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Wednesday, August 19, 2026 7:31 AM

Public Health

India’s Growing Metabolic Health Crisis: Obesity, Diabetes and Hypertension

For years, India’s biggest health challenges were closely associated with infectious diseases, malnutrition and limited access to healthcare. But the country is now facing another major public-health challenge: a rapidly growing burden of metabolic and non-communicable diseases. Obesity, diabetes, hypertension and abnormal cholesterol levels are increasingly affecting Indians across age groups and income categories. What makes the situation particularly concerning is that these conditions are closely connected. A person with excess weight may develop insulin resistance, which can increase the risk of type 2 diabetes. High blood pressure and abnormal cholesterol can further increase the risk of heart disease and stroke. The problem is no longer confined to older adults. Younger Indians are increasingly exposed to sedentary lifestyles, calorie-dense diets, poor sleep and chronic stress, creating the conditions for metabolic problems much earlier in life. The World Health Organization identifies unhealthy diets, physical inactivity, tobacco use and harmful alcohol consumption as major behavioural risk factors for non-communicable diseases. These behaviours contribute to metabolic changes such as raised blood pressure, high blood glucose, overweight and obesity. The scale of India’s metabolic health problem One of the clearest pictures of India’s metabolic health comes from the ICMR-INDIAB study, a large population-based study covering adults across 31 states and Union Territories. Published in The Lancet Diabetes & Endocrinology in 2023, the study assessed more than 113,000 participants and examined the prevalence of diabetes, prediabetes, hypertension, obesity and other metabolic conditions. The findings estimated that India had around 101 million people living with diabetes, while another 136 million were in the prediabetes category. The study also highlighted substantial levels of hypertension and obesity, with considerable variation between states and between urban and rural populations. This variation is important. India does not have a single metabolic-health profile. Dietary habits, economic conditions, urbanisation, physical activity, genetics and access to healthcare differ significantly from one region to another. Yet the broader direction is clear: metabolic disorders have become a major component of India’s disease burden. Obesity is becoming a public-health issue Obesity is often discussed as an issue of appearance or weight management. Medically, however, excess body fat can have much broader consequences. India’s Ministry of Health and Family Welfare notes that overweight and obesity are important risk factors for conditions including coronary heart disease, hypertension, stroke, type 2 diabetes, fatty liver disease, certain cancers and osteoarthritis. The concern is also spreading to younger generations. In July 2026, reporting based on the World Obesity Atlas 2026 estimated that approximately 41 million children in India were overweight or obese. Around the same time, ICMR-NIN unveiled policy recommendations focused on improving children’s food environments, including measures involving food advertising, labelling, school canteens and the pricing of unhealthy foods. Childhood obesity is particularly concerning because metabolic risk can accumulate over decades. A child who develops unhealthy eating patterns and low physical activity early in life may carry those behaviours into adolescence and adulthood. That does not mean every overweight child will develop diabetes or hypertension. But it does mean that prevention has to begin much earlier than the traditional idea of starting health checks only in middle age. Diabetes: India’s expanding metabolic challenge Diabetes is perhaps the most visible part of India’s metabolic-health crisis. Type 2 diabetes develops when the body becomes resistant to insulin or does not produce enough insulin to maintain healthy blood glucose levels. Genetics can play a role, but lifestyle and environmental factors also influence risk. India’s dietary transition has become an important part of the discussion. A 2025 study based on ICMR-INDIAB data and published in Nature Medicine examined dietary patterns among more than 18,000 adults. It reported associations between higher consumption of low-quality carbohydrates, including refined grains and added sugars, and increased odds of type 2 diabetes, prediabetes and obesity. The study also found that replacing a portion of dietary carbohydrates with protein, particularly from sources such as pulses, legumes and dairy, was associated with lower diabetes risk. This does not mean that carbohydrates are inherently unhealthy or that Indians should eliminate rice or wheat from their diets. Rather, it highlights the importance of diet quality, portion sizes and dietary balance. For many Indians, the issue is not simply the presence of carbohydrates but a dietary pattern dominated by refined grains and added sugars, combined with insufficient protein, fibre, vegetables and other nutrient-dense foods. Hypertension: The silent component of the crisis If diabetes is often associated with blood-sugar testing, hypertension presents a different challenge. High blood pressure can remain undetected for years because many people experience no obvious symptoms. Persistently elevated blood pressure places additional strain on blood vessels and the heart and increases the risk of cardiovascular disease, stroke and kidney problems. India’s National Programme for Prevention and Control of Non-Communicable Diseases includes population-based screening for hypertension and diabetes among people aged 30 years and above. The screening process includes assessment of risk factors, BMI and blood pressure, among other measures. Government data also indicate the scale of the response required. The National NCD portal reported more than 9.36 crore people under treatment for hypertension and diabetes as of June 2026. Importantly, the number of people receiving treatment should not be interpreted as the total number of Indians living with these diseases. It represents people captured within the government’s treatment system. Why are metabolic diseases increasing? There is no single cause. 1. Changing food habits India’s food environment has changed rapidly. Traditional diets have increasingly been supplemented or replaced by packaged foods, sugary drinks, refined carbohydrates, fried foods and highly processed snacks. Convenience has become an important factor, particularly in urban areas where long working hours and commuting leave less time for preparing meals. 2. Physical inactivity Modern work increasingly involves sitting for prolonged periods. Office jobs, commuting, screen-based entertainment and reduced everyday physical activity can result in people expending far fewer calories than previous generations. Regular exercise cannot completely compensate for an unhealthy diet, but physical activity remains an important component of metabolic health. 3. Urbanisation Urbanisation has brought economic opportunity

