'Medical Memoir' is a Health & Me series that delves into some of the most intriguing medical histories and unveils how medical innovations have evolved over time. Here, we trace the early stages of all things health, whether a vaccine, a treatment, a pill, or a cure.

With 7000 cases of chikungunya diagnosed in China, strict measures have been taken to ensure the outbreak doesn’t spread. The health officials have employed ‘COVID’ style restrictions to ensure the disease remains contained, with elephant mosquito who prey on Aedes mosquitoes, drones that identify mosquito breeding sites as well as people wearing masks are fogging parks and streets with insecticides.

Chikungunya is a viral disease spread by mosquitoes that causes fever, a rash, and severe joint pain. The name comes from a word that means “disease that bends up the joints,” describing the painful, stooped posture of those infected. The virus, known as CHIKV, is transmitted by Aedes mosquitoes and can cause severe complications, though it is rarely fatal.

However, this is not the first time history has witnessed Chikungunya, in fact the timeline of its identification stretches as far as the 1950s.

Origins of Chikungunya

According to the World Health Organization, chikungunya is a viral disease spread by mosquitoes. Its name comes from a language in Tanzania and means "that which bends up the joints," referring to the severe joint pain that can cause people to stoop over. The virus, called CHIKV, is related to the O'nyong nyong virus and was first identified in Tanzania in 1952. While typically not fatal, it can cause severe fever, rash, and long-lasting joint pain, with some cases leading to heart, liver, or neurological problems.

How Chikungunya Spreads and Transfers?

The primary way chikungunya is transmitted is through the bite of infected female Aedes mosquitoes, particularly the Aedes aegypti and Aedes albopictus species. These are the same mosquitoes that spread other diseases like dengue. In Africa, the virus is believed to be maintained in a cycle involving wild primates and various forest-dwelling Aedes mosquitoes. However, in urban areas, especially in Asia and elsewhere, the virus is spread mainly by mosquitoes living in cities.

The Journal of Infectious Diseases explains that over time, different genetic types (genotypes) of the chikungunya virus have emerged, including the Asian, West African, and East/Central/South African (ECSA) genotypes. A new variant, the Indian Ocean Lineage (IOL), appeared in 2004 and caused severe epidemics, mainly in Asia. A key mutation in this new variant, known as E1-A226V, made the virus much more effective at being transmitted by the widespread Aedes albopictus mosquito. This enhanced transmission is a major reason why the virus has spread so quickly to new regions, including parts of Europe and the Americas, which have also seen outbreaks in recent years.

Historical Timeline of Global Chikungunya Outbreak

For centuries, the virus was mainly found in parts of Africa. It was first officially identified in Tanzania in the 1950s. Over the next few decades, it also appeared in Asia, often causing outbreaks that were sometimes confused with dengue fever.

Before 2004

The disease's global spread took a dramatic turn in 2004 when a new and more infectious strain of the virus appeared in Kenya. This strain had a special mutation that made it much better at being transmitted by the Aedes albopictus mosquito. Because this mosquito species is so widespread, this new strain was able to travel and cause huge epidemics in new places.

2004 and Beyond

The new strain quickly spread to islands in the Indian Ocean, then to India and Southeast Asia. In 2007, it reached Europe, causing an outbreak in Italy. By 2013, the virus had made its way to the Americas, starting in the Caribbean and then rapidly spreading throughout North, Central, and South America. This was a major event because the people in the Americas had no prior immunity to the virus, making them very vulnerable to infection.

Today, chikungunya has been reported in more than 110 countries. The combination of a highly infectious virus strain and the widespread presence of mosquito carriers has made it a significant public health problem around the world. Scientists continue to monitor the virus's spread and look for ways to control its mosquito vectors to reduce the burden of this painful disease.

The virus has since caused outbreaks in Europe, starting with a case in Italy in 2007, and in the Americas, with the first local cases reported in the Caribbean in 2013. The lack of immunity in these new populations and the widespread presence of the mosquito vectors led to rapid transmission. Today, chikungunya is a major public health concern, with outbreaks occurring worldwide.

