Indian Journal of Communicable Diseases

A new virus named SARS-CoV-2 emerged in the 21st century, causing a devastating disease named the Corona Virus Disease of 2019 (COVID-19). The World Health Organization (WHO) declared this to be a Public Health Emergency of International Concern (PHEIC) on 30th January 2020 and characterized the outbreak as a pandemic on 11th March 2020. On 5th May 2023, the WHO Emergency Committee on COVID-19 recommended that given the disease was by now well established and ongoing, it no longer fits the definition of a PHEIC. Since the end of the pandemic, there have been sporadic cases. However, from mid-February 2025, global SARS-CoV-2 activity has been increasing, in countries, areas and territories across the world. The WHO advised all Member States to continue monitoring the situation and applying a risk-based, integrated approach to manage COVID-19. Since the end of PHEIC in May 2023, countries have adopted diverse approaches to manage future threat of COVID-19, either by integrating COVID-19 activities into existing respiratory disease programmes, or continuing targeted vertical interventions. Having learnt lessons from the COVID-19 pandemic, NITI Aayog in India constituted an Expert Group, which prepared a report on “Future Pandemic Preparedness and Emergency Response – A Framework for Action”. The Member States of the WHO are in the process of preparing a new accord, which would be a complement to other initiatives, including the International Health Regulations (IHR). The World Health Assembly is considering targeted amendments to the IHR. Both the IHR 2005 and the new instrument are expected to play central roles in pandemic prevention, preparedness and response in the future.

Tetanus remains a significant public health concern in low- and middle-income countries (LMICs), particularly among adults with incomplete immunization. This case report describes a 40-year-old male farmer from rural India who developed generalized tetanus following a puncture wound to the foot. Classical clinical features including trismus, generalized muscle spasms, and signs of autonomic dysfunction were present. The patient was managed in the intensive care unit with continuous intravenous magnesium sulphate (MgSO4) infusion at 1g/ hour, alongside supportive care and antibiotics. Notably, mechanical ventilation and sedative agents were not required throughout the hospital stay. Progressive improvement in muscle rigidity and spasms was observed by day two of treatment, and the patient was discharged after three weeks without complications. This case highlights the efficacy of magnesium sulphate as a neuromuscular depressant and autonomic stabilizer in moderate to severe tetanus. It underscores its potential to reduce the need for invasive ventilation, especially in resource-limited settings, and supports its use as a safe and cost-effective adjunct in tetanus management.

Patients with chronic conditions who are bedridden or immobile for extended periods of time frequently have pressure sores. Deep tissue infections caused by them may spread to include deeper structures like bones and cause severe morbidity. APRP has aided as an adjuvant therapy to optimise results in a variety of plastic surgical applications. In our case report, we go through how Autologous Platelet Rich Plasma (APRP) can be used in conjunction with other treatments to treat pressure sores.

Melioidosis is a serious life threatening infectious disease that is potentially acquired by ingestion, inhalation or inoculation of gram-negative bacillus Burkholderia pseudomallei, found in soil and water in tropical and subtropical regions globally. It have capability to attack on hosts immune system, leading to the development of acute, subacute, or chronic invasive infections and clinical spectrum ranges from subclinical to fulminant septicemia with disseminated abscesses especially in immunocompromised patients like uncontrolled diabetic, CKD, chronic alcoholism. The disease is grossly under reported in our country, most probably due to lack of awareness as well as multiple symptoms imitate with other condition, without any specific identifying features. So even if diagnose at times, it is already too late or even after death. Therefore the importance of awareness and knowledge of this disease is of great importance. In centra India aiims Bhopal is recognized centre for diagnosis, and management of melioidosis, we diagnosed more than 100 cases in last 3 years. It presents with various clinical presentations like pneumonia, pyrexia of unknown origin, prostatic melioidosis, cutaneous melioidosis, neurologic melioidosis, septic arthritis and osteomyelitis. It is a great mimicker of tuberculosis of any organ. The blood or abscess fluid culture continues is keystone of diagnosis. Prolong Intravenous therapy for 4 weeks (from 2 to 8 weeks) or until culture conversion followed by extended oral eradication therapy is essential to prevent relapse. The overall mortality is very high due to delays in diagnosis and appropriate treatment, predominantly in resource-poor areas. Here, we are reporting eight cases of melioidosis from Madhya Predesh, all were treated successfully with intravenous meropenem followed by oral doxycycline and cotrimoxazole.

Adult vaccination for pneumococcal pneumonia and invasive pneumococcal disease has faced challenges of low awareness and vaccination rates in India. Both the pneumococcal polysaccharide 23-valent vaccine (PPSV23) and 13-valent conjugate vaccine (PCV13) have been available in India and are part of guidelines and recommendations for elderly adults. Recently PCV20 has also been introduced for adults in India. Given India’s diverse socioeconomic profile, as well as generally lower drive among adults for appreciating the need, and spending on vaccines for themselves as compared to their children, it is imperative to use all available vaccines appropriately in adult pneumococcal vaccination practice. Current and evolving pneumococcal serotype epidemiology in Indian adults, availability of real-world data, cost and access of these vaccines, will determine the future pneumococcal vaccination landscape in our country.