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<p style="text-align:justify;">The word aupasargika means contagious. The [[Vyadhi|diseases]] that spread from one person or organism to another person or organism are ‘aupasargika [[Vyadhi|roga]]’. These types of diseases can spread through the same or the other pathogenic factors (microbes) like protozoa, yeast, bacteria, viruses etc. [[Ayurveda]] classics have mentioned the concept of epidemic/pandemic in the context of [[janapadodhvansa]] (community destruction). Air pollution, water pollution, climate change, and environmental factors are responsible for the spread of diseases on a large scale, resulting in epidemics/pandemics. Causes of vitiation of air, water, climate and place along with their characteristics are described in context of [[janapadodhvansa]]. The causes of contagious [[diseases]] are also described in ancient classical texts at various places. Technological advances in medical science have enabled us to know precise micro-organisms responsible for causing and spreading contagious [diseases]]. This chapter deals with the diagnosis and principles of management of contagious [[diseases]] described in [[ayurveda]] and its contemporary practices. </p>

<p style="text-align:justify;">The word aupasargika means contagious. The [[Vyadhi|diseases]] that spread from one person or organism to another person or organism are ‘aupasargika [[Vyadhi|roga]]’. These types of diseases can spread through the same or the other pathogenic factors (microbes) like protozoa, yeast, bacteria, viruses etc. [[Ayurveda]] classics have mentioned the concept of epidemic/pandemic in the context of [[janapadodhvansa]] (community destruction). Air pollution, water pollution, climate change, and environmental factors are responsible for the spread of diseases on a large scale, resulting in epidemics/pandemics. Causes of vitiation of air, water, climate and place along with their characteristics are described in context of [[janapadodhvansa]]. The causes of contagious [[diseases]] are also described in ancient classical texts at various places. Technological advances in medical science have enabled us to know precise micro-organisms responsible for causing and spreading contagious [[Vyadhi|diseases]]. This chapter deals with the diagnosis and principles of management of contagious [[diseases]] described in [[ayurveda]] and its contemporary practices. </p>

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#Accidental (akasmik)

#Accidental (akasmik)

==List of [[diseases]] ==

==List of [[diseases|contagious diseases]] ==

Ayurveda texts have listed the [[diseases]] that can spread through above means as below:

Ayurveda texts have listed the [[diseases]] that can spread through above means as below:

*[[Kushtha]] (~skin [[diseases]])

*[[Kushtha]] (~skin [[diseases]])

*Masurika (chickenpox)

*Masurika (chickenpox)

*Romantika (measles)

*Romantika (measles)

*[[Visarpa]] (erysipelas)

*[[Visarpa]] (erysipelas)

*Kandu (pruritus)

*Kandu (pruritus)

<p style="text-align:justify;">With every passing era, mankind has faced healthcare challenges in the form of pandemics like COVID-19, epidemics like cholera, plague etc. These are all aupasargika in nature. Understanding aupsargika roga not only helps to prevent the [[diseases]] at individual level, but also helps to prevent epidemics or pandemics. </p>

<p style="text-align:justify;">With every passing era, mankind has faced healthcare challenges in the form of pandemics like COVID-19, epidemics like cholera, plague etc. These are all aupasargika in nature. Understanding aupsargika roga not only helps to prevent the [[diseases]] at individual level, but also helps to prevent epidemics or pandemics. </p>

==Root cause for epidemics ([[janapadodhawansa]])==

==Root cause for epidemics ([[Janapadodhvansa|janapadodhavansa]])==

<p style="text-align:justify;">Root cause for vitiation of air etc. factors is 'adharma' or misdeeds performed by intellectual errors (prajnaparadha). Sinful acts may be in the form of wars, demons, germs & curse.  In the present day, sinful acts can include different activities like antinational elements indulging in bomb blast, crime, deforestation, not obeying government rules in the industries, discharge of untreated polluted water in to the river, automobile pollution etc., which produce air pollution. Disposal of wastewater in an improper method on land leads to pollution of soil. The basic cause of such act is intellectual errors (prajnaparadha), due to rajas & tamas predominance resulting in greed, selfishness, tendency to harm people, jealousy & anger. All these factors influence not only the individual, but also the society, leading to [[janapadodhwansa]].</p>

