KALYAN BANERJEE, director of the National Institute of Virology (NIV) in Pune, speaks to MAX MARTIN about the emergence and re-emergence of viral diseases in India. Banerjee warns that the hantavirus, one of the most lethal killers discovered till date, may be lurking around in India, infecting unsuspecting people. NIV scientists havefound antibodies to this virus in humans, but have no funds for further research
On the re-emergence of diseases that were believed to have been either eliminated or had subsided of their own accord:
If you are talking about re-emergence of viral diseases, none of these had actually vanished. Some diseases appear suddenly. This may be due to certain changes like overpopulation, people's behaviour, ecology and development. Some viral diseases are coming up in large numbers. The best example is AIDS. Then there are the vector-borne diseases which are re-emerging, such as malaria (non-viral) and dengue fever - the most important of all haemorrhagic fevers and the most rapidly spreading one.
On the role of the environment in checking the spread of diseases:
From the environmental management point of view, supply of good quality water is crucial in the control of many viral diseases. For example, dengue is a disease related to water supply and storage patterns. If there is inadequate supply of water, people will tend to store water for long, which might then become a breeding ground for dengue mosquitoes (Aedes aegypti) and subsequently cause a dengue outbreak.
What we need is better water management. If water management is good, viral diseases such as hepatitis-A, hepatitis-E and other enterovirus (gastrointestinal) infections will subside. Supply and disposal of water is, therefore, a crucial factor and so has to be tackled first.
on the role of genetic mutation in viruses as a reason for the re-emergence of diseases:
It is not exactly due to mutation. There may be a mutational element; we do not deny that. Although there is a constant change in genes, we cannot totally attribute the re-emergence of diseases to this. There may be some, but we are not very certain about it.
On whether the re-emergence often follows a predicted pattern:
Dengue has been well known. We have been investigating dengue epidemics in Delhi since 1967. Almost every alternate year or maybe once in three or four years, there has been such an epidemic. Earlier, dengue infections were not accompanied by any haemorrhagic fever, but in recent years this aspect of the disease has been easily visible.
On other diseases such as Japanese encephalitis:
Japanese encephalitis is also appearing in different parts of the country. This could be called an emerging disease, as is the case with dengue. In an article in a 1996 issue of the Indian Journal of Medical Research, I had listed what I understand to be the emerging viral diseases.
On evidence of the presence of hantavirus in India:
I have not isolated the hantavirus. But I had found antibodies of the hanta group of viruses in Gujarat during the plague epidemic, and in the Andaman and Nicobar islands. The antibodies were found in humans.
More work needs to be done on hantaviruses in the country. Almost nothing is known. I am almost certain that it causes some disease.
On its possible existence in some remote areas with the people being unaware about it:
Quite possible. We might be mixing it up with some other disease.
On whether this presence is a cause enough for concern:
If you see smoke, there has to be fire. But seeing smoke is not seeing the fire - that is the difference. There has to be a fire too somewhere. That premise I agree with. But how much is the fire? That I do not know. We have to work that out. On the efforts being made to study the Virus:
We have to do lot of work. Interestingly, the hantavirus samples are from different parts of the country. We are planning to do research on it. But we should have some money to do that. Somebody should finance us. Nothing can be done free of cost.
On how bad planning and resource cuts contribute to the present situation of emerging diseases:
I am not a planner as such. It would not be possible for me to comment on it. All I can say is that there has definitely been a reduction in resources meant for medical research. We are very starved of funds. There are many projects we would have liked to undertake; we could have even finished some of them, but we lack funds.
On projects which are not progressing because of a lack of funds:
This (hantavirus) is one. Then, we have more than 700 strains of dengue isolated in our laboratory waiting to be analysed. We would like to study how the genetic shift is taking place - all over the country, all over the world. But we cannot do it as we lack funds.
We first need to employ more people who will work with us. But the Indian Council of Medical Research has cut down on the staff over the last three years.
On whether this reduction was during the first major cut in the health budget:
Yes; from 1993, there has been a serious cut. There are so many vacant posts but they can't be filled. Also, there are many bright people but we can't give them a chance. So they are all going away.
On the institute's annual budget:
Sometimes we cannot even pay for our electricity bills!
On the latest developments in AIDS research:
AIDS is a big problem. We were working on AIDS epidemiology and population dynamics, but in 1993, the National AIDS Research Institute was carved out from our institute. They started work on a vaccine development project. Since then it has not been under our control. We work on only certain disease aspects of AIDS. One of my students is working on the subject of whether the bone marrow cells get infected with HIV. If they do get infected, then vaccines of any kind will not prove useful. But as we lack funds, our work remains incomplete.
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