It Could Happen to You
Why India need not worry about Zika
Our immunity may just tame the virus. Fingers crossed.
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Zika is coming. Not only is Zika coming, it is also pretending to be dengue.
Troubled and a bit scared, I started calling up doctors and microbiologists at the All India Institute of Medical Sciences, Delhi. The first reaction was one of irritation: “Let it come. You journalists always spread panic.”
Some international experts are saying that Zika is nearly on us, sir…
All I got was a terse, “Samples for the virus are being analysed by the National Institute of Virology in Pune and National Centre for Disease Control, Delhi. To the best of my knowledge, there are no cases in India so far.”
—But how dangerous can Zika be, if it comes to India?
—The Aedes mosquito has always been here.
—Does that mean…?
—I’m simply saying that only those who travelled to Zika-affected countries should seek medical attention if they feel unwell.
I tried my luck the third time: Is it being under-reported in some countries, do you think? I mean, can it be mistaken for dengue? After all, Zika, dengue, chikungunya, all have similar symptoms: fever, rashes, joint and muscle pain…
The response was short, sharp and snappy: “That’s pure speculation.” (Meaning, that sort of confusion must be happening in countries where doctors are not experienced enough and not handling tens of thousands of patients sick with mosquito bites every year).India has the right climate and abundant mosquitoes for the virus to settle, thrive and pan out as an epidemic.
Remarkably, each and every doctor started talking about chikungunya instead. They went into extreme detail on the crisis that is raging now and how overwhelmed they were with patient load. Someone even said that such was the flow of chikungunya patients that he was losing track of time and calling people up at 2 in the morning.
The message was clear: our doctors are determined to keep calm and carry on.
Yet another scare
They, of course, have a point. How many health scares have you had to deal with in the last few years? How many mysterious diseases have you had to read up on? SARS, MERS, avian influenza, the alphabet soup of H1N1, H2N2, H3N2, swine flu, Ebola…
In 2014, panic gripped the world over Ebola, the virus that spreads through body fluids - even dead bodies - and bleeds its victims to death. We were told no country was safe from it. The World Health Organization (WHO) predicted 10,000 new cases a week.
Peter Piot, director of London School of Hygiene and Tropical Medicine, the man who had helped discover the virus, pronounced that even a single occurrence of Ebola could spell doom for a tropical, poor and densely populated country like India. We did get ebola, more than one case, but nothing really happened. The country carried on as usual.
The same thing had happened with the deadly Severe Acute Respiratory Syndrome (SARS) in 2003. Despite the international alarm bells, the pandemic just did not happen in India. Even the 2009 swine flu was expected to spread like wild fire. Did it?
Need a new terror
Last year, as Ebola edged out of the WHO’s ‘Disease Outbreak News', Zika stepped in - from October. By January 2016, Ebola was almost forgotten. Zika became the new terror: four million people infected, 4,180 babies born with abnormally small heads and brain damage in Brazil and hundreds in Colombia paralysed with Guillain-Barré Syndrome. No treatment, no vaccine. In February, the WHO declared it a “public health emergency” of international concern.
With Brazil as its epicentre, the virus spread to 29 other countries. Even the UK, known to be inhospitable and cold to mosquitoes, has 50 Zika cases this year. And a number of reports have put India in the high-risk zone for Zika recently.
Yet - despite Zika’s ability to spread quickly, despite the large-scale presence of the Aedes mosquito in India, despite our yearly tryst with malaria, dengue and chikungunya- Zika has not been able to invade India, as yet.
God in immunity
Will Zika become a big threat? All depends on that one elusive factor: immunity. India has the right climate and abundant mosquitoes for the virus to settle, thrive and pan out as an epidemic. But this is a country where incessant migrations and invasions have taken place for at least 5,000 years. Every demographic intermingling has introduced innumerable unknown infections and diseases. And they have given us the chance to acquire immunity to many infectious diseases over time.
Take smallpox: it was a dreaded epidemic disease in the ancient world. India and Egypt had the disease as early as the 14th and 12th century BC respectively. Yet small pox could not wipe out populations in India and eventually became a part of life in India - with even folk goddesses developing around it (eg Sitala Devi). The same virus, however, virtually wiped out native Americans, with European settlers bringing in the highly contagious disease to the New World - to which they had no immunity.
The latest buzz
The latest buzz is that India may have had a long history of Zika infection (and hence of immunity to it). Way back in the 1950s, a group of scientists trying to figure out India’s burden of viral diseases had listed Zika as one of the 15 insect-borne diseases found commonly in the population (Journal of Immunology, 1953). What’s more, they had found that 33 of 196 people tested for Zika showed immunity to the virus - something that caused a very mild illness causing some rash and fever.
Zika, in its current avatar, is no longer just a mild thing: it involves fatal brain abnormalities and paralysis. The strength of our immunity will be tested yet again - if Zika comes in.
Will we win or Zika?