The National Capital is a safe city for the female Aedes aegypti mosquito. For the male too, but it’s the female that bites and transmits the deadly dengue fever which has Delhi and neighbouring cities in panic.
The situation is chaotic. Overburdened doctors, overflowing patients, limited hospital beds. It’s the biggest outbreak of dengue in Delhi in the last five year, but like every year, the official figure for the number of infections stands only at 1800.
A study done by US and Indian researchers, published in medical journal The Lancet found, the actual number of dengue cases in India are nearly 300 times higher than the official figure.
The scale of the under-reporting is shocking but in the last 50 years, the incidence of dengue has jumped 30 times world wide. The virus discovered 60 years back, can cause debilitating pain and fever, is fatal one in five times, yet, there is no fixed cure for it or a vaccine.
Dengue Vaccine: The Challenge
The World Health Organisation puts half the world at a risk of contracting dengue. In 2010 alone, 2.4 million cases of dengue fever were reported world-over, but The Lancet predicts, the actual number of cases could have been as high as 390 million!
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Till now, six vaccines against dengue have reached clinical trial stages. Leading the way is pharmaceutical giant Sanofi, whose vaccine was shown to cut the incidence of dengue by 61% in stage 3 animal clinical trials. Even if Sanofi’s candidate achieves the same efficacy rate in human trials, it will be a far-shot to tackle the disease head-on.
The big question then, why hasn’t two decades of research been successful in finding a cure for the deadly dengue disease?
The Complications:
1. A vaccine will not be as simple as one for measles or mumps: Dengue is caused by four related but entirely individual viruses (dengue 1 to 4), which differ in their antigenicity, meaning that any vaccine you develop must protect against not 1 virus, but 4. All measles and mumps viruses are considered antigenically the same; one virus = one vaccine.
2. Scientists don’t actually know what makes a good dengue vaccine: Is it high antibody levels? Cytotoxic T cells? Where must you evoke immunity? How do you know you’re successful if you don’t know what successful is?
3. There is no animal model out there which fully replicates what we see in humans. This further hampers any work we do on how the virus replicates in us and how we can prevent this with vaccination.
4. Dengue largely affects India, Africa, South- East Asia, Brazil; sparing the much of the developed world. For most part, drug companies respond to the rich-country markets. No wonder, only when Ebola, a disease of the dense tribal areas of Africa reared it’s ugly head in the West, a vaccine was churned out in no time. Clinical trials are not cheap and mosquito-borne diseases are not a priority. Period.
5. Experts don’t want any reversion to the virulent dengue virus. The use of live-attenuated viruses, always holds the risk of a genetic mutation turning your nice and safe vaccine virus back into its deadly counterpart. So experts have to be doubly sure before getting the license for clinical trials for a risky candidate.
Home Cure for the Deadly Sting
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In dengue, the condition goes worse if your platelets fall below the 50,000 mark. A transfusion of platelets will leave your pocket hurting by at least a lakh in a private hospital.
The Indian Institute of Forest Management has done a thorough study on the effectiveness of the papaya leaf juice in dengue patients and found that within two days patients reported a 30 to 60% jump in platelet counts and a “miraculous” relief in pain and overall discomfort.
Doctors in AIIMS advise juice made from fresh papaya leaves as an alternative to all dengue patients.
Papaya enzymes revive the white blood cells. Even though we recommend transfusion in severe cases, the juice could be an option for dengue patients who don’t suffer a drastic fall overnight. Even if it merely assists the natural process of revival, it’s worth consuming it.
– Dr Gautam Mukhopadhyay, Surgical Oncologist, Ruby General Hospital
(PS: Dengue fever is a severe, debilitating form of viral disease. In no way does educating reader’s about alternate treatment imply that you don’t seek medical attention. The disease can be fatal, follow your doctor’s advise)
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