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Kerala and the diversification of diseases

Kerala is reporting a host of diseases that are becoming far more prevalent in recent years. Many were almost entirely unreported within the state. Others were simply less common.

The increased prevalence of these diseases may indicate diseases from other states are spreading to Kerala. In the case of non-communicable diseases (NCDs) there may be as of yet unidentified causes, such as alterations to lifestyles, that are causing increased rates of diseases such as cancer.

Alternatively, the diseases may have always occurred at a similar rate to what is now being observed. Improvements to surveillance techniques may be giving more accurate recordings of disease prevalence.

Infectious diseases

Infectious diseases such as scrub typhus are making an appearance in Kerala for the first time. The disease was not recorded within Kerala until the past few years, claims Dr Rakesh P S of the Amrita Institute of Medical Sciences.

Scrub typhus had faded into obscurity following the end of the Second World War. However, India is currently seeing a resurgence of the disease. The first recent cases of which occurred when a number of cadets of the Indian Military Academy in Dehradun became infected with the disease following treks into the surrounding hills.

The disease is typically limited to rural areas, which may suggest it was still occurring during its time in obscurity. These cases may not have been recorded due to poor surveillance systems in rural India. The disease is caused by the Rickettsia bacteria, and is transmitted to human hosts via infected fleas, mites and ticks. Symptoms are flu-like and can be potentially fatal.

Other tick-borne diseases such as Kyasanur forest disease (also referred to as monkey fever) are becoming prevalent in areas such as Malappuram, Wayanad and Nilambur. The disease recently made headlines following an outbreak in Maharashtra which claimed the lives of nineteen individuals.

The disease is spread to humans either through bites from infected ticks or contact with an infected animal. Those identified as being the most at risk from the disease typically reside in rural areas and include farmers, livestock workers, hunters and cattle grazers.

Non-communicable diseases

NCDs are on the rise across India. Heart disease now accounts for 28 percent of all deaths in the country. In Kerala, however, there are very localised incidences of high cancer rates. Doctors have warned that without further study, the cause of such a rapid rise in cancer incidence will not be uncovered.

In the coastal belt of the state, thyroid cancer has rapidly increased among women aged 20 to 30 in the last five years, according to senior oncologist Dr Narayanan Kutty Warrier of the MVR Cancer Centre and Research Institute. Cancer in the large intestine has also been documented to have risen in the 30-50 age group.

In recent years, type II diabetes has been reported in younger age groups within the state. Previously diabetes was more common in those over 40. Recently, however, the disease has been increasingly common amongst upper middle class children according to endocrinologist Dr B Jayakumar.

Shifting lifestyle choices may account for many incidences of NCDs. Adopting unhealthy diets and consuming large quantities of junk food is a common risk factor and may be more common among children from a wealthy background. However, localised incidences of high cancer rates among young people with no obvious cause warrants further investigation.

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