Friday, April 28, 2017

DENGUE, ZIKA and MOSQUITO

Miss DENGUE






Latest first:  Miss Dengue has entered the Biology Question Paper of CBSE Examinations of 2024.


Dr. T. Rama Prasad                                                           November 2, 2017

Dear Miss Dengue,

          CONGRATULATIONS.   You have been a great success this time.  Stars were not favourable to you when you visited us a few years ago.   Now, you are equipped with good "Media Power" and "Kill Power."   Your 'Killer Image" is boosted by the 'proxy' deaths  caused by your "Sister Microbes."  Regular consumers of news could not have missed you on any day during the past few months -- on the health front, administrative arena and political canvas.  You have proved yourself to be a good player -- global score - 390 million; India - 18,700;  Kerala - 9,104;  Tamil Nadu - 4,174;  Karnataka - 1,945;  Gujarat - 616;  Andhra Pradesh - 600;  West Bengal - 469  (dengue cases as on July 2, 2017).  Fear mongering,  rumourmongering and politics helped you a lot.  Your name is on everybody's lips, though most  of us don't know how to pronounce your name correctly --  most of us call you "dengu" though the mostly accepted correct pronunciation is "daen-gay."

          Opposition parties held the governments responsible for the havoc caused by you.  You made us grapple with your outbreak while whipping up controversies.  And, you aroused too much of a political comment in Tamil Nadu -- you made the chief opposition leader (Stalin) to call the ruling regime as "Dengue Government", and made the Chief Minister (Edappadi K. Palaniswami) to charge that the fault-finder was only capable of criticising but not coming up with constructive suggestions to contain you and the mosquito (The Hindu, October 27, 2017) !!!  Ruling party and the administrators projected  a picture of well-oranized  action in place to contain you and your transmitter, the little devil, mosquito.  'Clean India' campaigns are inaugurated once again with vigour and vitality.  They say that they are doing the best that is possible.

          Heavy fines are imposed on a few of the millions who kept the environment 'mosquito-friendly'.  The well-oiled official machinery is going on as usual.  People run in circles as it is the easiest way;  and evasion overwhelms correction;  and rules are littered with commas and semicolons;  and the epitaph for every failure has excuses -- noncooperation by the public and paucity of funds.  Otherwise, ours also can become a 'fine' country like 'fine' Singapore with the proposal to levy a fine ranging from Rs.150 to Rs.10 lakh if mosquito breeding source is found in private premises.  Singapore is jocularly called a "FINE country" because of the very heavy FINES imposed by its government for even very minor offences (minor in our perception) like letting your dog defecate on a road.  "FINES" system has been working well in Singapore as bribing is not in vogue there to evade "FINES" ... and Miss D, you don't know about our systems and ground realities ... well, you need not know ... they are our internal affairs ... carry on with your job of infecting people !  

          And add to this the direction of a District Collector to "all the private establishments and households to take effective steps for the eradication of all the mosquito breeding sources on their premises within next two days"  (The Hindu, October 29, 2017).  Miss Dengue, what will you do after two days ?  In this context, Miss, you may get some comfort by reading my writings on 'eradication' of mosquito, published thirty years ago in The Hindu of October 6, 1986 !!!  (reprinted below).  That is because what could not be done in these 30 years can't possibly be done in 2 days !  Anyway, thank you Miss Dengue, the pronouncements of fines and 2-day ultimatum have sensitised people and created health awareness which would go a long way for facilitating better health in India.  Let us (excluding you Miss) pray that these may not belong to the usual "knee-jerk" reactions we had witnessed over decades.  Thank you for the terror and panic.

          Kudos, dear Miss Dengue, you could get such 'box-office-hit' publicity without a professional organisation -- but we are not sure, you may be having one as it may involve a lot of business though not as much as it was when your sister virus 'Swine  Flu' was allegedly declared a pandemic some years ago by vested interests to make money by selling 'Tamiflu' tablets, face masks, mosquito repellents, etc. -- for details, read the 'Scribbling' titled 'MODERN MEDICINE -- the good, the bad and the ugly' on this blog. 

