An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world.
India has become the focal point for a mosquito-borne plague that is sweeping the globe. Reported in just a handful of countries in the 1950s, dengue (pronounced DEN-gay) is now endemic in half the world's nations.

"The global dengue problem is far worse than most people know, and it keeps getting worse," said Dr. Raman Velayudhan, the World Health Organization's lead dengue coordinator.

The tropical disease, though life-threatening for a tiny fraction of those infected, can be extremely painful. Growing numbers of Western tourists are returning from warm-weather vacations with the disease, which has reached the shores of the United States and Europe. Last month, health officials in Miami announced a case of locally acquired dengue infection.

Here in India's capital, where areas of standing water contribute to the epidemic's growth, hospitals are overrun and feverish patients are sharing beds and languishing in hallways. At Kalawati Saran Hospital, a pediatric facility, a large crowd of relatives lay on mats and blankets under the shade of a huge banyan tree outside the hospital entrance recently.

Among them was Neelam, who said her two grandchildren were deathly ill inside. Eight-year-old Sneha got the disease first, followed by Tanya, 7, she said. The girls' parents treated them at home but then Sneha's temperature rose to 104 degrees, a rash spread across her legs and shoulders, and her pain grew unbearable.

"Sneha has been given five liters of blood," said Neelam, who has one name. "It is terrible."

Officials say that 30,002 people in India had been sickened with dengue fever through October, a 59 percent jump from the 18,860 recorded for all of 2011. But the real number of Indians who get dengue fever annually is in the millions, several experts said.

"I'd conservatively estimate that there are 37 million dengue infections occurring every year in India, and maybe 227,500 hospitalizations," said Dr. Scott Halstead, a tropical disease expert focused on dengue research.

A senior Indian government health official, who agreed to speak about the matter only on the condition of anonymity, acknowledged that official figures represent a mere sliver of dengue's actual toll. The government only counts cases of dengue that come from public hospitals and that have been confirmed by laboratories, the official said. Such a census, "which was deliberated at the highest levels," is a small subset that is nonetheless informative and comparable from one year to the next, he said.

"There is no denying that the actual number of cases would be much, much higher," the official said. "Our interest has not been to arrive at an exact figure."

The problem with that policy, said Dr. Manish Kakkar, a specialist at the Public Health Foundation of India, is that India's "massive underreporting of cases" has contributed to the disease's spread. Experts from around the world said that India's failure to construct an adequate dengue surveillance system has impeded awareness of the illness's vast reach, discouraged efforts to clean up the sources of the disease and slowed the search for a vaccine.

"When you look at the number of reported cases India has, it's a joke," said Dr. Harold S. Margolis, chief of the dengue branch at the Centers for Disease Control and Prevention in Atlanta.

Neighboring Sri Lanka, for instance, reported nearly three times as many dengue cases as India through August, according to the World Health Organization, even though India's population is 60 times larger.

Part of India's problem is that some officials view reports of dengue infections as politically damaging. In September, Mamata Banerjee, the chief minister of West Bengal, dismissed reports of an increasing number of dengue-related deaths, saying doctors were misdiagnosing. "So everyone is earning a bad name," she said at a news conference.

A central piece of evidence for those who contend that India suffers hundreds of times more dengue cases than the government acknowledges is a recent and as yet unpublished study of dengue infections in West Bengal that found about the same presence of dengue as in Thailand, where almost every child is infected by dengue at least once before adulthood.

"I would say that anybody over the age of 20 in India has been infected with dengue," said Dr. Timothy Endy, chief of infectious disease at Upstate Medical University in Syracuse.

For those who arrive in India as adults, "you have a reasonable expectation of getting dengue after a few months," said Dr. Joseph M. Vinetz, a professor at the University of California at San Diego. "If you stay for a longer period, it's a certainty."

The reason that such an extensive epidemic can hide in plain sight is that as many as 80 percent of dengue infections cause only mild symptoms of fatigue, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. For many, the disease is experienced as "maybe just a fever that someone shrugs off."

But the remaining 20 percent may be affected by more serious flulike symptoms, with high fever, vomiting, searing pain behind the eyes, skin rash, and muscle and joint aches that can be so intense that the illness has been dubbed "breakbone fever."

The acute part of the illness generally passes within two weeks, but symptoms of fatigue and depression can linger for months. In about 1 percent of cases, dengue advances to a life-threatening cascade of immune responses known as hemorrhagic or shock dengue.