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India Accounts for Nearly 70% of South Asia’s Childhood Leukaemia Cases: Lancet Study

India bears the highest burden of childhood leukaemia in South Asia, accounting for nearly 70% of all reported cases in the region, according to a new study published in The Lancet. Researchers attribute the high numbers largely to the country’s vast child population, along with challenges in timely diagnosis and access to specialised treatment. An estimated 25,000 to 50,000 children below the age of 15 are diagnosed with leukaemia in India every year. In West Bengal alone, population-based estimates suggest that around 1,000 to 1,800 children develop the disease annually. Data from hospitals such as Chittaranjan National Cancer Institute and NRS Medical College indicate that acute leukaemia represents nearly 39% of all paediatric cancers in the state. Leukaemia remains the most common childhood cancer in India, accounting for nearly 30–40% of all paediatric cancer cases. Among these, Acute Lymphoblastic Leukaemia (ALL) constitutes nearly three-fourths of diagnoses. Dr. Pritam Singha Roy, Consultant Paediatric Oncologist at Tata Medical Centre, said the number of reported cases has increased over the past decade due to improved diagnostic facilities, greater public awareness and government initiatives that have enabled more children to receive timely treatment. Experts note that India primarily tracks new cancer diagnoses rather than the total number of children living with the disease, making incidence data more readily available than prevalence figures. According to Dr. Narendra Agarwal, Haematologist and Bone Marrow Transplant Physician at Rajiv Gandhi Cancer Institute & Research Centre, India’s large population contributes significantly to its high case count, while many neighbouring countries may still have substantial numbers of undiagnosed or unreported cases. He added that delayed diagnosis remains a major concern, although treatment facilities and patient outcomes have improved considerably across the country. The study examined childhood cancer trends across the eight SAARC nations—India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, Afghanistan and the Maldives—which together are home to nearly 600 million children aged 0–14 years. Researchers estimated that the region recorded 37,716 new childhood cancer cases and 17,698 deaths in 2022. India accounted for 25,939 cases (68.8%), followed by Pakistan with 7,841 cases (20.8%). Leukaemia emerged as the leading childhood cancer across all SAARC countries, representing between 35% and 50% of cases, while central nervous system (CNS) tumours ranked second. The report also highlighted significant disparities in mortality and healthcare access across South Asia, with mortality-to-incidence ratios varying widely among countries. It called for stronger regional collaboration to improve cancer registration systems, expand access to specialised paediatric oncology care and ensure uninterrupted treatment for affected children. Source: TNN

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Almost Every Country Overuses Strong Antibiotics, Fueling Drug Resistance: Lancet Study

