HIV-AIDS: II

(Continued from "HIV-AIDS: MYTHS and FACTS-I")

Some more information (sent by Dr.Ismail):

TRANSMISSION OF THE VIRUS:

HIV transmission can occur when blood, semen (cum), pre-seminal fluid (pre-cum), vaginal fluid, or breast milk from an infected person enters the body of an uninfected person.

HIV can enter the body through a vein (e.g., injection drug use), the lining of the anus or rectum, the lining of the vagina and/or cervix, the opening to the penis, the mouth, other mucous membranes ( e.g., eyes or inside of the nose), or cuts and sores. Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria.

These are the most common ways that HIV is transmitted from one person to another:

* by having sex (anal, vaginal, or oral) with an HIV-infected person;
* by sharing needles or injection equipment with an injection drug user who is infected with HIV; or
* from HIV-infected women to their babies before or during birth, or through breast-feeding after birth.

HIV and AIDS:

Prior to 1996, scientists estimated that about half the people with HIV would develop AIDS within 10 years after becoming infected. This time varied greatly from person to person and depended on many factors, including a person's health status and their health-related behaviors.

Since 1996, the introduction of powerful anti-retroviral therapies has dramatically changed the progression time between HIV infection and the development of AIDS. There are also other medical treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. Because of these advances in drug therapies and other medical treatments, estimates of how many people will develop AIDS and how soon are being recalculated, revised, or are currently under study.

Also see the blog: iMedicine

HIV-AIDS: MYTHS and FACTS-I

Recently I have received a forwarded mail which stressed the need for creating awareness among the public about HIV and AIDS. The mail was from "Mayank, Brand Manager (Product Manager) handling anti HIV/AIDS portfolio (called as Antiretroviral Drugs) in Ranbaxy...". Here I go with more details and clarifications from Dr. Ismail who is doing research on HIV and TB in New jersy.
I am grateful to Trivikram, Bangalore and Vidya Sagar, hyderabad who forwarded this mail to me and also to Dr. Ismail who responded to my mail despite his busy schedule.

MYTHS:

As per the mail, "There was a story on junk some days back where it is said that a boy got infected by HIV virus by eating pani-puri.

Dr. Ismail says: Not true...virus will not survive and no transmission is reported through ingestion.

And there have also been rumours where people are affected by the HIV virus when they got pricked by an HIV infected needle in theaters..."

Dr. Ismail says: Maybe, if it is a fresh prick and the chance is 0.3% only even then.

NOW THE FACTS:

HIV (virus) requires *ONLY* *Blood or Semen* as medium to transmit from one body to another.

Dr. Ismail says: Even contact of mucous membranes is enough for transmission , saliva does contain virus but transmission is negligible....

HIV *can not* transmit even through *Saliva* (mucous) i.e. even if HIV-infected patient coughs and another person is exposed to his sputum (cough), the virus still can not transmit because concentration of virus particles in sputum is almost NIL & exposure to air anyway kills virus in fraction of seconds.


Dr. Ismail says: last sentence is true but not in seconds though!

In case HIV-infected person got an injury (like the cut in below mentioned story) and he is bleeding, the virus can transmit to another person only if another person has a cut/wound in his body & that too when *blood from both person comes in contact with each other* (this is also very very rare unless bleeding is very high) and not otherwise.

Dr. Ismail says: True but when blood contacts a breach in mucous membrane infection is possible theoritically!

HIV can never survive in any liquid medium other than blood or semen (& please for God sake ... never in Pani Puri wala's pani).

Dr. Ismail endorses: Not in pani-puri but HIV is found in varying concentrations or amounts in blood, semen, vaginal fluid, breast milk, saliva, and tears.

Even if one drinks an HIV infected blood (or semen) of someone (ingest through Gastro Intestinal track), the virus can not survive in the acidic pH of stomach. Highest extent of acidity is 0 (practically not possible) so imagine 1 as pH which is in our stomach.

Dr. Ismail says: True.
(Note: pH levels in our stomach may go as low as 1.0. This is a very acidic level. Solutions at a pH of 1.0 are strong enough to burn through fabrics, injure eyes or irritate skin. When food comes into the stomach, the pH may rise to 3.0 to 4.0)

there have also been rumours where people are affected by the HIV virus when they got pricked by an HIV infected needle in theaters..."

Dr. Ismail says: Maybe, if it is a fresh prick and the chance is 0.3% only even then.

Exposure of less than 1 second in AIR KILLS the HIV virus (story of needle pricks in Cinema theatres goes down the drain) .. Even if blood from a wound (of infected person) dries up (*blood clot*), *the virus dies* and can not infect anyone else.

Dr. Ismail says: True but as I mentioned earlier if that guy can make a prick on himseld and again prick other person and if the needle enters a vein or bloodvessel there is a risk of transmission.