Despite chikungunya being a global threat, there is currently no specific vaccine or treatment available. Efforts to combat the disease focus on supportive care to manage symptoms and preventive measures to control mosquito populations. The rapid spread of chikungunya, especially in tropical and subtropical regions and increasingly in temperate areas, underscores the critical need for public health officials and researchers to work together to find effective solutions, from better diagnostic tools and vaccines to robust vector control programs.

Azoospermia is not exactly headline news, probably because it affects only about 1 per cent of men. So if you have not heard of it before, you are not alone. But azoospermia is a condition where a man’s ejaculate contains no measurable sperm. While semen, the fluid released during ejaculation, is still present, the absence of sperm means natural conception becomes difficult or impossible. It can affect men of all ages and comes from a mix of causes, from physical blockages to genetics.

There is a lot going on behind the scenes, and not all azoospermia cases are created equal. Here is what you need to know about the condition.

Three Types of Azoospermia

Sperm are being made just fine, but there is a roadblock somewhere on their route. The sperm get stuck and cannot reach their destination. This is the most common kind, affecting roughly 40 per cent of folks with azoospermia.

2. Testicular (Nonobstructive) Azoospermia:

Here, your testicles are not making enough sperm or any at all, maybe due to damage or a structural issue.

3. Pretesticular (Also Nonobstructive) Azoospermia:

Your testicles look fine, but the hormonal signals telling them to get cracking are out of sync or missing.

What Causes This Sperm Shortage?You would not usually spot azoospermia until baby-making plans hit a snag. Some might notice side effects like lower sex drive or lumps in the testicles, but often it is a silent issue.

Here is what can cause those sperm roadblocks, according to reports:

The Blockages (Obstructive Causes)

• Testicle injuries or knocks
• Infections like epididymitis
• Past surgeries down there
• Retrograde ejaculation
• Cysts or random growths
• Vasectomy
• Genetics, like cystic fibrosis mutations messing with the sperm highways

Factory or Boss Problems (Nonobstructive Causes)

• Genetic syndromes like Klinefelter’s or Y chromosome deletions
• Low testosterone, weird prolactin levels, you name it
• Varicocele
• Certain medications that don’t play nice with sperm production
• Radiation, chemotherapy, or nasty toxins
• Missing or undescended testicles
• Orchitis
• Lifestyle choices: too many hot tubs, booze binges, or drug misuse

How Do Docs Figure Out What’s Happening?

• Medical history: injuries, surgeries, infections, meds, family history of infertility
• Physical exam, paying close attention to your precious bits
• Blood tests to check hormone levels
• Ultrasounds or X-rays
• Genetic tests if needed
• Sometimes even brain scans if hormone controls might be off

Can You Fix It?

Some azoospermia cases do have fixes.

• Blockages? Surgeons might clear or reconnect those sperm highways.
• Hormone hiccups? Doctors can prescribe treatments to get those signals back on track.
• No sperm production but sperm hiding in the testicles? A clever needle can retrieve them for IVF or ICSI.
• If it is genetic, genetic counselling can help you understand the risks and options.

Will Sperm Make a Comeback?

The million-dollar question: will those sperm return? If the problem is a blockage and surgery goes well, yes, sperm can show up in the semen again. But if your testicles cannot make sperm because of permanent damage or genetics, the chances shrink.

Researchers have developed an online tool that tells you your "heart age." Instead of giving you a complicated percentage risk of a heart attack or stroke, the tool gives you a single number that is easier to understand. For example, a 45-year-old person might find out they have a heart age of 60, which is a powerful way to show that their heart is working much harder than it should be.

The tool is based on the same information doctors already use to assess your risk, including your age, sex, cholesterol levels, blood pressure, and whether you smoke or have diabetes.

What Heart Age Reveals About Americans

According to the study published in the JAMA Cardiology, researchers tested the calculator on more than 14,000 U.S. adults. On average, they found that most people's hearts were older than their actual age. The gap was bigger for men than for women.

Women: Average age 51.3, average heart age 55.4

Men: Average age 49.7, average heart age 56.7

The difference was even greater for Black and Hispanic participants and those with lower income and education levels. A heart age that is five to ten years older than your real age is a sign that you should talk to your doctor about making lifestyle changes or starting treatment.

How Does This Tool Help Heart Health?