A new global study has found that nearly every country is overusing powerful antibiotics that are meant to be reserved for severe infections, raising concerns over the growing threat of antimicrobial resistance (AMR). The findings, published in The Lancet Public Health, suggest that inappropriate use of these medicines is accelerating the spread of drug-resistant bacteria. Researchers from the University of London and other institutions developed a framework to estimate the ideal level and type of antibiotic use for individual countries. They say the tool can help governments assess whether their antibiotic prescribing patterns are appropriate and guide efforts to curb both excessive and inappropriate antibiotic use. The World Health Organization (WHO) categorises antibiotics under its Access, Watch and Reserve (AWaRe) classification. ‘Access’ antibiotics, such as amoxicillin, are recommended as first-line treatments for common bacterial infections. ‘Watch’ antibiotics are stronger drugs that should only be used when standard treatments are ineffective, while ‘Reserve’ antibiotics are considered last-resort medicines for life-threatening drug-resistant infections. In 2024, the United Nations General Assembly endorsed the AWaRe framework as the global standard for antibiotic monitoring and set a target for at least 70% of antibiotic use worldwide to come from the Access category by 2030. However, researchers noted that no country-specific benchmarks had been established until now. The study grouped countries into four clusters based on factors including income levels, infectious disease burden and antibiotic resistance. Using 2019 data, the researchers estimated that around 43 billion antibiotic treatment courses were required globally, averaging approximately one course per person annually. They concluded that nearly 77% of these should ideally come from the Access category, reinforcing the UN’s 70% target. When researchers compared these estimates with actual antibiotic consumption data from 67 countries and territories, they found widespread misuse. Around 72% of the countries consumed more antibiotics overall than necessary, while 99% exceeded the expected use of Watch antibiotics. The analysis also found that more than half of the countries were underusing Reserve antibiotics, suggesting that some patients with serious drug-resistant infections may not be receiving the specialised treatments they require. Additionally, 60% of the countries continued prescribing antibiotics that the WHO no longer recommends. India, which falls under the study’s second cluster, was estimated to require between 9.9 and 14.7 defined daily doses (DDD) per 1,000 inhabitants per day (DID). However, the country’s actual antibiotic use stood at 18.3 DID, with Watch antibiotics accounting for 9.3 DID and Access antibiotics making up only 4.5 DID. The researchers also highlighted a significant global disparity. Low- and middle-income countries, which face a greater burden of infectious diseases and antimicrobial resistance, require relatively higher access to specialised Watch and Reserve antibiotics. Yet, wealthier nations currently consume these medicines at much higher rates. The authors urged governments to adopt stronger national antibiotic stewardship policies that reduce unnecessary prescriptions while ensuring patients with genuine medical needs have timely access to appropriate treatments. Source: PTI

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Poor Muscle Health Along With Obesity May Significantly Raise Type 2 Diabetes Risk: Study

A combination of poor muscle health and excess body fat may substantially increase the risk of developing type 2 diabetes, according to a new study published in the journal Diabetes Care. Researchers found that individuals with sarcopenic obesity—a condition marked by both obesity and reduced muscle mass and strength—face a considerably higher diabetes risk than those affected by either condition alone. The research, led by Zhongyang Guan, a PhD candidate at Curtin University in Australia, analyzed health data from 479,607 participants in the UK Biobank who were free of diabetes at the start of the study. During an average follow-up period of more than 14 years, nearly 32,950 participants developed type 2 diabetes. According to the findings, people with sarcopenic obesity were more than 3.5 times as likely to develop type 2 diabetes compared to individuals with a healthy body composition. They also had a 19% higher risk than people with obesity alone and a 91% higher risk than those with only sarcopenia. The study revealed that nearly 15% of participants with sarcopenic obesity developed type 2 diabetes within 10 years, compared with around 11% of those with obesity alone and only 3% of individuals without obesity or sarcopenia. Researchers also observed that the association between sarcopenic obesity and diabetes was particularly pronounced among women and adults younger than 60 years. Guan noted that while excess body weight is widely recognized as a diabetes risk factor, the findings highlight that muscle health plays an equally important role in determining an individual’s risk. The authors concluded that evaluating both body fat and muscle health could improve the identification of people at high risk of developing type 2 diabetes. Senior author Professor Mario Siervo from Curtin University’s Faculty of Health Sciences said healthcare providers should consider assessing muscle health alongside body weight. He added that maintaining muscle strength through regular physical activity, resistance training, and healthy lifestyle habits may help reduce the growing burden of type 2 diabetes, particularly as obesity rates continue to rise and populations age. Source: PTI

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One Billion More People Now Exposed to Extreme Heat Stress Than in the 1970s, Study Finds