HIV transmission is *ONLY* an *INFECTION* i.e. entrance of virus in one's body. It *DOES NOT MEAN AIDS*.

Dr. Ismail says: True AIDS is a later stage in the spectrum of illness caused by HIV and as a matter of fact people die of other infections like TB and diarrhea caused by lowering of immunity by HIV and not by HIV perse.

An HIV-infected person (after entrance of virus) can progress to condition of AIDS usually after *8 to 10 YEARS* (not in 15 days as in the mentioned story)

Dr. Ismail says: It may take from few months to 10 years depending on the viral load and innate immunity of the individual

It is *not HIV (virus) nor AIDS that kills a human* ..... the virus attacks immune cells (cells that fight against foreign pathogens/antigens) and hence a person's ability to fight against infections & diseases slowly diminishes and the person ultimately dies of a disease which is most likely TB.

Most importantly, HIV is no longer a dreadful disease .... it is "* CHRONIC MANAGEABLE DISEASE*" just like Diabetes or Hypertension.

Dr. Ismail says: It can be managed with practising healthy methods and antiretrovirals but can't be compared to Diabetes or Hypertension.

If there is anything you need to be careful from to prevent HIV, it is *Unsafe Sex*, *Blood transfusion* (check before taking) / Blood donation (use sterilized needles only) and any *blood contact during an accident *or so where amount of bleeding is very high.

(See the next post: HIV-AIDS: II)

Vande Mataram

A few "Letters to the Editor" published in today's The Hindu:

The controversy triggered by the Union Human Resource Development Minister's observation that the recitation of Vande Mataram in educational institutions is not mandatory and the statement of the Jama Masjid Shahi Imam, Syed Ahmed Bukhari, that its rendition is against the tenets of Islam is unfortunate. The national song only salutes the motherland. -Ahmad M. Abdi, Mumbai

Vande Mataram is nothing but a greeting to the motherland and an appreciation of its enchanting natural beauty. It is just a patriotic national song. Let us not offer a narrow, religious interpretation to it. -Mumtaz Ali Khan, Bangalore

'Vande Mataram' was one among the many slogans that united India. According to an HRD directive to the States, the national song must be recited in all educational institutions on September 7 to mark its centenary. Mr. Singh has now indicated that the recitation is not mandatory. Is it necessary to pander to the sentiments of a few in such matters? -D. Venkateswar Rao, Paloncha, A.P.

Is it in order for the Centre to direct the educational institutions to recite the song to honour the patriots and then give in to objections from some quarters? -M.S. Rajasekaran, Chennai

That the recitation of the national song has been made voluntary so as not to hurt the sentiments of a few who feel asking them to sing it would amount to their suppression is condemnable. At a time when the youth are unaware of the origin and importance of our national anthem and song, Mr. Singh's move will go a long way in ensuring that they remain thus. -Mahesh Kolary, Palakkad, Kerala

Defending poet Subramania Bharati's patriotic songs that were banned by the British, Congress leader Satyamurthi pointed to the universality of his songs. The U.S. currency carries the words `In God We Trust,' though many atheists have objected to them. Everyone who is proud to be an Indian should respect the national song. Minority or majority sentiment should not be attached to it. -V.E. Venkataramani, Chennai

What led to floods?

From Gargi Parsai's report in The Hindu

Expert says the authorities waited for the dams to fill up before releasing the water

The dams had 47 per cent water before the monsoon
This is "negligence" of operations

NEW DELHI : It seems that mismanagement and negligent operations of the large reservoirs on the rivers cause the floods in Gujarat, Maharashtra, Madhya Pradesh, Karnataka and Andhra Pradesh.

Himanshu Thakkar of the South Asia Network on Dams, Rivers and People, claims that the big dams that were expected to regulate water flows were actually responsible for the floods in these States that also happen to have the largest number of big reservoirs. Dams in these States had an average of 47 per cent storage before the monsoon set it, which in itself was a potential for causing floods.

Demanding a probe into what caused floods in these States and whether they were avoidable, Mr. Thakkar said action should be taken against those responsible for "mismanagement."

"The nation has paid huge costs in creating these reservoir capacities, and negligence in the dam operations is leading to disastrous consequences which are entirely avoidable," he said.

Storage

Officials from the Central Water Commission told that normally dams were supposed to be emptied out before monsoon by releasing water for irrigation and other purposes. "Reservoir storages are built up at the end of the monsoon, to prevent floods downstream."

But as per the Central Water Commission statistics, in the Tapi basin, various dams had upto 41 per cent storage before monsoon.

In the Narmada basin, the Tawa dam was already filled up to 22.58 per cent before the monsoon.

Likewise, in the Krishna basin, the Koyna dam was filled up to 25.19 per cent, the Khadakvasla up to 12.5 per cent, the Narayanpur up to 44.1 per cent, the Srisailam up to 17 per cent and the Nagarjunsagar was filled up to 47.08 per cent.