         You are a poor virus to be contended with the herbal drug, "Nilavembu (Andrographis paniculata) kashayam" which is mostly given free of cost and actively recommended by the State government.  No expensive specific drug is available to kill you.  However, you dear,  had a lot of fun with the controversies about the  'kashayam / kudineer'.   'Nilavembu' was reportedly endorsed to be effective by 17 studies, and the US-based 'Memorial Sloan Kettering Cancer Center' found 'Nilavembu' to be effective in reducing severity and duration of various ailments. However, a five-member committee sent to Tamil Nadu by the Central government said they would not recommend mass administration of 'Nilavembu'.  And, dear,  you are the cause for kicking up a controversy about this herbal medicine. A famous cinema actor and a politician in the making {Kamal Haasan) suggested to his fans not to distribute the 'kashayam'.  And, the High Court directed authorities to register an FIR against the actor if any cognizable offence was made of his action on the 'kashayam'.  You played an interesting role, darling Dengue,  in feeding  the news-hungry media continuously.
  
          But, dear Miss D, you have the potential to make a huge commission (call it 'royalty') if a 'Dengue Vaccine' is marketed in India.  You can become a billionaire overnight, as we gullible people would fall for it just as we are now rushing for admissions into hospitals at the slightest hint of feverishness and the chilling thought of your 'kill-power' !!!  Of course, you know very well, Miss  Dengue, that a great majority of the people infected by you would recover without any treatment or with just a bit of symptomatic treatment,  and that 80 per cent of those infected by you do not have any symptoms --  contributing to 'herd immunity'.  Only very few run into serious problems like 'Dengue Haemorhagic Fever' and 'Dengue Shock Syndrome'.  But how could you create so much of fuss with a few deaths ?  Yes, "few" when compared to 1,000 deaths every day due to your cousin microbe 'tuberculosis' in India, and the news of 20 deaths every day due to your uncle 'Japanese Encephalitis virus' (or 'scrub typhus' - another controversy !) in a medical college hospital in Gorakhpur.  Then, why are we loaded with morbid fear about you, dear ? 

          We seem to need a vaccine to protect us from you.  So, my dear Miss Dengue, read below about "your vaccine" and introduce it in India and make hay while the sun shines (while the scare is still abundant).  And we fools would stand in the queue with currency bundles for your vaccine which may in fact increase your 'kill power'.  Though it is 'suspended'  in Philippines, you may be able to market it here through 'well-greased machinery'. 

          For the present, Miss, you may make good pocket money by striking a deal with the manufacturers of mosquito-related  repellents, vaporisers,  coils,  creams, oils, and the like.  Also, don't forget to read what I scribbled about your sister "ZIKA virus" down below.  Best wishes, dear, for a prosperous future.  May the MEDIA (not God) bless you !!!

Postscript

And, finally, Miss Dengue, one request -- please don't get married.  No, no, not that --not that your marriage would end my 'girlfriendship' with you -- but, because you may choose a more virulent virus than you as your life mate which may result in your giving birth to very vicious 'child viruses' which may wipe out humankind from this planet !!!

And, one proposal, darling, in the national interest.  Why not we both go on a long holiday to your native African rain forests to grant India a respite !

Your loving boyfriend,

T. Rama Prasad.

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Dear reader,  
          If media do not report any more 'Dengue deaths',  you may take it granted that Miss Dengue had acceded to the proposal in my 'love letter' above.  I hope to return leaving her behind. In the national interest,  I should see that she doesn't develop an attachment  lest she may come back to India.   If you wish to know about my real love letters, read the 'Scribbling' titled 'MY LOVE STORY  &  good old days' on this blog.
         T. Rama Prasad.
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WORLD's first DENGUE VACCINE ... March 6, 2017
(This is what I wrote on FACEBOOK while in Singapore)




WORLD's first DENGUE VACCINE ... March 6, 2017
(This is what I wrote on FACEBOOK while in Singapore)

Being in Singapore today (March 6, 2017), I happened to see in the newspapers here that the world’s first Dengue vaccine, DENGVAXIA, will be commercially available in Singapore starting this week, though it is not as effective against Den 1 and Den 2 (the common strains circulating in Singapore) as it is against Den 3 and Den 4 strains (http://www.straitstimes.com/…/first-dengue-vaccine-availabl… ).