A new study has revealed that nearly one billion more people across the world are now experiencing at least one day of extreme heat stress every year compared to the 1970s, highlighting the growing intensity, frequency, and duration of dangerous heat conditions globally. The research, conducted by scientists from the European Centre for Medium-Range Weather Forecasts based in the U.K. and Germany, suggests that governments urgently need stronger heat-health action plans, early warning systems, urban cooling strategies, and improved climate risk assessments to better protect populations from rising heat-related threats. Heat stress refers to the overall heat burden placed on the human body and is determined by multiple environmental factors, including temperature, humidity, wind speed, and solar radiation. Researchers used the Universal Thermal Climate Index (UTCI), commonly described as a “feels-like” temperature, to evaluate how these combined factors impact human health. Published in the journal Nature Climate Change, the study examined global heat stress data spanning from 1950 to 2024 and found that both daytime and nighttime temperatures have significantly intensified since the 1970s. According to the researchers, during the 1970s nearly 55 percent of the world’s population experienced around 90 days of strong heat stress annually. In today’s climate, that figure has increased to 70 percent. Exposure to at least one day of extreme heat stress has also risen from 16 percent to 22 percent globally, translating into roughly one billion additional people being affected. The analysis further found that nighttime temperatures are rising faster than daytime temperatures. The 10 warmest nights recorded annually have been warming at an average rate of 0.32 degrees Celsius per decade, slightly higher than the 0.27 degrees Celsius increase observed during the 10 hottest daytime periods. Researchers also noted that extreme “feels-like” temperatures are becoming more frequent across every continent, with subtropical regions witnessing the sharpest rise in heat exposure. Areas including southern parts of North America, southern Europe, northern and southern Africa, as well as South America, are now facing up to 50 extra days every year of strong to extreme heat stress compared to conditions seen in the 1970s. The findings add to growing concerns over the accelerating impact of climate change and underline the urgent need for countries worldwide to develop stronger adaptation measures as extreme heat events become increasingly common. Source: PTI

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India Aims to Eliminate Sickle Cell Anaemia Before 2047, Says President Murmu

Droupadi Murmu has expressed confidence that India will eliminate sickle cell anaemia much before the government’s 2047 target, urging all states to intensify efforts and spread awareness about the disease, particularly among tribal communities where prevalence remains significantly higher. Speaking at a government event in Omkareshwar, Khandwa district of Madhya Pradesh, the President said that with collective participation from all states, the country is well-positioned to achieve its mission of eradicating sickle cell-related diseases ahead of schedule. She highlighted that since the launch of the National Sickle Cell Anaemia Elimination Mission in 2023, several major milestones have already been achieved, including the screening of over seven crore individuals aged between 0 and 40 years. The initiative has so far identified nearly 2.5 lakh affected patients and over 20 lakh carriers, making it one of the world’s largest genetic disease screening programmes. President Murmu also commended Madhya Pradesh for screening more than 1.25 crore people and distributing genetic counselling cards to a majority of beneficiaries. She emphasized that sickle cell anaemia should not be underestimated, as the hereditary disease passes from one generation to another, but can be treated and eventually eliminated through sustained intervention. The President praised the mission launched by Narendra Modi in Shahdol in 2023, describing it as India’s first nationwide campaign integrating public health, tribal welfare, genetic science, and digital monitoring. She noted that 17 states are actively participating in the campaign to help India achieve a sickle cell disease-free future. Source: The Hindu

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Kerala Reports 85 Confirmed Shigellosis Cases in 2026, Health Department Intensifies Preventive Measures

