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It was painful to watch my cousin writhe in pain, battling a 105-degree fever, on a cold hospital bed. The 32-year-old is allergic to analgesics, which means his pain cannot be alleviated. The next three days he would be shivering in ice baths, to keep his organs from frying. All thanks to an unwarranted mosquito bite! The dreaded word had been spoken – he is dengue positive.The whole family is anxious and praying for a fast recovery, and blessing the stars for the silver lining of an early detection. Unfortunately, dengue in India, is raging rampant even today. Last week there have been 180+ reported cases in Chandigarh alone. So, dengue is up, close and dangerous. And what is worse, the disease has no known cure – like most viral diseases, one needs to let the virus run its course. But what if there was a Dengue vaccine?
Just in case you are not sure what Dengue is
It is a flavivirus disease found in tropical regions, mostly. The disease has four known strains, with no specific treatment and prevention being, currently, limited to vector control measures.
The Aedis Aegypti mosquito that carries the vector is a day hunter, as opposed to the malaria carrier, Anopheles.
So, it can get you anywhere – at work, during your commute or during your chai break at the street corner. The disease causes very high fever, joint pain, nausea, bleeding and in the most unfortunate cases, death.
Dengue is an endemic in India today
In 2016, until August, there were 27,879 cases of dengue and 60 deaths because of dengue hemorrhagic fever, in India. Delhi has been one of the most affected cities, with 432 reported cases till date (per the National Vector Borne Disease Control Program website).
So, bottom-line, we have a nasty killer on the loose with no way to get rid of it. At this point, a preventive would be most welcome!
The Ray of Hope – a preventive vaccine against Dengue is finally here
For the last 20 years, scientists have been exploring a preventive vaccination for Dengue, an initiative that has been delayed due to varied technological challenges of the discovery process.
Last December, Sanofi Pasteur, a French multinational pharmaceutical, registered the first-ever preventive vaccination for Dengue, Dengvaxia, in Mexico.
It has been registered for use in individuals between 9 and 45 years of age, living in endemic areas.
In April 2016, WHO recommended the use of the vaccine in endemic regions and inoculations have already started in Latin American countries. It is estimated that dengue cases can drop 50% even if only 20% of the population gets inoculated.
So, why are we not getting it already?
There are many reasons why the decision to launch the inoculation is not a simple one. The most important concern is that in the case of Dengue, the second infection might be worse than the first, per Imperial College London. So, in geographies that the virus is not actually endemic – the vaccine might do more harm than good. While anecdotally India does look endemic, in practice, it is a difficult call to make.
Secondly, as per the legal norms of our country, a drug must go through three phases of clinical trial in the region before it can be approved. Sanofi requested a waiver on the phase-III clinical trials, basis there results in other countries, a request that has been refused by Indian Health Ministry in May 2016, in accordance with the law.
So, we have to wait it out until Sanofi finishes all the required processes and gets a permit to launch the drug in India.
Is that a bureaucratic dead end for the vaccine?
Absolutely not! Sanofi is completing the regulatory process to launch the vaccine in the country.
Besides, Sun Pharmaceuticals of India is also working in partnership with a non-profit research organization, International Centre for Genetic Engineering and Biotechnology (ICGEB) to develop a botanical drug to fight the dengue virus.
There are five other clinical trials as well, that are very close to a breakthrough.
So, despite the temporary hurdles, I am hopeful that soon, we would win our battle against this mortal enemy.
Would you inoculate yourself and the family, if there is a preventive dengue vaccine available? Do you have any concerns/thoughts? Comment below or write to us at email@example.com
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