Many experts believe this new tool is a great way to help people understand their heart health. Presenting risk as a simple "heart age" is more impactful and easier to grasp than a percentage. However, some doctors are not so sure. They point out that we don't have proof that knowing your heart age actually leads to people making healthier choices. They also worry that a person with a low heart age might get a false sense of security and ignore other risk factors.

How to Use the Heart Age Tool

If you want to try the tool, you'll need some information from your last doctor's visit, such as your blood pressure and cholesterol numbers. If your heart age is higher than your actual age, it's a good idea to speak with your doctor. They can help you create a plan to lower it by focusing on key areas like:

• Lowering high blood pressure and cholesterol
• Quitting smoking
• Improving your diet
• Exercising more often

Can Slow Down Your Biological Aging?

According to the National Institute of Health, treatments are still being developed, there are many things you can do right now to slow the aging process. Experts agree that the best ways to stay healthy as you age are the same things you already know:

• Physical activity is considered one of the most effective ways to combat aging.
• Healthy eating is also crucial.
• Calorie restriction (CR), or reducing your calorie intake while still getting essential nutrients, has been shown to increase longevity and delay age-related diseases in studies. A two-year study found that people who reduced their calories by an average of 12.5% showed a slower biological aging pace.
• Other key lifestyle choices include not smoking, maintaining a healthy weight, getting enough sleep, and managing health conditions like high blood pressure and cholesterol.

As soon as we heat peak summer heat in India, the only thig most people look forward to are the monsoon rains. Even with untimely mid-summer rains, people breathe a sigh of relief, even if it is momentary. With the transition of summer to monsoon, people find themselves feeling relieved that their risk of heat-related issues are lesser. However, it is still a looming issue, nonetheless.

A 2024 study published in the Advancing Earth and Space Sciences, points out the increasing danger of moist heat in India, especially during monsoon breaks. It finds that the periods of dry weather during monsoon season are becoming more frequent and is exposing hundreds of millions of people to life-threatening conditions.

The report points to global warming and specific weather patterns as the main causes, which in turn are projected to have serious consequences for public health and the economy.

What is Moist Heat and Why is it a Problem?

Moist heat is a combination of high temperature and high humidity. It's especially dangerous because the high humidity prevents sweat from evaporating, which is how our bodies cool down.

The report uses the Wet-Bulb Globe Temperature (WBGT) to measure this risk. A WBGT of over 31°C is considered hazardous for physical work. This is a critical point where people working outside can suffer from heat exhaustion, heatstroke, and other life-threatening conditions.

How is Heat In Monsoon An Issue

The study's most significant finding is that monsoon breaks, which are short periods without rain during the monsoon season, are surprisingly dangerous. While we often think of the monsoon as a time of cooling rain, these breaks create conditions of extreme moist heat. The report shows that monsoon breaks are a far greater threat than the hot summer months.

Widespread Danger:Between 1951 and 2020, monsoon breaks led to an increase in the area of India exposed to dangerous WBGT levels. This affected at least 670 million people.

Greater Risk Than Other Seasons: The risk of extreme moist heat during monsoon breaks is substantially higher than during other times of the year.

What Is The Reason Behind Heat In Monsoon?

The research points to two main factors behind the rise in extreme moist heat during monsoon breaks:

Global Warming

The study found a strong link between rising global temperatures and the increase in moist heat extremes in India. This suggests that global warming is making these events more frequent and intense.

Monsoon Weather Patterns

Specific weather patterns during monsoon breaks, like periods of prolonged warming and changes in air circulation, are also driving up moist heat levels. The presence of high humidity and heat during these dry spells creates a perfect storm for dangerous conditions.

How Does Heat In Monsoon Affect People?

This research has major implications for public health and policy in India, a country where a large portion of the population works in agriculture and construction.

Reduced Work Performance

The study projects that work performance in India could decline by 30-40% by the end of the century due to rising moist heat.

Economic Consequences

This drop in productivity could lead to a significant economic loss, potentially reducing India's GDP by as much as 4% and causing crop prices to rise.

Need for Policy Change

The findings emphasize the urgent need for a review of outdoor working hours and the development of new public health policies to protect workers from the growing threat of extreme moist heat.