Kerala has reported 85 confirmed cases and more than 70 suspected cases of shigellosis, a highly contagious bacterial infection commonly known as bacillary dysentery, as of June 7, prompting health authorities to strengthen preventive measures across the state. The disease, caused by Shigella bacteria, has been detected sporadically in all districts, with localized outbreaks reported in Wayanad, Kozhikode, Alappuzha, and Malappuram. In Wayanad, two students from Mar Baselios School tested positive on Monday, while several other children are suspected to have contracted the infection. Health officials have expressed concern over the vulnerability of children under five years of age, the elderly, and immunocompromised individuals. While most healthy adults recover without complications, the disease can prove fatal in high-risk groups. Kerala has recorded two child fatalities linked to shigellosis this year, one in April and another on June 6, both in Kozhikode. Shigellosis spreads through contaminated food, water, and surfaces, as well as through close contact with infected individuals. Symptoms typically appear within one to two days and include fever, diarrhoea, vomiting, nausea, abdominal discomfort, blood in stools, and frequent painful bowel movements. The Health Department has urged the public to maintain strict personal and food hygiene practices, including thorough handwashing with soap before meals, food preparation, and after using the toilet. People have also been advised to consume boiled drinking water, avoid stale or raw foods, use ORS to prevent dehydration, and complete prescribed antibiotic courses. Households with infected individuals have been instructed to keep personal items, utensils, clothing, and bedding separate to prevent transmission. Recovered patients have also been advised to avoid serving food or attending public gatherings for at least two weeks after symptoms disappear. Food establishments have been directed to ensure hygienic food handling practices and verify the health status of food handlers. Authorities have also warned against the use of industrial ice in beverages. Health Minister K. Muraleedharan said the Food Safety Department has been instructed to intensify inspections and take action, including issuing closure notices, against eateries and street vendors found violating hygiene norms. Meanwhile, Opposition Leader Pinarayi Vijayan called for urgent and coordinated action by health authorities and local self-government bodies to prevent further spread of the infection across the state. Source: The Hindu

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Bangladesh Measles Death Toll Climbs to 585 as Outbreak Continues to Spread

Bangladesh’s measles outbreak has claimed two more lives, pushing the total death toll to 585 since March 15, according to health authorities. The latest fatalities, both involving children, were reported within a 24-hour period ending Sunday morning and have been classified as suspected measles deaths by the Directorate General of Health Services (DGHS). With these additions, the number of suspected measles-related deaths has risen to 495, while 90 deaths have been officially confirmed. The outbreak continues to place significant pressure on the country’s healthcare system, with 1,324 new suspected cases reported over the past day. This has increased the cumulative number of suspected infections to 70,936. Meanwhile, 53 new confirmed cases were recorded, taking the total confirmed infections to 9,049. Since mid-March, 56,886 people with suspected measles symptoms have been hospitalised across Bangladesh. Of these, 52,841 patients have recovered, according to DGHS data. The crisis has also sparked concerns over vaccine availability. Last week, UNICEF revealed that it had repeatedly warned Bangladesh’s previous interim administration, led by Muhammad Yunus, about vaccine shortages that could lead to a widespread outbreak. Speaking at a media briefing in Dhaka, UNICEF Bangladesh Representative Rana Flowers said the organisation had sent multiple letters and raised the issue during at least 10 meetings with health officials between 2024 and 2026. According to Flowers, UNICEF consistently cautioned authorities that delays in vaccine procurement could trigger a major public health emergency. She further noted that UNICEF Deputy Executive Director Ted Chaiban had also highlighted the issue during discussions with Bangladesh’s Foreign Ministry during his visit to the country last year. UNICEF has pledged to support the ongoing investigation launched by the current BNP-led government and provide relevant evidence regarding the vaccine shortage and the subsequent outbreak. Source: IANS

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WHO Estimates COVID-19 Linked to 22.1 Million Excess Deaths Worldwide Between 2020 and 2023

