An American ‘killer disease’ is now stealthily stepping at Kolkata doorstep. The city doctors now feel that paediatricians should also be aware of the disease cystic fibrosis (CF) while attending to child patients with cough, fever and regular pneumonia.

Around 780 children in the Institute of Child Health (ICH), one of the premier hospitals in the city for childcare, have been tested positive for cystic fibrosis in its laboratory during the past several years virtually alerting the paediatricians to keep watch on the disease that is restricted mainly in North America.

“With launch of lab diagnostic facilities in our institute we regularly get children affected with CF disorder showing symptoms of recurrent pneumonia with regular cough and fever. In our laboratory sweat test of around 770 children were tested CF positive during the past several years. We have asked our doctors to keep watch on patients if they have the clinical history of these symptoms,” Dr Apurba Ghosh, director of ICH, told The Statesman.

He added: “Hardly one or two laboratories in the city have the lab infrastructure to conduct sweat and gene tests to confirm CF.”

“CF is a rare disease that is restricted mainly in America. In India, the disease is also being reported among both children and adults. With the advent of modern treatment facilities a patient affected with CF may have longer life span like 40 to 50 years. The manifestation of the CF symptoms is found among children,” said Dr Penchala Swamy Mittadodla, a US-based NRI pulmonologist associated with Mercy Hospital Rogers.

“We have reported a 24-year-old CF patient with fever, cough, hemoptysis, and weight loss of one week duration prior to admission to the hospital. Past sputum cultures grew methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa.

“The patient was treated with broad spectrum antibiotics based on previous culture data, but failed to improve. Chest radiograph and computed tomography (CT) chest revealed chronic collapse of the anterior subsegment of right upper lobe and multiple bilateral cavitary lesions which were worse compared to prior films. It was a rare case of Mycobacterium tuberculosis (MTB) infection is rarely seen in CF patients,” Dr Mittadodla added.

“I also attend four to five CF patients every year and this shows that the disease is no more restricted to western countries only. With the regular detection of CF cases time has come to conduct studies and research work on this genetic disorder mainly among children,” said Dr Alok Gopal Ghosal, a senior pulmonologist and former head of chest medicine at NRS Medical College & Hospital.

“I think paediatricians should take the issue seriously while attending child patients showing CF like symptoms,” Dr Ghosal felt.

Several years ago, state-run Calcutta Medical College and Hospital had done a research work on a 29-year-old CF patient in Bengal. Repeated sweat chloride tests revealed high values suggestive of CF. “High level of awareness is needed to diagnose CF in India because of its rarity,” the study had recommended.

What is cystic fibrosis?

Cystic fibrosis or CF is a fatal genetic disease with multisystem disorders characterised by chronic pulmonary infection, bronchiectasis, exocrine pancreatic insufficiency and elevated sweat chloride level. It is commonly considered as a pediatric disease. But it is now being diagnosed in increasing number of adults due to increased survival from availability of potent antibiotics, nutritional facility and diagnosis of mild cases which were unrecognised previously.