The Dengvaxia has been given to about a million children in Philippines. An 11-year-old boy died days after getting the vaccination, but it was said that he died of complications arising out of congenital heart disease. And ‘public health advocates’ are warning that the vaccine could increase dengue’s severity due to what is called “antibody-dependent enhancement”, three years down the road.  The Executive Director of the Philippine Foundation for Vaccination said that there will always be people against vaccinations as there is no vaccine that is 100 per cent effective and safe ( http://www.straitstimes.com/…/dengvaxia-given-to-a-million-… ). Added to this confusion, is the study (2016) by an international team of scientists (York University, etc.) which found that vaccination against ‘Dengue fever’ can increase ‘Zika virus’ outbreaks !


As on December 5, 2017, the Food Drugs and Administration (FDA) of Philippines ordered suspension of sale, distribution and marketing of the dengue vaccine, DENGVAXIA (of Sanofi Pasteur company) as it poses potential risk to those who never had dengue. The vaccine may cause severe form of dengue if exposed to the virus, in the case of persons who never had dengue before being vaccinated.  The 733,000  public school children who were vaccinated  are at risk.  The Department of Health (DOH) ordered an investigation.  The fate of these children is to be studied and the alleged culprits behind this botched P 3.5 billion anti-dengue massive vaccination drive are to be identified.   Introduced the vaccine in a hurry to make money ! Of course, everybody is in a hurry to introduce before competitors did.  Yes, it is disgraceful to 'Modern Medicine'.  To read about more disgraceful things,  read the 'Scribbling' titled 'HCQ, IVERMECTIN, Coronavirus and Frauds'  &  'MODERN MEDICINE -- the Good, the Bad and the Ugly' on this blog.


June 2021

  • A vaccine to prevent dengue (Dengvaxia®) is licensed and available in some countries for people aged 9 to 45 years. The World Health Organization recommends that the vaccine only be given to persons with confirmed previous dengue virus infection.
  • The vaccine manufacturer, Sanofi Pasteur, announced in 2017 that people who receive the vaccine and have not been previously infected with a dengue virus may be at risk of developing severe dengue if they get dengue after being vaccinated. 

DENGUE VACCINE in INDIA by 2026

        It is reported (The Hindu, March 19, 2024) that 'Indian Immunologicals Limited' (a subsidiary of the National Dairy Development Board)  has finished the first phase of clinical trials and is set to release the vaccine in mid-2026.  The company which launched the Hepatitis A vaccine, Havisure, is also developing a vaccine for the Zika virus and for the Kyasanur Forest Disease (KFD).  The KFD virus was first identified in 1957 in Karnataka's forests, infecting hundreds of people annually since then.  Ticks and infected animals like monkeys may transmit this disease.
        Let's hope that this Dengue vaccine won't end up like the 'DENGVAXIA'.

October 8, 2021
"Dengue affects tens of millions each year, producing brutal symptoms that have earned it the moniker "BREAKBONE FEVER."  It is estimated to infect at least 98 million people a year and is endemic in 128 countries worldwide, and there is no specific drug active against this disease so far.    As there are four different strains, it is difficult to make a vaccine for all and the vaccines face the problem of the dreaded "Antibody Dependent Enhancement" complication.  The journal NATURE just published (October 2021) an article giving a hope that a compound named JNJ-A07 may become an effective drug against this virus in course of time, if it passes through all the clinical trials and approvals.


Back at home,  Madhavi Yennapu, Scientist, National Institute of Science, Technology and Development Studies, Delhi suspects that the idea of including expensive combination vaccines (pentavalent 5 in 1 vaccine) in the Universal Immunisation Programme is a ‘politico-economic’ move (THE WEEK, Feb. 17, 2013).  And in 2017, a huge opposition to “MR vaccination to children”,  propelled by ‘social network media’, caused stupendous confusion to the parents in Tamil Nadu.

         All this is a testament to our thoughtless tinkering with NATURE, causing ecological imbalance leading to more diseases, more vaccinations, more drugs, more side-effects and more confusion. We have to blame ourselves. Medical care has become a monumental conundrum.