A new report released by the World Health Organization has revealed that the COVID-19 pandemic was associated with an estimated 22.1 million excess deaths globally between 2020 and 2023, underscoring the devastating impact the crisis had on health systems and societies worldwide. Published in the WHO’s latest World Health Statistics report, the figure is more than three times higher than the officially reported COVID-19 death toll, as it includes both direct fatalities caused by the virus and indirect deaths resulting from disrupted healthcare services, delayed treatments, and strained medical systems. According to the report, the pandemic erased nearly a decade of progress in global life expectancy, with recovery remaining slow and uneven across different regions of the world. Despite the setbacks, the report highlighted encouraging progress in several public health areas. New HIV infections declined by 40% between 2010 and 2024, while tobacco and alcohol consumption also registered reductions during the same period. The number of people requiring treatment for neglected tropical diseases dropped by 36%. The WHO further noted improvements in access to essential services between 2015 and 2024. Nearly 961 million people gained access to safe drinking water, 1.2 billion received improved sanitation facilities, 1.6 billion gained access to basic hygiene services, and 1.4 billion people benefited from cleaner cooking solutions. Regional progress was also evident in some areas. The WHO African Region recorded a 70% reduction in HIV infections and a 28% decline in tuberculosis cases, outperforming global averages. Meanwhile, the South-East Asia Region was reported to be on course to meet its 2025 malaria reduction milestone. However, the report warned that several health challenges continue to threaten global progress. Malaria incidence has risen by 8.5% since 2015, moving the world further away from international targets. Anaemia continues to affect 30.7% of women of reproductive age globally, with little improvement over the last decade. The prevalence of overweight children under five reached 5.5% in 2024, while violence against women remains a serious concern, with one in four women worldwide experiencing intimate partner violence. WHO Director-General Tedros Adhanom Ghebreyesus stated that the findings reflect “both progress and persistent inequality,” adding that millions of people, especially women, children, and underserved populations, still lack access to the fundamental conditions required for healthy living. The report also expressed concern over slowing progress toward Universal Health Coverage (UHC). Between 2015 and 2023, the global UHC service coverage index improved only slightly from 68 to 71. Additionally, one in four people globally experienced financial hardship due to healthcare expenses, while nearly 1.6 billion people were either living in or pushed into poverty because of out-of-pocket medical costs in 2022. Childhood vaccination coverage also remains below global targets, contributing to renewed outbreaks of preventable diseases. Although maternal mortality has declined by 40% since 2000 and under-five mortality by 51%, many nations are still unlikely to meet the 2030 health goals. Progress in reducing deaths from non-communicable diseases has slowed considerably since 2015. The WHO further highlighted environmental and lifestyle risks contributing to poor health outcomes. Air pollution was linked to an estimated 6.6 million deaths globally in 2021, while unsafe water, sanitation, and hygiene conditions contributed to 1.4 million deaths in 2019. Yukiko Nakatani stressed the urgent need for stronger investment in primary healthcare, prevention strategies, and sustainable health financing to build more resilient healthcare systems. The report also exposed major shortcomings in global health data collection. By the end of 2025, only 18% of countries were reporting mortality data to the WHO within a year, and nearly one-third had never submitted cause-of-death information. Out of an estimated 61 million deaths worldwide in 2023, only about one-third included cause-of-death reporting, while just one-fifth contained properly coded International Classification of Diseases (ICD) data. The WHO warned that these data gaps severely weaken the ability of governments and health agencies to monitor disease trends, compare health outcomes internationally, and respond effectively to future public health emergencies. Source: The Hindu

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Two Indian Nationals on MV Hondius Show No Symptoms as India Monitors Hantavirus Situation

The Ministry of Health and Family Welfare has confirmed that two Indian nationals currently onboard the cruise ship MV Hondius, where hantavirus cases were reported, are asymptomatic and remain under medical observation under international health guidelines. In an official statement issued Friday, the ministry said it is closely tracking developments and coordinating with the World Health Organization along with other global health bodies. Authorities added that preventive public health steps are being taken to ensure the safety of Indian citizens. According to preliminary information shared through the International Health Regulations (IHR) mechanism, eight probable hantavirus cases have been identified on the vessel so far. Out of these, five have been laboratory confirmed, while three deaths have also been reported. Officials stated that WHO was informed about the outbreak during the first week of May. The two Indian passengers onboard have not shown symptoms and continue to be monitored. The virus involved is reported to be the Andes strain of hantavirus, a variant found in South America that has limited ability for human-to-human transmission. Experts note that transmission generally requires close and prolonged contact. WHO has currently assessed the wider public health risk as low, though more cases may emerge due to the virus’s long incubation period. WHO is also overseeing response measures under IHR protocols, including diagnostic assistance, epidemiological review, and safe travel arrangements for passengers and crew. As a precaution, India’s Public Health Emergency Operations Centre under the National Centre for Disease Control and Integrated Disease Surveillance Programme held a high-level preparedness review meeting. Hantaviruses are commonly spread through rodents such as mice and rats, or through contact with their urine, droppings, or saliva. Symptoms may develop between one and eight weeks after exposure and often include fever, headache, muscle pain, nausea, vomiting, and abdominal discomfort. There is no specific cure for hantavirus infections, but early supportive treatment can improve outcomes by managing respiratory, heart, and kidney complications. Prevention mainly depends on avoiding exposure to infected rodents. Source: The Hindu

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