<p style="text-align:justify;">Root cause for vitiation of air etc. factors is 'adharma' or misdeeds performed by intellectual errors ([[prajnaparadha]]). Sinful acts may be in the form of wars, demons, germs & curse.  In the present day, sinful acts can include different activities like antinational elements indulging in bomb blast, crime, deforestation, not obeying government rules in the industries, discharge of untreated polluted water in to the river, automobile pollution etc., which produce air pollution. Disposal of wastewater in an improper method on land leads to pollution of soil. The basic cause of such act is intellectual errors (prajnaparadha), due to rajas & tamas predominance resulting in greed, selfishness, tendency to harm people, jealousy & anger. All these factors influence not only the individual, but also the society, leading to [[janapadodhvansa]].</p>

==Preventive aspects==

==Preventive aspects==

<p style="text-align:justify;">[[Ayurveda]] durably gives priority to preservation of [[health]] of healthy person. Immunity plays a major role in occurrence and non-occurrence of any [[disease]], especially in such type of infectious [[disease]]. [[Ayurveda]] believes in ‘Sahaja [[bala]]’ (inherent immunity) of person. If that is reduced, then the possibility of getting an infection is greater. So, [[ayurveda]] recommends a comprehensive regimen for safeguarding health and increasing [[vyadhikshamatva]] (immunity) as a code of the health conduct viz ‘swasthavritta’. It includes the following practices: [Cha.Sa.[[Sutra Sthana]] 7/53-60], [Cha.Sa.[[Vimana Sthana]] 3/13-17]</p>

<p style="text-align:justify;">[[Ayurveda]] durably gives priority to preservation of [[health]] of healthy person. Immunity plays a major role in occurrence and non-occurrence of any [[disease]], especially in such type of infectious [[disease]]. [[Ayurveda]] believes in ‘Sahaja [[bala]]’ (inherent immunity) of person. If that is reduced, then the possibility of getting an infection is greater. So, [[ayurveda]] recommends a comprehensive regimen for safeguarding health and increasing [[vyadhikshamatva]] (immunity) as a code of the health conduct viz ‘swasthavritta’. It includes the following practices: [Cha. Sa. [[Sutra Sthana]] 7/53-60], [Cha.Sa.[[Vimana Sthana]] 3/13-17]</p>

*[[Dinacharya]] (daily code of health conduct)

*[[Dinacharya]] (daily code of health conduct)

*[[Ritucharya (conduct in relation to various seasons)

*[[Ritucharya (conduct in relation to various seasons)

*[[Sadvritta]] (details about life style, [[diet]], [[exercise]], personal and social hygiene)

*[[Sadvritta]] (details about life style, [[Ahara vidhi|diet]], [[Vyayama|exercise]], personal and social hygiene)

*Avoiding [[prajnaparadha]] (intellectual errors)

*Avoiding [[prajnaparadha]] (intellectual errors)

*Controlling senses ([[indriya]]pashama)

*Controlling senses ([[indriya|indriya u]]pashama)

*Memorizing the health protocols and following it

*Memorizing the health protocols and following it

*[[Shodhana]] (suitable purification therapies as per season and constitution).

*[[Shodhana]] (suitable purification therapies as per season and constitution).

*Following advices given by authorities and elder persons

*Following advices given by authorities and elder persons

*[[Ahara vidhi]] (dietary guidelines) [Cha.Sa. [[Sutra Sthana]] 7/53-54]

*[[Ahara vidhi]] (dietary guidelines) [Cha.Sa. [[Sutra Sthana]] 7/53-54]

These all-precautionary measures not only aid to increasing immunity, but also resist the mode of transmission of infectious agents like bacteria, viruses, and fungi. The preventive measures as advised in [[janapadodhwansa]] shall also be followed.  

