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Zika Virus: India is Not an Exception - Amit Sengupta

The World Health Organization has declared the Zika virus spread as an international public health emergency, prompted by a growing concern that it could cause birth defects. And US President Barack Obama wants $1.8 billion funding to fight this mosquito-borne illness that is causing the proliferation of a rare birth defect in some Latin American countries. It is projected that Zika could infect as many as four million people by the end of the year. 

Newsclick caught up with Dr. Amit Sengupta of All India People's Science Network to know more about its effect, impact and threat in India. According to Dr. Sengupta, Zika is also spread by mosquitoes from the same family that spread Dengue and Chikungunya. There is no treatment for this disease currently, leaving vaccination as the only way out. The developed nations should help the other countries on developing the basic health-care measures, else, the role of WHO would be limited, asserts Dr. Sengupta. 

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Rough Transcript:

Prabir Purkayastha (PP): Hello and welcome to Newsclick. Today, we have with us Dr. Amit Sengupta of Peopl'e Health Movement and All India People's Science Network to discuss the Zika virus which has been spreading in the world and has caused enormous amount of problems including microcephaly in babies. Amit, this seems to be something which was very restricted earlier has spread from parts of Africa to now expected to spread to rest of the world. So what is the Zika virus, what effect it have and how it is spread like this. This is what we going to discuss. Shall we start with what is the Zika virus.

Amit Sengupta (AS): The Zika virus is actually a part of the same family of viruses which causes dengue fever or yellow fever and it causes illness what has been described as a symptoms of milder version of dengue. It causes a few days of fever with rashes which usually lasts for three to five days. And there is a very little evidence that you do get complications with it. It's really in it's not a very problematic infection. What has in the past few months caused concern in the virus spreading it is seen to be core lated to the sudden rise in incidence of what is known as microcephaly in new born babies. microcephaly means a small brain real microcephaly not just a normal variation where children can have relatively smaller heads. But real microcephaly means that it impacts in the development of the brain and such children are likely to be disabled in various ways they likely to have both physical and mental disabilities later in life. It is a very serious problem and you can't do anything about it. Once you have a baby with microcephaly in terms of actually treating the conditions. Now, first just to understand that it is still a correlation because all it is still not established. But there seems to be a strong evidence that there is a link between pregnant women and the Zika virus and rise in incidence of microcephaly. In Brazil where most of the work has been going on try to see if there is a correlation. They have identified about and this is the northern part of Brazil where this infection is actually spreading. They have identified something like 400 new cases of microcephaly in few months whereas you would expect probably less than that number in a year in normal population in the entire country of Brazil. So that's the kind of correlation we are looking at. We also know now that the virus is capable of crossing the placenta. All virus can not cross placenta but we know that it does cross placenta. So that is the concern of virus.


PP: Concern means it really spreads to the babies.

AS: So it can enter the sack in which the baby is in the pregnant mother. Now, going back Zika has been known since it was identified in 1947. so very long time back interestingly in the Rhesus monkey not in the human population.


PP: Zika forests in Uganda. So close to Kampala

AS: Zika gets it's name from Zika forest in Uganda and for long it has been primarily seen as a virus effecting monkeys with stray human incidence but we have evidence that the human incidence was taking place across the narrow band in the equatorial region from Africa right across Asia. In fact, there are reports that you had Zika detected in India also many decades back. So it is not new in that....


PP: So there has been transfer from monkey to human in terms of infection but some time but it was a very low level of infection and confined to very few people and only few people.

AS: Well that is not very clear because there are also reports that in certain countries Uganda and neighbouring countries Gabban for example a few years back had an epidemic of Zika. So antibody tests have shown that humans in that region equatorial and Ugandan belt a very high number of people do seem to have antibodies to Zika which means they have been infected at some point. Important thing to here understand is it has spread over a decade.


PP: So the spread of Zika virus Aedis mosquito seems to be a part of that Isn't it that the mosquito thats carries Dengue and Yellow fever and couple of other things?

