Recent advances in infectious diseases in South Asia

Nandini Chatterjee, MD, is a professor of medicine and editor in chief of the McMaster Textbook of Internal Medicine South Asia Edition.

If you were to name the 3 most important recent advances in infectious diseases in South Asia that are relevant for everyday practice, what would they be?

There are many new developments in the field of infectious diseases in South Asia, but to name a few, I would say that there’s a resurgence of zoonoses, which we are encountering every day. One of them is leptospirosis, which we encounter in our emergency rooms (ERs).

The next thing that we are encountering very often is the emergence of extrapulmonary tuberculosis, as well very important, coming hand-in-hand with drug-resistant varieties specifically even to newer drugs, like bedaquiline.

Another thing we are noticing very frequently nowadays is that instead of Salmonella Typhi enteric fever, we are coming across patients with enteric fever caused by the Paratyphi variety. The underlying cause seems to be improved vaccination, which protects against S Typhi enteric fever but not against Paratyphi.

Thirdly, extrapulmonary tuberculosis seems to have emerged as a new threat, specifically after the post–coronavirus disease 2019 (COVID-19) immunosuppressed situation and hand-in-hand the drug resistance is raising its ugly head. It was always there, but it seems that newer drugs like bedaquiline are also becoming resistant to this infection.