These all-precautionary measures not only aid to increasing immunity, but also resist the mode of transmission of infectious agents like bacteria, viruses, and fungi. The preventive measures as advised in [[Janapadodhvansa|janapadodhwansa]] shall also be followed.  

== Treatment measures==

== Treatment measures==

<p style="text-align:justify;">New [[disease]] like COVID19 is one of recently known aupasargika [[roga]] (contagious or infectious [[diseases]]). The studies on the effect of Ayurveda formulations and therapies in the management of COVID-19 are supportive of the protocol of management of aupasargika roga. Few important studies related with the ayurvedic management of COVID-19 are highlighted as follows: </p>

<p style="text-align:justify;">New [[disease]] like COVID19 is one of recently known aupasargika [[roga]] (contagious or infectious [[diseases]]). The studies on the effect of Ayurveda formulations and therapies in the management of COVID-19 are supportive of the protocol of management of aupasargika roga. Few important studies related with the ayurvedic management of COVID-19 are highlighted as follows: </p>

<ol style="text-align:justify;"><li>In a case report, P.L.T Girija et al<ref name="ref1">Girija P.L.T, Sivan N. Ayurvedic treatment of COVID-19: A case report.Journal of Ayurveda and Integrative Medicine,2022,13(1):100329.</ref> noticed that the COVID-19 patient’s condition did not deteriorate when ayurvedic treatment was taken. Despite the patient having severe cough and fever more than 39.1°C, the patient’s condition did not worsen and develop breathlessness. Median time for onset of symptoms to recovery in mild and severe cases was 2 and 3–6 weeks, respectively. Furthermore, time interval between onset and developing severe symptoms such as hypoxia was one week. This patient had recovered in 7 days. Hence, it can be said that the duration of the disease was presumably shorter, because of the ayurvedic medicines. The regulated diet played an important supportive role in the cure. The diet advised was soup made of mung dal and cooked parboiled rice which is easy to digest (laghu) and stimulated the digestive power ([[agni]] [[deepana]]) and it nourished the patient. </li>

<ol style="text-align:justify;"><li>In a case report, P.L.T Girija et al<ref name="ref1">Girija P.L.T, Sivan N. Ayurvedic treatment of COVID-19: A case report.Journal of Ayurveda and Integrative Medicine,2022,13(1):100329.</ref> noticed that the COVID-19 patient’s condition did not deteriorate when ayurvedic treatment was taken. Despite the patient having severe cough and fever more than 39.1°C, the patient’s condition did not worsen and develop breathlessness. Median time for onset of symptoms to recovery in mild and severe cases was 2 and 3–6 weeks, respectively. Furthermore, time interval between onset and developing severe symptoms such as hypoxia was one week. This patient had recovered in 7 days. Hence, it can be said that the duration of the disease was presumably shorter, because of the ayurvedic medicines. The regulated diet played an important supportive role in the cure. The diet advised was soup made of mung dal and cooked parboiled rice which is easy to digest (laghu) and stimulated the digestive power ([[agni]] [[deepana]]) and it nourished the patient. </li>

<li>Ram Deo Pandit et al<ref name="ref2">Pandit R.D, Singh R.K. COVID-19 Ayurveda treatment protocol of governmentsof Nepal and India: A review and perspective. Applied Science & Technology Annals,2020, Vol.1, No.1 :72-80.</ref> concluded that polyherbal drugs in the protocol should be taken into series of clinical trials to test its effectiveness against COVID-19 and discover the pharmaco-clinical evidences and prove effectiveness. Immunity is vital factor in the management of COVID-19 pandemic condition. The prevention /arrest of pandemic can be achieved by adopting proper food habits and life styles as well as regularly taking the rasayanas.  It is need of time to implement  these    principles  in    National health policies  to  make  the  Nation  healthy.  </li>