AS:Aedes Aegypti is a mosquito which is a common carrier of Zika which is the same which carries Dengue and chikungunya as well. It's a day biter.


PP: It also carries yellow fever.

AS: No, yellow fever is actually different. So the yellow fever virus is similar to the Zika virus but mosquito is different. But, again Aedies is now the most common mosquito in the world and one of the things that is predicted in global warming is. One of the few things actually predicts of the health effects of global warming is that global warming will mean that mosquito, pests of similar kind will start inhabiting the area where they were not found. And we are seeing that for example Europe, Southern Europe mosquitoes did not exist. So that is another pathway which can explain why you were seeing viruses being transmitted in regions which earlier not diseases caused by this.


PP: But the Aedis mosquito has been there in Brazl of course.

AS: Yeah, in North Brazil there has been of course.


PP: Similar as equatorial Africa in terms of what you see.

AS: But it also means is that the potential for Zica to spread now to newer regions is much more because you are likely to have more mosquitoes in the area where you did not have those mosquitoes earlier. But in the case of Brazil you were right that is not the primary reason.


PP: How did it spread to Brazil.

AS: So from the it is believed to have and in fact, it is interesting. Now, the studies in fact indicate that it is not African variety because when viruses moves from one place to another there are small changes that happen in their genetic make up. So you can identify the actual origin of virus. So actually this is Asian virus which spread to Brazil, that is what is being conjectured. So Asia is been know to exist in the population in countries such as Thailand, Singapore the whole tropical belt as I was talking about earlier. And from here to French colonies, Tahiti etc. into Brazil. The exact route is, the issue also is today in the age of globalization where you have much easier travel it is very difficult to actually trace how this transmissions are taking place but what we do know this transmission is much easier because it it much more mobile population that we have today in the globe and all infections are prone to this problem today that suddenly you have an emergence infection hitherto non-immune population who have never been exposed to this that also leads to pandemic kind of situations epidemics in specific regions because it spreads much faster.


PP: So the microcephaly could have existed because of Zika but it was not really know because number was very less. So that being the argument why correlation now been made so much larger population.

AS: Questions have been asked why we do not see cluster of Microsephelie in Africa for example where it's been know to exist or in parts of Asia. Now, if it is much slower transmission there would be time for her deminity to develop and more and more people who are actually immune to it. So you might see a small spike but not the kind of spike you would expect into a totally non immune population as we are seeing in Brazil. Interesting thing as I said in Brazil earlier it's still a correlation it's not a causality as has been. But there is much stronger another correlation another condition which is called Guillain-Barré syndrome which is a neurological disorder where you have what is called ascending paralysis and you can actually be completely paralyzed. Guillain-Barré syndrome is associated with a number of viral infections.


PP: Coming back to the issue of spread of the Zika virus and now that it is associated with known to be possibly associated with two sorts of problems which certainly is more serious that a few days fever. What is the response that we can make to this kind of spread.

AS: I think we need to step back and look at the issue back, the fact that we are now been forced to fight virus by virus. Earlier it was Ebola, before it was H1N1, the Avian flu etc. so new viruses it's not, it's always always had new viruses. The pace at which we are seeing the new viruses appear in countries where it did not exists or effecting human population when it did not effect human population points to some underlying reasons. Of course, there are obvious underlying reasons that we can look at is that globalization means that people are traveling much more than they are and obviously you have to deal with it, there is nothing you can do. We just quite the sort of response of reverse what the US has said where it looks every new infection is an assault on it's security and it is almost militarized response of how you try to sanitize your borders, how you clamp down on movement of people etc.


PP: Different form of Donald Trump's Mexican wall etc.

AS: Exactly. Now it's something it is impossible. It is stupid even.


PP: Viruses are too small to be stopped the wall you said.

AS: And they are not really afraid of the military but then what could be their response. Now one of the responses and it is not specific to any particular virus is better surveillance. Now, unfortunately, it is precisely in this period


PP: When you mean surveillance you don't mean NSA.

