of high levels of sugar, salt and trans fat, among others. 'If a package notes that it has so many grams per cent of fat or carbohydrate or trans fats, unless I have studied nutrition, I wouldn't understand any of it. That's why you require warning labels that communicate clearly and help people recognise there's a problem with the salt or sugar in the product,' says Dr Reddy. The UK and Ireland, for instance, follow a 'traffic light packaging' model, where red, amber and green colours are used to indicate the levels of fat, saturated fat, sugar, and salt in food products. Public health scientist and epidemiologist Dr Monika Arora says the country needs a behavioural change in terms of salt consumption. 'Salt can be reduced in the food served in schools, hospitals and government canteens, which are regulated places. The tongue and palate get adjusted to a gradual reduction. Midday meal is an excellent way of going about it. Another way is to tax high-salt products, making it an incentive for the industry to start reformulating their products,' she says. Celebrity chef and entrepreneur Sanjeev Kapoor says he realised the dangers of excess salt much before it became a talking point. 'When I dived deeper into healthier food options, I realised that it is not only sugar that is the culprit, but also salt,' he says. He also joined hands with the government to raise awareness about healthy food habits through FSSAI's 'Eat Right Movement' that focussed on 'reduction of high fat, sugar and salt foods in the diet'. 'We have to understand that taste is something that you get used to. Your palate gets trained. Salt is a flavour enhancer. If there is low salt in a dish, other flavours may also seem muted. But it also hides flavours. Which means if you add too much salt in a dish, the top note is of salt and you never experience the real flavour of other ingredients. If you want to use less salt, you can start by enhancing the flavour with other ingredients. Lemon works really well as do herbs like mint, coriander, basil and tulsi,' he says. While cutting down on salt may seem like hard work, Kapoor's new catchphrase may hold the key — around 20 years ago, while he started with 'Namak Swad Anusar (salt as per taste)', he now swears by 'Namak Sehat Anusar (salt as per health)'.
Time of India
a day ago
- Time of India
ICMR study found Covid vaccination didn't raise risk of unexplained sudden deaths among young adults: J P Nadda
New Delhi: An ICMR study has found that Covid vaccination did not increase the risk of unexplained sudden deaths among young adults in India, Union Health Minister J P Nadda told Lok Sabha on Friday. Past Covid hospitalization, family history of sudden death and certain lifestyle behaviours increased the likelihood of unexplained sudden deaths. Responding to a question, Nadda said the Indian Council of Medical Research (ICMR) has informed that it and the National Centre for Disease Control (NCDC) explored two approaches to investigate the causes of sudden death. The first approach was a retrospective case-control study to determine the risk factors associated with sudden death and the second approach of the study was to prospectively investigate sudden deaths in young adults using a virtual autopsy approach. The ICMR-National Institute of Epidemiology (NIE) conducted a study titled "Factors associated with unexplained sudden deaths among adults aged 18-45 years in India - A multicentric matched case-control study" at 47 tertiary care hospitals located across 19 states and Union territories during May-August 2023. Cases were apparently healthy individuals without any known co-morbidity, who suddenly (less than 24 hours of hospitalization or seen apparently healthy 24 hours before death) died of unexplained causes during October 1, 2021-March 31, 2023, Nadda stated. Four controls were included per case matched for age, gender and neighbourhood. Information was collected regarding data on COVID-19 vaccination/infection, post-Covid conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency, binge drinking and vigorous-intensity physical activity two days before death among the cases or interviewed controls, he said. A total of 729 sudden death cases and 2916 controls were included in the analysis. It was observed that receiving two doses of Covid vaccine significantly reduced the odds of unexplained sudden death, Nadda stated. Past COVID-19 hospitalization, family history of sudden death, binge drinking 48 hours before death/interview, use of recreational drug/substance and performing vigorous-intensity physical activity 48 hours before death/interview increased the odds of sudden death. "Hence, the study observed that COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviours increased the likelihood of unexplained sudden death," he said. The second study, titled "Establishing the cause in sudden unexplained deaths in young" conducted by the All India Institute of Medical Sciences (AIIMS), Delhi with funding and in collaboration with ICMR, is a prospective work aimed at determining the common causes of sudden deaths in young adults. Early analysis of data from the study indicates that heart attacks, or myocardial infarction (MI), continue to be the leading cause of sudden death in this age group. Importantly, no major changes in the pattern of causes have been observed when compared with previous years before the Covid pandemic. Together, these two studies offer a more comprehensive understanding of sudden unexplained deaths in young adults in India, Nadda said. It has also been revealed that Covid vaccination does not appear to increase the risk, whereas, the role of underlying health issues, genetic predisposition and risky lifestyle choices does play a role in unexplained sudden deaths, he said.
Time of India
a day ago
- Time of India
Seven more health institutions in Kerala get NQAS certification
T'puram: Seven more health institutions in the state have secured the prestigious National Quality Assurance Standards (NQAS) certification, taking the total number of accredited facilities in the state to 240, health minister Veena George said on Friday. Tired of too many ads? go ad free now Among the newly certified institutions, the Begur family health centre in Wayanad scored the highest with 98.79%, followed by the Koppam community health centre in Palakkad with 97.63%, and the Perumanna family health centre in Kozhikode with 95.08%. Among others, the Chaliyar family health centre in Kozhikode secured 94.47%, the Kunnamangalam family health centre in Kozhikode got 90.75%, the Chattanchal family health centre in Kasaragod scored 86.88%, and the Panathur family health centre in Kasaragod received 85.88%. With these additions, Kerala now has 240 NQAS-accredited health institutions, including seven district hospitals, five taluk hospitals, 12 community health centres, 46 urban family health centres, 160 family health centres, and 10 Janakeeya health centres. In addition to NQAS, 14 hospitals in the state have secured the National Lakshya certification for quality maternal healthcare, while five others have been awarded the Muskan certification for child-friendly services. The NQAS certification is valid for a period of three years, after which a reassessment is carried out by a national-level team. Annual inspections are also conducted at the state level to ensure continued compliance with quality benchmarks. Accredited institutions receive financial incentives to support service quality. Family and urban family health centres are allotted Rs 2 lakh each annually, Janakeeya health centres receive Rs 18,000 per service package, and other hospitals are granted Rs 10,000 per bed every year. The minister said that these recognitions reflect the state's focused efforts to improve primary healthcare delivery and maintain high standards across all levels of the public health system.