<li>Ram Deo Pandit et al<ref name="ref2">Pandit R.D, Singh R.K. COVID-19 Ayurveda treatment protocol of governmentsof Nepal and India: A review and perspective. Applied Science & Technology Annals,2020, Vol.1, No.1 :72-80.</ref> concluded that polyherbal drugs in the protocol should be taken into series of clinical trials to test its effectiveness against COVID-19 and discover the pharmaco-clinical evidences and prove effectiveness. Immunity is vital factor in the management of COVID-19 pandemic condition. The prevention /arrest of pandemic can be achieved by adopting proper food habits and life styles as well as regularly taking the [[rasayana]].  It is need of time to implement  these    principles  in    National health policies  to  make  the  Nation  healthy.  </li>

<li>In a case report on COVID-19 patient with hypoxia by Jyoti Anand Joshi<ref name="ref3">Joshi J.A, Puthiyedath R. Outcomes of Ayurvedic care in a COVID-19 patient with hypoxia – A case report. Journal of Ayurveda and Integrative Medicine, 2022, 13 (1): 100363.</ref> suggested the potential of ayurvedic supportive care for recovery of COVID-19 patients even when they are oxygen-dependent. In this case, the patient declined Fabiflu because of the prohibitive cost, uncertainty of benefits and potential side-effects. Ayurvedic care based on an individualised and whole system approach could fill gaps and unmet needs in our response to the COVID-19 challenge.</li>

<li>In a case report on COVID-19 patient with hypoxia by Jyoti Anand Joshi<ref name="ref3">Joshi J.A, Puthiyedath R. Outcomes of Ayurvedic care in a COVID-19 patient with hypoxia – A case report. Journal of Ayurveda and Integrative Medicine, 2022, 13 (1): 100363.</ref> suggested the potential of ayurvedic supportive care for recovery of COVID-19 patients even when they are oxygen-dependent. In this case, the patient declined Fabiflu because of the prohibitive cost, uncertainty of benefits and potential side-effects. Ayurvedic care based on an individualized and whole system approach could fill gaps and unmet needs in our response to the COVID-19 challenge.</li>

<li>A study conducted by Anup Thakar<ref name="ref4">Thakar A, Panara K et.ol. Add-on Ayurveda Treatment for Early Stage COVID-19: A Single Center Retrospective Cohort Study From Gujarat, India. Journal of Evidence-Based Integrative Medicine. 2021, Volume 26:1-7.</ref> et al. suggested that ayurveda treatment as adjunctive might be more effective in mild/early-stage COVID-19 patients as compared to stand alone conventional care. This may provide leads to generate hypotheses for designing future studies, such as by helping identify the potential drug candidates from Ayurveda treatment and provide preliminary evidence for further clinical use in COVID-19 patients.</li>

<li>A study conducted by Anup Thakar<ref name="ref4">Thakar A, Panara K et.ol. Add-on Ayurveda Treatment for Early Stage COVID-19: A Single Center Retrospective Cohort Study From Gujarat, India. Journal of Evidence-Based Integrative Medicine. 2021, Volume 26:1-7.</ref> et al. suggested that ayurveda treatment as adjunctive might be more effective in mild/early-stage COVID-19 patients as compared to stand alone conventional care. This may provide leads to generate hypotheses for designing future studies, such as by helping identify the potential drug candidates from Ayurveda treatment and provide preliminary evidence for further clinical use in COVID-19 patients.</li>

<li>Shivangi Talwar<ref name="ref5">Talwar S, Sood S et. al. Ayurveda and Allopathic Therapeutic Strategies in Coronavirus Pandemic Treatment 2020. Clinical Pharmacology,2020; 6(6): 354–363.</ref> et al. reviewed ayurveda and allopathic therapeutic strategies in Coronavirus pandemic treatment and summarizes the utility of currently opted therapies for COVID-19. No suitable medicine was found to exist for this virus infection. The rapidly increasing patient’s data of COVID-19 is triggering scientific communities to come forward to develop some possible therapy. The most reassuring treatment is considered to be remdesivir. This drug is known to possess strong antiviral activity as proven by several in vitro studies. Oseltamivir has not presented with suitability, and corticosteroids are at present not recommended. On the other hand, homeopathy and Ayurveda may be promising, but not applicable towards all types of patients. Therefore, the present study concluded that COVID-19 infection can be prevented by following government guidelines and opting immune-boosting Ayurveda routes.</li>