AS: Disease surveillance we are talking about. Now it is interesting, that precisely in this period when globalization is leading to much larger mobility to people and interchange of people etc., you are also seeing a period when there is a much larger restriction to international agencies involved in disease surveillance. For example, the World Health Organization, thirty years back was the premier institution which would have been doing this. WHO has been starved deliberately like all UN agencies of the funding by the United States and the rich countries. It is a toothless organization in many ways. And you do not really have international bodies which can replace WHO in which today countries have some stake and also some respect for. Now, you have surveillance system which run for example by CDC, US CDC etc. Countries do not believe that they are doing this work without any ulterior motive.


PP: But, you can not really treat individual in this particular case. You really have to treat it as a global health, public health issue.

AS: Exactly, if you have to treat it as a global health, public health issue, the response has to be international. It can not be itself a local or national act only. You need local responses. That's one part of it, then the only way of addressing this problem of it being associated with microcephaly is vaccination because treatment is not really addressing the issue because once you have the infection, the babies are at risk probably. German measles case is the real comparison here. German measles was known to cause birth defects and it is almost eliminated because of the vaccination. Now Vaccines. Who is going to make the vaccines, where is the capacity of vaccine manufacture lie today. It is largely with northern manufacturers. It is interesting that India while it is seen as the seat of the major generic drug manufacturer is not actually a major vaccine manufacturer. In fact, we are importing our own vaccines today. Again, something to look at that why he said we have not spent in building up vaccine manufacturing capacity.


PP: We earlier had leading vaccine manufacturer.

AS: For the older vaccines the public sector units were the leading manufacturing organisations. We managed to strangle them somehow they have become mere shadows of what they have become earlier and the private vaccine manufacturers are actually not really competitive with the global market. So we have a global scenario where vaccine manufacturing is northern country driven. Even if you were to even for a futuristic scenario, if you were to develop vaccine in a situation where the Zika virus is spreading like wild fire, suppose we assume that, we might see a re-run of what happened during the scare of the H1NI pandemic. Now, the pandemic was something a false alarm but what did we see there. The vaccines were manufactured but the entire stock of vaccines that was going to be manufactured were already bought up by Europe and North America. It is something like 90 to 95% of entire capacity. There is a limit to the capacity of the vaccine manufacturer. Let's keep that in mind. It was bought by the Northern countries. Now, in such a futuristic scenario where Zika effects India, you won't be able to compete with Europe and North America to get your share of vaccines. They would have seek out for themselves the major portion of the vaccine which points to the point that they need a much larger sharing of the new knowledge and mechanisms by which sharing of new knowledge takes place.


PP: Last question, Chikungunya Virus has come to India and spread quite a bit around. Do you expect Zika also to come and obviously, the Brazil hosting the Olympics next year, it is expected there would be a large population will go to Brazil from all over the world. Would you expect, a part of the problem given the fact that Aedis a quite a common mosquito right now?

AS: Let me answer differently. There is no reason that it will not come to India given what we were discussing earlier. There is a very high possibility that it will spread in India. What we don't know and this is just something that might save us a bit. What we know is Zica existed in India earlier. We don't know the extent to which Zica has infected people in last few decades. So if we have some levels of immunity to Zica virus probably it will not spread as fast as we are seeing in entirely naive population in Brazil. That's only possible saving face. Otherwise there is no reason why it will not spread in India.


PP: Dengue infection does not provide any immunity to Zica ?

AS: Those are the things which scientists are now looking at. For example, when you test for antibodies to Zica you get a lot of false positives because you have the same antibodies showing up in those who have had Dengue in the infection. In fact, yellow fever vaccinated people also show up this same antibody. So there is a possibility there could be some levels of cross immunity that people might have in India and again that would contribute to what I was calling saving grace earlier. But, Zica coming to India is more or less a foregone conclusion.

PP: Thank you very much Amit. We will discuss Zica and other such issues in future as well. Thank you. Thank you very much for coming to Newsclick.

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