Photo taken in a medical facility in Singapore on the day of release of the Dengue vaccine --  March 2017


Dr. T. Rama Prasad,   http://drtramaprasad.blogspot.com
'PAY WHAT YOU CAN’ Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.


The 7th Regional Committee Session of Health Organization (WHO) --  South-East Asia Region held at Male recently (2017) observed that:

1.  Dengvaxia (CYD-TDV) vaccine should b considered only in geographic settings with

     high endemicity.
2.  The capacity of health systems should be strengthened to prevent, detect and
      eliminate existing and emerging vector-borne diseases such as dengue,
      chikungunya and malaria.

3.  The risk of getting vector-borne diseases has increased primarily due to 
      unplanned urbanisation,  increased movement of people and goods, and 
      environmental changes.

4.  India is battling a multiple onslaught of dengue, malaria, chikungunya (10,952 cases) 
     and other such diseases.  The root cause of transmission (mosquito) is to be contained.

5.  Vector-borne diseases are preventable if vector control is implemented.

6.  Your diet, lifestyle and the environment --  all play an important role in determining
     the risk of the vector-born diseases.  While t is imperative to maintain good
      hygienic living conditions and good sanitation all around,  it can also help to 
      include certain foods in your daily diet that improve immunity and increase capacity
      to fight infections.  Some of such foods are:

          a)  HONEY,  b)  GINGER,  c)  TURMERIC. d)  LEMON  e)  CURD (yogurt)

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The 'Dengue virus' is transmitted to humans through the bites of infected female mosquitoes, primarily the Aedes aegypti mosquito. Other species within the Aedes genus can also act as vectors, but their contribution is secondary to Aedes aegypti

The most prominent mosquito-borne diseases are transmitted by three genera of mosquitoes – Aedes, Culex, and Anopheles.


Mosquito-borne diseases are illnesses spread by the bite of an infected mosquito. They include:

Viruses cause most diseases spread to people by mosquitoes. Malaria is caused by a parasite.

Different mosquitoes carry different diseases. The incidence of these illnesses depends up on where people live or travel to, and the time of the year.


         I am stunningly amused to read a front-page bold news report about mosquito control by analysing the buzz sound of mosquitoes which "could be a crucial input for shaping appropriate and timely control measures for mosquito-born diseases" (The Hindu, November 2, 2017).  A 'Stanford University' team seems to claim to be on the way to control mosquitoes and the related diseases,  if people record the buzz sound of their mosquitoes and share the recording with an international database.  It is reported that they would identify the various species of mosquitoes by the wing-beat frequency of the mosquitoes and their location across the world and plan for a global battle against the creature.  Are you able to understand this digital war ?  I couldn't.  We would be running to hospitals while they methodically plan to create a world map of what type of mosquito resides where !  Tomorrow, another research study may be published saying that by recording and analysing the cough sound of TB patients the drug-resistance profile of the infecting bacillus may be found out and that TB could be wiped out !!!  Of course,  1,000  persons would still  be dying of TB everyday in India. 
         Crazy research goes on in countries which have too much of funds and a dearth of good subjects of practical value !  Research could take man to MOON and kill 100,000 persons on 6 August 1945 in Hiroshima, but could not wipe out the tiny mosquito !!!  Shameful.  Research -- search for sense or nonsense !

          Interestingly,  the following are my writings published in newspapers 30 years  ago.  The suggestions made at that point of time are still valid today.  What progress did we make ??? 

                                                             --  T. Rama Prasad,  November 1, 2017.



October 6, 1986


THE  HINDU, Oct 6,  1986
THE  HINDU, Oct 31,  1987






--  Dr. T. Rama Prasad,  October 6,  1986





(Not) Dear Mosquito,

We hate you.  We feel defeated by you. None of our weapons worked to wipe you out.  As you can see from the above writings, I have been crusading against you for the past 30 years, but only you have become stronger, developing  resistance to a wide-range of insecticides, hosting more and more of dangerous microbes,  causing the death of scores of people across the world.  

