Dengue, a mosquito-borne disease is currently a proliferating global health problem. With approximately 3 billion people at risk of being infected, dengue fever is now considered as the most dangerous mosquito-borne viral disease in the world. A recent study done at the University of Oxford, estimated that India had the largest number of dengue cases, with about 33 million apparent and another 100 million asymptomatic infections occurring annually. The country has witnessed over 21,000 cases of dengue this year alone. Officials in the Union Health ministry are attributing early onset of monsoon as one of the factors for the spurt. The highest number of cases has been reported in Kerala with 11,000, followed by Tamil Nadu with 4,174 and Karnataka with 2916 until 2nd July 2017. While dengue continues to claim lives, a vaccine to tackle the deadly vector-borne disease continues to elude India. Though dengue vaccine has been approved in other countries, they remain under review in India despite increasing number of fresh cases every year.
India has been fighting a losing battle against this disease. The two vaccines that can help against this dreaded disease are: Dengvaxia (a foreign vaccine) and DS4 (Indian)– both awaits regulatory clearances.
•The world’s first dengue vaccine named Dengvaxia manufactured by Sanofi Pasteurs was recommended by the World Health Organization (WHO) to introduce this vaccine in dengue endemic countries. Even though the WHO has lit green signal for this vaccine, the government of India is still not sure about how effective this would be.
•An indigenous dengue vaccine developed by the International Centre for Genetic Engineering and Biotechnology (ICGEB) in collaboration with Sun Pharmaceutical Industries Ltd is still in its nascent stage (pre-clinical trial), by all accounts, this vaccine could at least take another eight years to reach the public. So, should India bite the bullet and go ahead with Dengvaxia?
All about Dengue
The name dengue originated from the Swahili word for “bone breaking fever” or the word for “the walk of a dandie” in Spanish. The first probable case of dengue fever was recorded during the Jin Dynasty (265–420 AD) in China.
Dengue is a viral infection transmitted by the bite of an infected female Aedes mosquito. There are four distinct serotypes of the dengue virus (DEN 1, DEN 2, DEN 3 and DEN 4). Symptoms appear in 3 to 14 days (average 4–7 days) after the infective bite. Dengue fever is a flu-like illness that affects infants, young children and adults. There is no specific treatment for dengue fever. Early signs of dengue may include high fever, joint pains, headache, nausea, appetite loss, vomiting, dip in blood pressure and would perpetuate with a characteristic skin rash. The severe symptoms are characterized by a drop in the level of blood platelets, blood plasma leakage or a severely low blood pressure.
Our assessment is that urbanization, rapid movement of people and goods, favorable climatic conditions and lack of trained staff have all contributed to the exponential growth of dengue. What makes the situation grimmer is the absence of an outlined treatment for the disease. Therefore, the need for an effective tetravalent dengue vaccine is of high public health priority. Although, Dengvaxia, dengue vaccine is available across the world and is authorized in 11 countries, the Indian government has not yet given a green signal to launch. India continues to wait for a dengue vaccine while the dengue death rate continues to soar.
How can we bridge this gap? Are we staring at a massive health crisis?
Prevention is better than cure and it is true in the case of dengue if all preventive measures are taken with due care and attention. The government should ensure a live reporting of dengue incidence. This will keep people informed and aware of the areas it is more prevalent in, which should translate into a heightened cautiousness. A nexus between citizens and health officials and the adoption of maximum preventive measures to stop the growth of mosquitoes will certainly help in controlling the dengue outbreak.