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

Hepatitis C Nobel Prize

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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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Asthma

Asthma Symptoms in Adults: Early Signs, Triggers, and When to Seek Care

Asthma is often perceived as a childhood condition, but a significant number of cases develop or persist into adulthood. In India, adult asthma is increasingly recognised due to rising air pollution, occupational exposure and lifestyle-related risk factors. Unfortunately, asthma symptoms in adults are frequently misdiagnosed as recurrent infections, allergies or age-related breathlessness, leading to delayed treatment.

Understanding adult asthma symptoms is critical for early diagnosis, effective control and prevention of severe attacks.

 

What Is Asthma?

Asthma is a chronic inflammatory disease of the airways. In asthma, the airways become:

  • inflamed
     

  • narrow
     

  • overly sensitive to triggers
     

This leads to difficulty in breathing, especially during exposure to specific stimuli.

 

Why Adult Asthma Is Often Missed

Adult asthma symptoms may:

  • appear gradually
     

  • vary in severity
     

  • mimic common respiratory conditions
     

According to Indian Council of Medical Research and WHO data, many adults remain undiagnosed for years, increasing the risk of complications.

 

Common Asthma Symptoms in Adults

Wheezing

A high-pitched whistling sound while breathing, especially during exhalation, is a classic asthma sign.

 

Shortness of Breath

Adults with asthma often feel:

  • breathless during routine activities
     

  • difficulty taking deep breaths
     

This may worsen at night or early morning.

 

Chest Tightness

Many describe a sensation of pressure or tightness in the chest, which can be mistaken for heart-related issues.

 

Chronic Cough

A persistent cough, especially:

  • at night
     

  • early morning
     

  • after exercise
     

is a common but overlooked asthma symptom.

 

Symptoms That Worsen With Triggers

Asthma symptoms often intensify after exposure to specific triggers.

Air Pollution and Smoke

Urban pollution, vehicle emissions and indoor smoke significantly worsen asthma symptoms in adults.

 

Allergens

Dust mites, pollen, mould and pet dander are common triggers.

 

Respiratory Infections

Viral infections can trigger asthma flare-ups or reveal undiagnosed asthma.

 

Physical Activity

Exercise-induced asthma causes breathlessness and wheezing during or after physical exertion.

 

Weather Changes

Cold air, humidity and sudden temperature changes can aggravate symptoms.

 

Adult-Onset Asthma

Adult-onset asthma differs from childhood asthma.

Characteristics include:

  • onset after age 20–30
     

  • less association with childhood allergies
     

  • more persistent symptoms
     

  • higher likelihood of severe disease
     

Occupational exposure and hormonal changes contribute to adult-onset asthma.

 

Risk Factors for Asthma in Adults

Several factors increase asthma risk:

  • long-term exposure to pollution
     

  • smoking or passive smoking
     

  • occupational chemicals or dust
     

  • obesity
     

  • family history of asthma
     

  • chronic sinusitis or allergies
     

Women may experience asthma onset or worsening during hormonal changes.

 

When Asthma Symptoms Become Serious

Seek immediate medical attention if experiencing:

  • severe breathlessness
     

  • difficulty speaking in full sentences
     

  • bluish lips or fingertips
     

  • rapid worsening of symptoms
     

  • poor response to usual inhalers
     

These signs indicate a potentially life-threatening asthma attack.

 

How Adult Asthma Is Diagnosed

Diagnosis includes:

  • detailed symptom history
     

  • physical examination
     

  • lung function tests (spirometry)
     

  • response to bronchodilators
     

Early diagnosis improves long-term outcomes.

 

Impact of Untreated Asthma

Untreated asthma can lead to:

  • frequent attacks
     

  • reduced lung function
     

  • sleep disturbances
     

  • missed workdays
     

  • reduced quality of life
     

According to Lancet respiratory studies, uncontrolled asthma increases hospitalisation risk.

 

Managing Asthma Symptoms in Adults

Effective asthma management focuses on:

  • identifying and avoiding triggers
     

  • using prescribed inhalers correctly
     

  • monitoring symptoms regularly
     

  • maintaining follow-up care
     

Asthma action plans help patients recognise worsening symptoms early.

 

Role of Preventive Healthcare

Preventive healthcare helps:

  • detect asthma early
     

  • assess lung function
     

  • guide lifestyle modifications
     

Regular health checkups are especially important for individuals with respiratory symptoms or occupational exposure.

 

Lifestyle Measures That Support Asthma Control

Helpful practices include:

  • avoiding smoking
     

  • improving indoor air quality
     

  • wearing masks in polluted environments
     

  • maintaining healthy weight
     

  • regular, moderate exercise
     

Lifestyle support complements medical treatment.

 

Mental Health and Asthma

Stress and anxiety can worsen asthma symptoms.

Stress management:

  • reduces symptom frequency
     

  • improves medication response
     

Holistic care improves asthma outcomes.

 

Importance of Medication Adherence

Asthma medications work best when:

  • taken regularly as prescribed
     

  • inhaler technique is correct
     

Skipping treatment increases flare-up risk.

 

Long-Term Outlook for Adults With Asthma

With proper management:

  • symptoms are well controlled
     

  • severe attacks are preventable
     

  • normal activity levels are achievable
     

Most adults with asthma lead active, productive lives.

 

Conclusion

Asthma symptoms in adults are often subtle, variable and easily mistaken for common respiratory problems. Wheezing, breathlessness, chest tightness and chronic cough should not be ignored, especially when triggered by pollution, exercise or weather changes. Early diagnosis, trigger control and consistent treatment are essential to prevent severe attacks and preserve lung health. Recognising adult asthma early empowers individuals to manage symptoms effectively and maintain a good quality of life.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory Disease and Asthma Studies
  • World Health Organization (WHO) – Asthma Management and Prevention Guidelines
  • National Family Health Survey (NFHS-5) – Respiratory Health Indicators
  • Lancet Respiratory Medicine – Adult Asthma Outcomes and Management
  • NITI Aayog – Air Pollution and Respiratory Health Reports
  • Statista – Global Asthma Prevalence and Trends

See all

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