Treating diseases — going back to go forward  Premium

In The Hindu’s weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying there. This week: life after death, ethics of medical research and a hopeful new TB regime.

This week in health: life after death, ethics of medical research and a hopeful new TB regime.

It’s rare that we have, in these parts, a real medical whodunit, an unravelling of a medical mystery, nearly 200 years post facto too. While post-mortems are common, it is undeniably rare that one digs deep and long, and employs every tool in the trade to smoke out the mystery behind what happened all that long ago. That is what makes this article all that interesting: Who killed Beethoven? Nearly two centuries after Beethoven the musical genius of the Western world, who suffered from what seemed like multiple ailments, passed on, scientists finally discovered his cause of death. Hepatologist Abby Cyriac Philips breaks down for us the paleopathological process of investigation that used locks of hair and skull fragments reportedly to study the cause of death. Incidentally, close to World Hepatitis Day, it became obvious that the culprit was Hepatitis B, egged on of course by the quarts of wine generously consumed in those days. 

Paleopathology, or studies on the preserved remains of ancient human populations, have been revelatory. Besides offering valuable insights into a past life, they also provide for researchers an ability to see into the past, in order to see into the future. From diagnosis of tuberculosis, leprosy, and venereal and non-venereal diseases in fossils, mummified remains over the years, for instance, have provided an understanding of how the pathogens have behaved, the paths of mutation, to a possible better understanding of the vector and its host. Turns out old bones can help us gaze into the crystal ball of the past, after all.

(While we are on the subject of Hepatitis, do check out my quiz on the site.)

From the past to the present, even the future maybe. India takes its first step towards opening the door to Controlled Human Infection Studies, says Bindu Shajan Perappadan.  For long, it has been believed that CHIS has a bunch of ethical issues, as it involves intentionally exposing healthy human volunteers to pathogens in a controlled environment. However, the Indian Council of Medical Research’s (ICMR) Bioethics Unit is set to change this. Of course, it has been employed outside of India to study multiple pathogens and possible solutions. It is more often used to study ‘less-deadly diseases’ such as influenza, dengue, typhoid, cholera and malaria, unlike in traditional clinical studies. At this point of time, the ICMR has only invited comments on its consensus policy paper on CHIS for a month. Do read this explainer by R. Prasad on what the CHIS means to India, to understand the ethical concerns, its advantages and what could possibly go wrong. Also read The Hindu’s editorial on CHIS, calling it a welcome move, but insisting that robust institutional mechanisms be put in place. 

Further, on detection, Vinod Scaria and Sridhar Sivasubbu record how cell-free DNA promises to transform how we find diseases. Thanks to a cfDNA-based technique, clinicians can now screen mothers from a few millilitres of blood, obtained after nine or ten weeks of pregnancy, to ensure the developing foetus is devoid of some chromosomal abnormalities.

Staying on the topic of diseases, and continuing to note the rising trend of dengue cases, globally, here is another article on how changing climate climatic conditions in Europe, such as increased heat waves, floods, and prolonged hot summers, have created favourable environments for dengue-causing mosquito species. Bani Jolly et al explain that the recent surge in dengue cases worldwide ,including India, means immediate attention of the government and action from them.