          For centuries, we have been letting you thrive on our blood, but you have been ungrateful, biting the feeding hand.  See your co-creature, the humble 'House Fly'.  It eats leftovers, doesn't disturb our sleep and doesn't kill us like you.  When I was a medical student, more than half-a-century ago, you used to transmit only a few diseases like filariasis and malaria.  Over the decades you have become stronger with our blood and started transmitting new and dangerous diseases.  This is not good reciprocation.  We hate you, ungrateful blood-sucking beast.  You can't go about singing any more -- we are developing a 'Nuclear Tool' through 'Sterile Insect Technique' to biologically control you.  No best wishes.

Yours unfriendly,

T. Rama Prasad.
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WORLD MOSQUITO DAY -- August 20

         Such a small creature called mosquito has been causing problems of gargantuan proportions across the globe (malaria, dengue, etc.). We have miserably failed to contain this little devil.
         The latest method (A nuclear tool -- Sterile Insect Technique) that is being tried is to "mass-produce" sterile male mosquitoes in laboratories in huge numbers and leave them in the environment to biologically control the mosquito population !
   " ...World Mosquito Day, observed annually on 20 August, is a commemoration of Indian doctor Sir Ronald Ross's discovery in 1897 that female mosquitoes transmit malaria between humans... Ross is responsible for the annual observance, having declared shortly after his discovery that the day should be known as World Mosquito Day in the future ...
         The London School of Hygiene & Tropical Medicine holds Mosquito Day celebrations every year, including events such as parties and exhibitions, a tradition dating back to as early as the 1930s ... "
“Mosquitoes remind us that we are not as high up on the food chain as we think.”                                                                                                                        -- Tom Wilson
Sir Ronald Ross
PLAY UP  &  PLAY DOWN

          The goal is never achieved.  Every now and again,  a disease would surface and there would be a spurt of activity,  followed by a period of inactivity.  There would be a wave-like reactions and measures.  Then the business would be as usual -- lucky for the mosquito and the microbes.  Every episode results in more rules, regulations, committees and bureaucratic activity.  What is expected of them would be different from what is achieved.  This dichotomy is something we Indians have been used to for decades.  The Lokpal is a living example.  We run in circles,  because it's easy.  The episodes erupt periodically and subside.  You don't worry, reader, as long as your immunity is good.

          Imbalanced, we dance.  We suspect every fever to be due to dengue now,  and we forget about it after some time.  A few months ago, around August 2017, we were given the impression that a vast section of youth in India were "infected" by the suicidal "Blue Whale Challenge" game, and we are silent on that.  And around the same time-period, we came to know that about 20 deaths occur daily due to encephalitis virus (brought to focus by allegations of the deaths due to lack of oxygen supply) in a medical college hospital in Gorakhpur.  And soon later the media are silent on this.  And now, October 2017, starvation deaths in Jharkhand.  Media game --  sensationalisation, blowing up, criticism, knee-jerk reactions. --  then the business as usual.  This is not to trivialise or belittle the governmental efforts, but to put it in perspective.  Why 1,000 deaths per day due to TB every day in India is not even in 'foot notes' of the media ?


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ZIKA  virus

Dr. T. Rama Prasad      

                                                                                                           
July 11, 2017

         Zika has hit the headlines again today (July 11, 2017) with the news that Tamil Nadu (India) has reported its first case of Zika virus.  The patient, a 27-year-old man and a tailor,  from Krishnagiri district complained of fever, redness of eyes, tiredness, knee pain and head ache.  Three months ago, he travelled to Bengaluru and Andhra Pradesh.  This could just be the tip of an iceberg of various  infections transmitted by the little giant, MOSQUITO.  Nothing to get panicked. No need for knee- jerk reactions.   CONTAIN  THE  MOSQUITO  IF  YOU  CAN !!!  

Like many other diseases, Zika also might have been in India since a long time.  Only we didn't have the means to diagnose it. In those good old days of Madras Presidency, one from Tiruvallur was found to be having antibodies against Zika, in the 1950s.  He must have been exposed to the virus and developed antibodies to it.  A study done way back in 1952-53 showed that one-sixth of the blood samples tested in India contained antibodies to Zika.  Hence, it is not a new invader.  Many known or unknown viruses infect us now and then and we get over the disease without specific treatment.  Only in a minority of the cases, specific blood tests are done.  When a test reveals the presence of a rare and known virus,  the 'VIP' virus 'goes viral on the Net' !!!