<li>Shivangi Talwar<ref name="ref5">Talwar S, Sood S et. al. Ayurveda and Allopathic Therapeutic Strategies in Coronavirus Pandemic Treatment 2020. Clinical Pharmacology,2020; 6(6): 354–363.</ref> et al. reviewed ayurveda and allopathic therapeutic strategies in Coronavirus pandemic treatment and summarizes the utility of currently opted therapies for COVID-19. No suitable medicine was found to exist for this virus infection. The rapidly increasing patient’s data of COVID-19 is triggering scientific communities to come forward to develop some possible therapy. The most reassuring treatment is considered to be remdesivir. This drug is known to possess strong antiviral activity as proven by several in vitro studies. Oseltamivir has not presented with suitability, and corticosteroids are at present not recommended. On the other hand, homeopathy and Ayurveda may be promising, but not applicable towards all types of patients. Therefore, the present study concluded that COVID-19 infection can be prevented by following government guidelines and opting immune-boosting Ayurveda routes.</li>

<li>In a study, Alka Mishra<ref name="ref6">Mishra A. et. ol. The use of integrative therapy based on Yoga and Ayurveda in the treatment of a high-risk case of COVID-19/SARS-CoV-2 with multiple comorbidities: a case report. Journal of Medical Case Reports, 2021; 15:95.</ref> et al found that the Integrative therapy was effective in mitigating the symptoms of COVID-19 in a patient with multiple comorbidities. Moreover, a significant improvement in blood sugar levels was also achieved. </li>

<li>In a study, Alka Mishra<ref name="ref6">Mishra A. et. ol. The use of integrative therapy based on Yoga and Ayurveda in the treatment of a high-risk case of COVID-19/SARS-CoV-2 with multiple comorbidities: a case report. Journal of Medical Case Reports, 2021; 15:95.</ref> et al found that the Integrative therapy was effective in mitigating the symptoms of COVID-19 in a patient with multiple comorbidities. Moreover, a significant improvement in blood sugar levels was also achieved. </li>

<li>In a paper published by Ram Manohar<ref name="ref7">Puthiyedath R.et. ol. Ayurvedic clinical profile of COVID-19 – A preliminary report.Journal of Ayurveda and Integrative Medicine, 2022; 1:100326.</ref> et. Al. on ayurvedic clinical profile of COVID-19 suggested that COVID-19 can be classified as agantuka jvara with a vata kapha pradhana sannipata presentation. The dominance of pitta in certain stages of the disease and in some patients should be considered. However, COVID-19 needs to be further subclassified under the category of vata kapha pradhana sannipata jvara on the basis of a more detailed analysis of clinical symptomatology of a cross section of COVID-19 patients representing diverse populations from different geographical regions in the world. It is possible to develop provisional Ayurvedic clinical classifications of COVID-19 in consultation with modern medical doctors treating COVID-19 patients an Interdisciplinary AYUSH research Task force for COVID -19 is the need of the hour. Such policy decisions may create a better integrative environment in the future which underlines the significance of this study.</li>

<li>In a paper published by Ram Manohar<ref name="ref7">Puthiyedath R.et. ol. Ayurvedic clinical profile of COVID-19 – A preliminary report.Journal of Ayurveda and Integrative Medicine, 2022; 1:100326.</ref> et. Al. on ayurvedic clinical profile of COVID-19 suggested that COVID-19 can be classified as agantuka jvara with a vata kapha pradhana sannipata presentation. The dominance of pitta in certain stages of the disease and in some patients should be considered. However, COVID-19 needs to be further subclassified under the category of vata kapha pradhana sannipata jvara on the basis of a more detailed analysis of clinical symptomatology of a cross section of COVID-19 patients representing diverse populations from different geographical regions in the world. It is possible to develop provisional Ayurvedic clinical classifications of COVID-19 in consultation with modern medical doctors treating COVID-19 patients an Interdisciplinary AYUSH research Task force for COVID -19 is the need of the hour. Such policy decisions may create a better integrative environment in the future which underlines the significance of this study.</li>

