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Tuesday, 19 May 2015

ICMR issues guidelines for diagnosis and management of rickettsial diseases in India

The Indian Council of Medical Research (ICMR) has issued guidelines for diagnosis and management of rickettsial diseases in India. These guidelines will comprehensively address the various concerns regarding the clinical assessment, treatment, and laboratory diagnosis of rickettsial diseases in India and the world. 

The new document will benefit the physicians, healthcare workers, scientific community, regulatory agencies, public healthcare professionals and the public at large.  These guidelines have been developed for scientific purpose with the aim to provide physicians and healthcare workers with practical information to assist with the diagnosis and care of patients with rickettsial infections and also stimulate thinking among scientists interested in developing this area in the country at the various levels of healthcare and thus help the people to lead a normal and healthy life.  

Rickettsial diseases are considered some of the most covert emerging and re-emerging diseases and are being increasingly recognized in India.  Rickettsial infections are caused by a variety of obligate intracellular, gram-negative bacteria from the genera Rickettsia, Orientia, Ehrlichia, Neorickettsia, Neoehrlichia, and Anaplasma, belonging to the Alphaproteobacteria. 

Rickettsial diseases continue to be the source of severe illness and death in healthy adults and children, in spite of the availability of low cost, effective antimicrobial therapy. The greatest challenge is the difficult diagnostic dilemma posed by these infections early in their clinical course, when antibiotic therapy is most effective. Early signs and symptoms of these illnesses are notoriously nonspecific or mimic benign viral illnesses, making diagnosis difficult.  The care and management of people with rickettsial diseases is done primarily by the general practitioners and physicians. 

However, there are no clear directions or Guidelines for its management. A need for availability of a set of Guidelines which can be used by doctors, scientists and public health workers all over the country was strongly felt. With this in view, Department of Health Research (DHR) and ICMR took the initiative to formulate the guidelines.
A Task Force was constituted to examine various management guidelines available and deliberate on the relevant issues keeping in view the local conditions. The guidelines formulated and presented in this document define a framework for recognizing manifestations, identifying appropriate diagnostic tests and initiating prompt and effective treatment. 

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