This potentially mortal condition generally happens only after a second dengue infection. There are four strains of the dengue virus, and infection with a second strain can fool the immune system, allowing the virus to replicate. When the body finally realizes its mistake, it floods the system with so many immune attackers that they are poisonous. Such patients must be provided intravenous fluids and round-the-clock care to avoid death.

Twenty years ago, just one of every 50 tourists who returned from the tropics with fever was infected by dengue; now, it is one in six, said Dr. Velayudhan, the W.H.O. official. The Portuguese archipelago of Madeira is in the midst of an epidemic.

On Oct. 9, Puerto Rico's Health Department declared a dengue epidemic after at least six people died and nearly 5,000 people were sickened.

The great danger of having hundreds of millions of people in India with undiagnosed and unacknowledged primary infections is that a sudden shift in the circulating dengue strain could cause a widespread increase in life-threatening illnesses.

"We have been fortunate so far," said Dr. Kakkar of the Indian public health group. "But if, God forbid, we come across that situation we probably need far better health-care management and inpatient care facilities."

Trucks spewing pesticides against mosquitoes are now a regular presence in New Delhi neighborhoods, but rapid and disorderly urbanization - a hallmark of India's development - increases the risks of dengue proliferation, so few believe the government here can do much to halt its spread.

The best hope for relief is a vaccine, but a recent trial of the most advanced vaccine candidate largely failed.

"I think we're looking at 10 to 12 years before we see an effective vaccine, and that's if we're lucky," Dr. Halstead said. "In the meantime, we're in trouble."

With the festive season in full swing, it becomes extremely difficult to refrain from overindulgence in food. Festivities are an easy excuse for people to set aside there diet plan and gorge on delicacies that they otherwise tend to avoid. From roadside chat to home made puri kachori; relishing on boxes of sweets sent by friends and relatives and a cup of coffee with every guest dropping by what more does one need to feel the cramps in stomach at the end of the day's long celebration.

Unchecked and unhealthy eating habits during the festival season can, and in most cases do lead to food poisoning and disturbance in the bowels. Vomiting, diarrhea, abdominal pain or stomach cramps, a low-grade fever, headaches, and muscle aches are symptoms that one experiences with food poisoning.

Here are the top five easy and quick home remedies to get instant relief from food poising:

1. Ginger: Ginger is a well known remedy for various gastrointestinal distresses. Loaded with potent anti-inflammatory compounds ginger helps quell nausea and gastric distress. Chewing a piece of ginger tossed in honey helps relieve the severity of nausea. Ginger tea relieves stomach cramps and upset caused by food poisoning.

2. Cumin: Add a tablespoon of crushed cumin seeds to the soup to soothe the inflammation in your stomach. Crushed cumin with fenugreek powder mixed with a glass of water or half a cup crud helps relive abdominal pain and vomiting. Cumin seeds are of great benefit to the digestive system as they help stimulate the secretion of pancreatic enzymes, compounds necessary for proper digestion and nutrient assimilation.

3. Basil: Basil is another excellent home remedy to cure stomach infection due to its anti-bacterial properties.

Taking juice of basil leaves with water empty stomach in the morning enhances digestive power. Basil juice helps stop vomiting immediately. Strain the juice of a few basil leaves and add it to a tablespoon of honey to get instant relief.

Mix chopped basil leaves, sea salt and one shake of black pepper to three tablespoon of crud. Take the mixture three times in a day till you are totally cured of food poisoning. It will also cure any cramps or gas problem associated with food poisoning.

4. Lemon: The acidity of the lemon juice kills the micro-organism and toxins in the gastrointestinal tract.

Squeeze juice of a lemon and add a pinch of sugar to it and drink, or you can even add lemon to your tea.

Since fluid intake is very important as one tends to lose more water through diarrhea taking lemon juice in short intervals helps you keep hydrated.

5. Peppermint tea: Peppermint oil helps relieve symptoms of irritable bowel syndrome, including indigestion, dyspepsia, and colonic muscle spasms. It is extremely beneficial for people suffering from stomach spasms due to food poisoning. Add a few drops to your tea; your cramps will vanish in a couple of hours.

Washington: Mayo Clinic researchers have found a potential drug therapy for treating an inherited form of kidney disease called autosomal dominant polycystic kidney disease (ADPKD).

