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#Post#: 2456--------------------------------------------------
India, partnering with China, has launched encephalitis
vaccination campaign to combat the
DIR By: lubhan
Date: December 16, 2016, 4:01 am
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some years ago, dying children stood outside hospitals in
northern India waiting for an empty bed during one of the worst
encephalitis outbreaks in recent memory. Now, they're lining up
again for hours to receive a shot that could save their lives.
Since May, nearly 11 million children ages 1 to 15 have been
vaccinated against mosquito-borne Japanese encephalitis in
high-risk areas of four northern Indian states, U.S.-based
nonprofit group PATH said.
It was the first-ever mass immunization campaign to fight the
brain-damaging virus, and many skeptics doubted it would ever
happen this fast.
But the 2005 outbreak, which killed about 1,800 children and
left many survivors permanently disabled with physical and
neurological damage, sparked a wave of quick action rarely seen
within India's bureaucracy-clogged government.
Critical news reports and images of unconscious children lying
two to a bed led to a public outcry, and India's top health
officials promised to take action before the next rainy season,
said Dr. Julie Jacobson, director of PATH's Japanese
Encephalitis Project.
"They latched on to the idea of vaccine being the answer," said
Jacobson, who pushed for six years for the vaccination campaign.
"All the rest of the stuff doesn't work. They've been (having
outbreaks) for 30 years, and it keeps happening."
Most victims live in the poorest corners of India, typically
surrounded by rice paddies in farming villages. The mosquitoes
transmit the virus from pigs and birds to humans. Since most
infected people never develop symptoms, many adults are immune
from earlier exposure — leaving young children most vulnerable.
Japanese encephalitis is closely related to West Nile virus but
is found only in Asia. It attacks the central nervous system,
damaging the brain and spinal cord. High fevers are often
followed by seizures and comas, and many children need
ventilators to breathe.
An estimated 50,000 cases — more than 10,000 of them fatal —
occur annually, the World Health Organization says. Up to
a third of survivors suffer problems ranging from paralysis to
mental disabilities.
India's vaccination campaign was based on a partnership with
China.
The Chinese have virtually wiped out the disease after making
their own vaccine and distributing it widely since 1988. It is
made from a weakened form of the virus and given in one shot
that protects for a lifetime.
India produces limited amounts of another vaccine, used widely
in Western countries. It is more expensive, harder to
manufacture and requires multiple injections. Even at full
capacity, the sole Indian manufacturer could only reach a
fraction of children in need.
China agreed to make about 13 million doses for India at a
discounted price — about $3.8 million, said Dr. S. Sarkar, an
adviser on immunization for WHO and the Indian government.
That's about 29 cents per child.
Sarkar ran the country's immunization program for 18 years and
saw the virus return each year after the monsoon season from
June through September left ideal breeding grounds for
mosquitoes. He was amazed by the huge crowds of children that
showed up for the free shots, which will later be given to other
affected areas and eventually added into routine vaccinations.
"Without any fear in their eyes, they were coming out of the
centers laughing. They didn't cry when they were standing and
getting their shots," Sarkar said. "I think we have achieved
something."
Jacobson said the campaign should produce a dramatic decrease in
cases this year, but some doctors fear the campaign — covering
11 districts in the states of Uttar Pradesh, West Bengal, Assam
and Karnataka — will still not be enough. Most children did not
fall ill last year until late in the rainy season.
Health officials in Assam last week reported 25 Japanese
encephalitis deaths and dozens of other suspected cases.
In Uttar Pradesh state, four children have already tested
positive for the virus and another 48 have been hospitalized
with symptoms, said Dr. A.K. Rathi, pediatrics chief at BRD
Medical College hospital in Gorakhpur, where the bulk of last
year's cases died.
About 200,000 unprotected children remain scattered across
hundreds of villages, said Dr. K.P. Kushwaha, a senior
pediatrician at the hospital.
"The (encephalitis) patients have started trickling in," he
said. "It is a matter of time when they will start pouring."
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