<li>Srivastava Niraj<ref name="ref8">Srivastava N,Saxena V. A review on scope of immune-modulatory drugs in Ayurveda for prevention and treatment of Covid-19.  Plant science today, 2020; 7 (3): 417-723.</ref> et al. reviewed that Ayurveda recommends ‘rasayana dravyas’ like Ashwagandha (Withania somnifera (L.) Dunal), Amalaki  (Phyllanthus emblica  L.), Tulasi (Ocimum sanctum L.), Guduchi  (Tinospora cordifolia  (Willd.)Miers), Pippali (Piper longum L.) etc exhibit antiviral,  anti-inflammatory and antioxidant properties, it may be favorable to consider them for the treatment of COVID-19.</li>

<li>Srivastava Niraj<ref name="ref8">Srivastava N,Saxena V. A review on scope of immune-modulatory drugs in Ayurveda for prevention and treatment of Covid-19.  Plant science today, 2020; 7 (3): 417-723.</ref> et al. reviewed that Ayurveda recommends ‘rasayana dravyas’ like [[Ashwagandha]] (Withania somnifera (L.) Dunal), [[Amalaki]]   (Phyllanthus emblica  L.), [[Tulasi]] (Ocimum sanctum L.), [[Guduchi]]   (Tinospora cordifolia  (Willd.)Miers), [[Pippali]] (Piper longum L.) etc exhibit antiviral,  anti-inflammatory and antioxidant properties, it may be favorable to consider them for the treatment of COVID-19.</li>

<li>Shankar Gautam<ref name="ref9">Shankar G, Arun G, Sahanshila C, Urza B. Immunity against COVID-19: Potential role of Ayush Kwath. Journal of Ayurveda and Integrative Medicine, 2022; 13(1): 100350.</ref> et. al concluded that Ayush kwatha due to its antiviral, immune-modulatory, antioxidant, anti-inflammatory, anti-platelet, anti-atherosclerotic, hepato-protective, reno-protective properties; seems to be effective in regulating immunity for the prevention and reduction of viral disease complications. As there is lack of enough evidence to support its specific role against coronavirus, there is a requirement to validate the effectiveness of these formulations with extensive biotechnological, pharmacological, and clinical research.</li>

<li>Shankar Gautam<ref name="ref9">Shankar G, Arun G, Sahanshila C, Urza B. Immunity against COVID-19: Potential role of Ayush Kwath. Journal of Ayurveda and Integrative Medicine, 2022; 13(1): 100350.</ref> et. al concluded that Ayush kwatha due to its antiviral, immune-modulatory, antioxidant, anti-inflammatory, anti-platelet, anti-atherosclerotic, hepato-protective, reno-protective properties; seems to be effective in regulating immunity for the prevention and reduction of viral disease complications. As there is lack of enough evidence to support its specific role against coronavirus, there is a requirement to validate the effectiveness of these formulations with extensive biotechnological, pharmacological, and clinical research.</li>

<li>Sanjeev Rastogi<ref name="ref10">Rastogi S. Ayurveda co-interventions have supported complete recovery in severe COVID-19 infection with a chest severity score 18/25 : A case report. Journal of Ayurveda and Integrative Medicine, 2022; 13(2):100417.</ref> concluded that Ayurvedic interventions have supported complete recovery in severe COVID-19 infection with a chest severity score 18/25. This case report highlighted that despite prolonged hospitalization in an ICU, Ayurvedic intervention can prevent deterioration leading to complications, and enable complete recovery.</li>

<li>Sanjeev Rastogi<ref name="ref10">Rastogi S. Ayurveda co-interventions have supported complete recovery in severe COVID-19 infection with a chest severity score 18/25 : A case report. Journal of Ayurveda and Integrative Medicine, 2022; 13(2):100417.</ref> concluded that Ayurvedic interventions have supported complete recovery in severe COVID-19 infection with a chest severity score 18/25. This case report highlighted that despite prolonged hospitalization in an ICU, Ayurvedic intervention can prevent deterioration leading to complications, and enable complete recovery.</li>