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Indian Swine-Flu Virus Just Got A Lot More Dangerous

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By Samar Halarnkar:

A potentially virulent and distinct strain of the swine-flu virus that continues to kill and panic people appears to have taken hold in India, a new study conducted by scientists at Massachusetts Institute of Technology (MIT) has found. This is contrary to a recent Indian assertion that no mutations were found in the version of the H1N1 virus circulating in India (A/California/04/2009—to use its official name); a strain first identified during a pandemic in the US state of California in 2009.

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The official Indian stand, made clear here, declares the Indian strain to be “antigenically stable”, meaning it has not mutated.

But an examination of the genetic sequences – or alphabet chains – of the Indian H1N1 strain reveals important changes linked to greater virulence, according to the MIT paper released in the international journal, Cell Host and Microbe.

These changes in the virus’s genetic alphabet potentially allow its easier binding and entry into human cells and more efficient transmission. A clue to how the H1N1 virus is evolving genetically comes from Florida, where another study discovered just such a mutation. “Genetic changes in this virus must be monitored to predict the effect of future pandemic viruses,” the study said.

These mutations might explain why the current outbreak, which should have faded with the onset of warmer weather, continues, the study’s co-author, Ram Sasisekharan, told IndiaSpend in an e-mail interview. The other author is Kannan Tharakaraman, a research scientist.

As on March 9, swine flu had claimed 1,482 lives across India and infected 26,000. As the graph below shows, this is easily India’s most devastating H1N1 pandemic in recent years.

Source: Ministry of Health & Family Welfare; *Figures as on March 9, 2015
Source: Ministry of Health & Family Welfare; *Figures as on March 9, 2015

“In addition to the mutations responsible for increasing human receptor binding and virulence, other factors, such as the high population density in India, ease of person-to-person transmission, potential for inter-species transmission and lack of sophisticated farming practices could potentially aid the circulation of this virus,” said Sasisekharan, a professor of biological engineering at MIT in the US.

India deposited only two genetic sequences as samples that could be studied in public genetic databases (some examples are here and here) globally during 2014-15, which suggests poor surveillance.

These databases contain 4,213 complete genetic sequences of the H1N1 virus. The majority come from the US (38.4%), China (7.2%), UK (6.5%) and Singapore (6%). “Unfortunately, India ranks low (14th) in this list, contributing less than 1.5% of sequences,” write Saisekharan and Tharakaraman in their paper.

Sasisekharan calls for greater Indian scientific attention to tracking and releasing genetic information about the current flu pandemic.

“Surveillance involves having some simple, standardised protocols in place,” said Sasisekharan. “This includes continuous monitoring and timely reporting of outbreaks, sequencing of viruses in human and animals, particularly subtypes that are known to infect or spread in humans, and rapid dissemination of whole viral genome sequences in public databases.”

The virus strain that the Indian government believes is circulating in India, A/California/04/2009, spread across 74 countries in less than a year. In its genetic structure, said Sasisekharan, the virus is similar to the 1918 Spanish flu virus, which killed more than 40 million people and infected half the world’s population.

However, in its ability to bind to a particular receptor on human cells, the California version of the Spanish flu virus was considerably less efficient. This is why monitoring the genetic structure of flu viruses is important in predicting outbreaks.

Sasisekharan and a group of scientists previously demonstrated that it does not take much for the California strain of the H1N1 to become deadlier.

It requires only a relatively uncomplicated two-letter change in the genetic code of H1N1 to induce a mutation that could make the virus more virulent, Sasisekharan and his colleagues showed in laboratory experiments in 2011.

More study, and greater scientific openness from India, should reveal if that laboratory warning could have become reality.

This article was originally published by IndiaSpend.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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