The medication, tolvaptan, slowed the pace of kidney cyst growth over the three years of the study.

The multicenter study found tolvaptan demonstrated a nearly 50 percent reduction in the rate of increase in total kidney volume (a measurement of kidney cyst growth) in ADPKD patients over the study period, compared to placebo.

"ADPKD is the most common inherited and the fourth most common overall cause of kidney failure worldwide," said lead author Vicente Torres, M.D., Ph.D., Mayo Clinic nephrologist.

"In most patients with this disease, relentless cyst growth within the kidneys destroys the tissue, causes hypertension and painful complications, and negatively impacts the quality of life.
"The results of this study reveal a potential treatment that blunts kidney growth, lessens associated symptoms and slows kidney function decline when given over three years," Dr. Torres added.

While the trial findings are encouraging, tolvaptan has not yet been approved for this indication, Dr. Torres noted.

The phase three clinical trial results were being presented today at the American Society of Nephrology annual meeting and published online in the New England Journal of Medicine.

A year after the municipal corporation was lauded for its efforts in bringing down malaria cases, another mosquito-borne infectious disease is giving its officials sleepless nights.

During its routine survey last week, the Brihanmumbai Municipal Corporation (BMC) found most of the dengue mosquito breeding spots in the suburbs. To curb this menace, civic officials are working 24x7 fumigating the city and educating the public, especially housing societies.

"Our weekly-offs and public holidays have been cancelled. We have set up a rapid action force and are conducting indoor fumigation and anti-larval treatment services extensively," said a pesticide officer from H east ward (Bandra, Khar and Santa Cruz).

Officials of the H east ward health department found at least 25 dengue mosquito breeding spots in October alone. "At least 95% of the breeding spots were in housing societies, and the larvae were found in ornamental plants," said a pesticide officer.

The BMC is also holding special awareness programmes for housing societies. "We have sent letters to the society chairmen asking them to attend the programme. So far, the response has been good," said a pest control officer from K west ward.

With nursing homes and private hospitals seeing a large number of dengue admissions, they are sending the patient details to the BMC every day. "This year, we have seen manydengue admissions. At present, six such patients are being treated at here," Dr Anil Suchak, medical director of Suchak Nursing Home, Malad (East).

Dr Rajiv Walawalkar, who owns a nursing home in Ghatkopar, said: "Patients with dipping platelet counts are being admitted to hospitals as physicians don't want to take any chances."

Doctors opined that a patient's family usually gets lax with the treatment after the fever subsides. But this may lead to the platelet count dropping again and a relapse.

Though chances of dengue proving fatal is very low, a patient can slip into a dengue haemorrhagic shock syndrome if more that two types of dengue virus attack him back to back.

The average age we experience memory loss is 57 but it can begin as early as our thirties, new research has revealed.

In an online poll, 11 per cent of respondents said they had started to notice their memory suffering in their 40s. Six per cent had noticed it in their 30s.

The survey also revealed that the over-50s are plagued by the fear of memory loss and many have frequent and embarrassing memory lapses.

Examples included leaving the house without putting on socks, forgetting how to spell common words like 'hour' and even struggling to remember their own name when introducing themselves at a business meeting.

The research, published to coincide with the UK's first ever online Memory Training course, also revealed that half of over-50s have been embarrassed about forgetting simple things.

Other people's names came top of the list at 37 per cent, followed by keys and glasses at 19 per cent.

More unusual examples included not remembering the word for 'apple', how to spell 'hour' and names of colours.

Some people even admitted to leaving loved ones behind in shops.

While these memory lapses can be seen as humorous mishaps or plain old forgetfulness, the research does reveal that 31 per cent of people are concerned about losing their memory now and a further 31 per cent are concerned that it could become a problem for them in the future.

According to the research, the 92 per cent of over-50s do try to keep their minds and memory active.

The survey of more than 1,000 adults aged over 50 was commissioned by adult learning website Love to Learn.

It has teamed up with former world memory champion Jonathan Hancock, who is the course's online tutor.

He said: 'Brilliant memory is something you do, not something you own. The brain is a muscle and changes according to how you exercise it and what you practise. Everyone can train their memory, and can surprise themselves with how much they can improve it.'

The course claims to deal with different areas of memory training from techniques used by the Greeks and Romans to modern methods for remembering names, important dates, numbers, lists and ideas.