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Published on: Oct 28, 2020
2 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Hepatitis C Nobel Prize

Earlier this month the Nobel Prize in Physiology and Medicine was jointly awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the Hepatitis C virus. This helped push our understanding of blood-borne hepatitis, a major global health problem that is one of the leading causes of cirrhosis and liver cancer alongside Hepatitis B. It led the way in introducing new tests for chronic hepatitis as well as new treatments that have saved the lives of millions.

HEPATITIS

Hepatitis is the inflammation of your liver, the largest solid organ in your body. Though there are numerous other causes of hepatitis, including alcohol abuse, drugs and toxins (including paracetamol overdose), and autoimmune disorders (such as Wilson’s disease), viral infections are the most common worldwide causes for hepatitis. Hepatitis A was the first to be discovered, transmitted by polluted food and water, and results in a short-term transient hepatitis. Hepatitis B on the other hand is transmitted through blood and is more of an issue as it can lead to chronic cirrhosis and possible liver cancer. It can remain indolent in a person, causing disease long after the initial infection.

Blood borne hepatitis was first discovered in the 1960s, when it was found that some patients would become ill after receiving blood transfusions. Despite this discovery and new tests for Hepatitis B reducing the number of transfusion related hepatitis, a large number of cases remained.

NOT A, NOT B

Harvey Alter, working at the US National Institute of Health, was studying the occurrence of hepatitis in blood transfusion patients. His team showed that blood from these infected patients could transmit the disease to chimpanzees, resulting in hepatitis. This agent had the properties of a virus, one that was “non-A, non B” hepatitis.

Further investigation into the virus would require the input of Michael Houghton, working for Chiron pharmaceutical. His team created a collection of DNA fragments found in the blood of infected chimpanzees. Though the majority of these fragments were from the chimpanzee, enough were from the virus. They were able to utilise this information to identify antibodies against the suspected virus, and ultimately identify it as the flavivirus Hepatitis C.

The final piece of the puzzle was shown by Charles M Rice, a researcher at Washington University, St Louis – could the virus alone cause hepatitis. He studied the RNA of Hepatitis C to identify regions that may be used for replication, and areas that might hinder replication. This was key as the virus can lay dormant for years, replicating at a slow rate before causing damage to the liver. For researchers, this was an issue as it was not feasible to wait years and see if the suspected virus caused hepatitis. By genetically engineering the viral genome, he developed a variant of Hepatitis C that would only multiple rapidly and have no mechanism to inactivate itself for dormancy. This strain caused rapid changes to the livers of infected chimpanzees; the same changes seen in hepatitis patients.

. ;.,hrvxzThe impact was significant. Prior to this, receiving a blood transfusion was like Russian Roulette. You were receiving life saving therapy, but it coZuld also be a hidden death sentence. Now that hepatitis had been discovered, it became possible to screen patients prior to donation, to screen blood transfusion bags, and to start developing treatments for the virus.

The fight is not over yet. There are still over 70 million people who still live with the virus, and it still kills around 400,000 a year. Its only very recently that we have found treatments that can reduce the viral load in patients to levels that they are considered cured. This treatment remains expensive, and we are very far away from eradication itself.

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Heat Exhaustion Warning Signs: Symptoms You Should Never Ignore

Heat-related illnesses are common during hot weather, particularly in tropical countries like India where summer temperatures can become extreme. Heat exhaustion is a serious condition that occurs when the body overheats due to prolonged exposure to high temperatures and inadequate hydration.

Recognizing heat exhaustion warning signs early can prevent life-threatening complications such as heatstroke.

What Is Heat Exhaustion?

Heat exhaustion is a heat-related illness caused by:

Excessive heat exposure
Dehydration
Loss of electrolytes through sweating

It often occurs during outdoor work, exercise or travel in hot environments.

If untreated, it may progress to heatstroke — a medical emergency.

Common Heat Exhaustion Warning Signs

1. Heavy Sweating

Excessive sweating is one of the earliest signs.

The body attempts to cool itself through perspiration, leading to fluid loss.

2. Dizziness or Lightheadedness

Low blood pressure due to dehydration may cause:

Feeling faint
Blurred vision
Weakness

3. Fatigue and Weakness

Muscle weakness and exhaustion occur as the body struggles to regulate temperature.

4. Nausea and Vomiting

Digestive discomfort is common in heat-related illnesses.

5. Headache

Dehydration and heat stress can trigger throbbing headaches.

6. Muscle Cramps

Electrolyte imbalance may cause painful muscle cramps, especially in legs.

7. Rapid Heartbeat

Increased heart rate helps circulate blood for cooling but may indicate strain.

8. Cool, Clammy Skin

Despite hot weather, skin may feel cool and moist due to heavy sweating.

Who Is at Higher Risk?

Certain groups are more vulnerable:

Outdoor laborers
Athletes
Elderly individuals
Children
People with chronic illnesses
Individuals on certain medications

Urban heat exposure increases risk during peak summer months in India.

Heat Exhaustion vs Heatstroke

Heat exhaustion is serious but manageable if treated promptly.

Heatstroke symptoms include:

High body temperature (above 40°C)
Confusion or disorientation
Dry, hot skin
Seizures
Loss of consciousness

Heatstroke requires immediate emergency medical attention.

Immediate Steps to Take

If heat exhaustion is suspected:

Move to a cool, shaded area
Loosen tight clothing
Drink water or oral rehydration solution
Apply cool cloths to body
Rest until symptoms improve

Seek medical care if symptoms persist beyond one hour.

Prevention Tips

Stay Hydrated

Drink water regularly, even if not thirsty.

Avoid Peak Sun Hours

Limit outdoor activity between 12 PM and 4 PM.

Wear Light Clothing

Choose loose, breathable fabrics.

Use Sun Protection

Wear hats and sunglasses when outdoors.

Take Frequent Breaks

Rest in shaded or air-conditioned areas.

Maintain Electrolyte Balance

Use oral rehydration solutions if sweating heavily.

Heat Illness in the Indian Context

India frequently experiences heatwaves, especially in northern and central regions. Public awareness about hydration and heat safety is essential to reduce hospitalizations and fatalities.

Community-level education can significantly improve prevention.

When to Seek Medical Help

Immediate medical attention is required if:

Symptoms worsen
Body temperature rises significantly
Confusion develops
Fainting occurs
Vomiting persists

Early treatment prevents severe complications.

Conclusion

Heat exhaustion is a preventable but potentially dangerous condition. Recognizing warning signs such as heavy sweating, dizziness, nausea and muscle cramps allows timely intervention.

With rising summer temperatures, especially in India, proactive hydration and heat safety measures are essential. Preventive care and awareness can protect vulnerable individuals and reduce health risks.

Staying cool and hydrated is the simplest way to safeguard your health during hot weather.

References

Indian Meteorological Department – Heatwave Reports
World Health Organization – Heat-Related Illness Guidelines
Indian Council of Medical Research – Public Health Advisory
National Disaster Management Authority (India) – Heatwave Action Plan
Lancet Planetary Health – Climate and Health Research

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