Zika, Zika, where were you
All these decades ?
Searching, searching for you
Engaged were we in debates. 
Zika, Zika, why not you
Go back to African rain forests ?
                        --  T. Rama Prasad



We can't ask the MOSQUITO to go away, as it is mightier than an elephant !!!
See,  the elephant is scared of the mosquito !
May 28, 2017

                  News grabbed the headlines today (May 28, 2017) of the first three cases of ZIKA  VIRUS in India which were detected about five months ago.  Public health experts wondered why the information was kept as a secret for five months  --  national security involved !  Incredible India !  The usual preventive advisory against the little giant, MOSQUITO (which spreads zika, dengue, chikungunya, yellow fever, brain fever, filariasis, etc.)  splashed across the media once again.   Déjà vu !

            The following is what I wrote and published on January 30, 2016 – about one and a half years ago.   Read in between the lines to know what our science, commerce and deeds really are.
                                                                                        
                                          January 30, 2016

ZIKA virus -- Jan 30, 2016
You might have just read about ZIKA virus and its possible link with microcephaly in newborn babies, as well as neurological problems in adults. And about the statement of the Head of the World Health Organization (WHO) that the ZIKA virus "is now spreading explosively" in the Americas. And it may get the nod of the WHO to acquire the status of the evil of "Global Public Health Emergency" magnitude. Yes, very sweet news for the industry which made a fortune when the WHO declared "SWINE FLU" as a pandemic in 2009 (some alleged that it was a pro-industry declaration without validity -- http://www.thehindu.com/…/pandemics-in-t…/article6625928.ece ) . The trick is to create a panic across the world and make money by selling globally products which are made to be perceived as necessary. In fact, panic itself has become pandemic according to the medical scholars, Luc Bonneux and Wim Van Damme.
It may be interesting to know that the ZIKA virus was first isolated in 1947 from a monkey in ZIKA Forest of Uganda and that a mosquito population capable of transmitting the ZIKA virus has been found in the neighborhood of Capitol Hill of Washington.  While this virus usually spreads through mosquito bites, a person in Texas seems to have been infected through sex with a person who had returned from South America. And, curiously, none of the thousands of Zika- infected women in Columbia gave birth to babies with microcephaly which is strongly suspected to be associated with Zika infection in many other countries.  “The eye could be a reservoir for Zika virus;  may spread through tears,” said Michael S Diamond, a professor at Washington University School of Medicine (2016).
Perhaps, many viruses started their global journey from African rain forests, striking terror across the world. We have interfered too much with 'Nature', intruding into the forests and causing 'tropical biosphere devastation' leading to ecological imbalance which may be the cause for the emergence of new dangerous (Biosafety Level 4) microbes.
Some known new / dangerous microbes are: Marburg virus (MARV), Ravn (RAVV), Nipah virus, Japanesee Encephalitis, Naegleria (brain-eating amoeba, Cryptococcosis, Hanta viruses, Hendra virus, Helminths virus, MERS-CoV, NDM-1, A/H1 N1 flu, SARS, Ebola, etc. There must be a number of unknown microbes infecting / killing people around the globe. We just can't diagnose these cases, and often give them wrong diagnostic labels.

Don't  get scared, my dear friends.The new diseases make sensational headlines though they may not cause as much harm as the existing ones. The fashion is to talk about new diseases while ignoring the old diseases which cause more economic damage and kill more number of people. Tuberculosis (TB) is an example. In laid-back India, 1,000 persons are dying every day due to TB. And now, the most dangerous drug-resistant TB, the XDR-TB (resistant to almost all the available drugs) is emerging. God, save us !
 I wrote 40 years ago (Apr. 28, 1977) in THE HINDU that "development of drug resistance, which is a result of inadequate and irregular treatment mostly, has far-reaching implications and if unchecked would make tuberculosis totally unmanageable by the present methods in course of time, whatever be the means."

Dr. T. Rama Prasad,   http://drtramaprasad.blogspot.com
'PAY  WHAT  YOU  CAN' Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.





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