In the Godavari basin, the Jayakwasi had a storage of 28.33 per cent and in the Sabarmati basin, the Dharoi dam was filled up to 42.59 per cent.

Mr. Thakkar said releases from the dams — under instruction from the State Irrigation departments — after the onset of the monsoon were normally kept under wraps. More often than not, the secrecy hid gross neglect and mismanagement, as had happened this year.

He alleged that the large-scale loss of lives and businesses in Surat could have been avoided by early, regulated releases when it was known that the Ukai dam across the Tapi was filling up fast. The dam was 51 per cent full on July 20, 77.54 per cent full on August 3 and 100 per cent on August 7. Even when it was getting high inflows of up to nine to ten lakh cusecs, the authorities waited for the dam to fill up before releasing water. This meant the sudden release of up to 10 lakh cusecs for several days, leading to unprecedented flooding. This, when the Tapi downstream from dam had a drainage capacity of only about 3.5 lakh cusecs. The releases also coincided with high tide, leading to prolonged flooding.

Mr. Thakkar claimed that in the Sardar Sarovar Project also, the main canal was opened by just 0.5 metres on August 2, releasing just about 580 cusecs,when inflows were over 98,000 cusecs. Downstream releases were just around 21,000 cusecs. This led to a build-up of water, of up to 128 metres, leading to "illegal and avoidable" submergence of land, houses and habitats of thousands of rural and tribal families. The situation was similar in the Krishna, Godavari and Sabarmati basins.

New Report

`Pesticide levels in soft drinks too high'

THE HINDU Special Correspondent
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New study indicates pesticides 24 times higher than Bureau of Indian Standards norms

# "The levels in some samples exceeded the BIS standards by 140 times for the deadly pesticide Lindane, a confirmed carcinogen"
# "Heptachlor, banned in India, was found in 71 per cent of the samples, at levels four times higher than BIS standards"
****************************************************************
NEW DELHI: The Centre for Science and Environment (CSE) on Wednesday came out with a new report on the levels of pesticides in soft drinks available in the market.

The report indicated the presence of an average of three to five different pesticides in all the samples, 24 times higher than the Bureau of Indian Standards (BIS) norms, which have been finalised but not yet notified.

The latest CSE study is based on tests conducted on 57 samples of 11 soft drink brands from 25 different manufacturing plants of Coca-Cola and Pepsico, spread over 12 States.

The levels in some samples — for instance, Coca-Cola bought in Kolkata — exceeded the BIS standards by 140 times for the deadly pesticide Lindane, a confirmed carcinogen.

Similarly, a Coca-Cola sample manufactured in Thane contained 200 times more of the neurotoxin, Chlorpyrifos, than the BIS standard, said Sunita Narain of CSE releasing the report here.

Three years after the centre released its first findings on pesticide residue in soft drinks, the new study shows that nothing much has changed and soft drinks remain unsafe and unhealthy. Even the directions given by the Joint Parliamentary Committee have been disregarded: standards for safety have been finalised but blocked because of opposition by the companies, Ms. Narain alleged.

In 2003, the average level of pesticide residue in samples from Delhi was 34 times above the same BIS standard, but this time the CSE has found pesticide residue as high as 52 times in bottles brought in Kolkata and 42 times in bottles bought in Nainital and Gorakhpur. Similarly, bottles bought in Mumbai, manufactured in Thane and Nagpur, allegedly had residue 34 times above the BIS standard.

Heptachlor, banned in India, was allegedly found in 71 per cent of the samples, at levels four times higher than BIS standards.

The average amount of pesticide residue found in all the samples was 11.85 parts per billion (ppb) or 24 times higher than the BIS standards for total pesticides in soft drinks (0.5 ppb). Pepsi Cola contained 30 times higher residue on an average, while Coca-Cola contained 27 times higher than average.

Endorsed by JPC

The current study was conducted by the same Pollution Monitoring Laboratory of CSE that had tested the samples in 2003, and the methodology was endorsed by the JPC despite doubts raised by the cola companies over the veracity of the tests. This time further improvements had been made, and the laboratory now had ISO 9001:2000 quality management system accreditation and it was equipped with state-of-the-art GS-MS equipment, Ms. Narain said.

In February 2004, confirming the unsafe levels of pesticides in soft drinks, the JPC had directed the Government to set standards for these residues in the products. Since then, BIS has, in its sectional committee, met over 20 times to deliberate on the standards, and in October 2005 the standards were finalised.

Ms. Narain alleged that the final standards were being opposed by the Union Health and Family Welfare Ministry on the ground that more research needed to be done. In this respect, she quoted a letter written by the Union Health Secretary to his counterpart in the Ministry of Consumer Affairs. The letter was written on March 29, 2006 — the day the standards were to be formally finalised. The standards were finalised, but not notified, Ms. Narain said.