Monkeypox Virus: New Pandemic Threat in India or Just Panic? Dr. Ishwar Gilada Speaks—Exclusive Chat
Join us as we discuss the WHO's declaration of monkeypox as a public health emergency of international concern. With over 99,000 cases and 208 deaths reported globally, a new sexually transmissible strain raises alarm. Learn about the virus, its symptoms, and why it's particularly dangerous for vulnerable groups like children and those with weakened immune systems. Get the latest updates on this evolving global health crisis.
#Monkeypox #MPoxVirus #Coronvirus #COVID19 #AIDS #HIV #Oneindia #Oneindianews
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#Monkeypox #MPoxVirus #Coronvirus #COVID19 #AIDS #HIV #Oneindia #Oneindianews
~HT.97~PR.320~ED.101~
Transcript
00:00The monkeypox virus is a type of an orthopox virus family, from where we had smallpox,
00:07variola, cow pox, horse pox, squirrel pox, rat pox, Alaska pox and monkeypox was there
00:16in monkeys in Africa particularly, Central Aids built up Africa, around 1958 this case
00:22of monkeypox was diagnosed. When you describe this as STI then your focus goes on the sexually
00:28active people and those who are indulging in higher sexual activity like sex workers,
00:36male, female or trans where you can focus on them.
00:40Hello and welcome to this special broadcast on One India News, this is me Ansh Pandey.
00:45Today morning viewers, the World Health Organization again declared monkeypox a
00:51global health emergency and a major concern for the world. If we talk of it right now,
00:57many cases are being reported in Europe, South Africa and even in our neighborhood that is
01:04Pakistan. But is that a concern for India? For that to talk, we have got Dr. Ishwar
01:10Gilada with us who is a very known voice in India for fighting the AIDS, the major disease.
01:17He's also the President of the AIDS Society of India. Dr. Gilada, welcome for this
01:22interview regarding the monkeypox. Thank you. Thank you very much.
01:28Thank you. Surely you're welcome, sir. Sir, without wasting time, I would like to ask
01:33first major question. Sir, what exactly is this monkeypox virus and what exactly are the symptoms
01:42and the cause of origin? Can you shed a little light on that?
01:46You see, monkeypox virus is a type of an orthopoxvirus family from where we had smallpox,
01:54variola, cowpox, horsepox, squirrelpox, ratpox, Alaska pox and monkeypox was there in monkeys
02:04in Africa, particularly Central Aids belt of Africa. Around 1958, this case of monkeypox was
02:10diagnosed. When it is in monkeys, it is monkeypox. But when it was transmitted from the monkeys to
02:18human being, that was around 1970 in DRC Congo, which was at that time called Congo or Zaire,
02:26country name of Zaire. Then it got divided into two countries, DRC Congo, Democratic Republic
02:32of Congo and second Congo is called Brazza Congo. So in DRC Congo, that river belt of Congo river,
02:41this was commonly found. Thereafter, it was endemic. Endemic means only in that part of
02:47world only. And then it became endemic to some Western African countries. That was Senegal,
02:54Dakar, the capital of Senegal or Chad, Nigeria, those countries. And also it was endemic there.
03:04When it went out from there in around 22, in 2022, around May, it went to some of the countries
03:14in Western Asia, Western Europe and America and Australia.
03:23That time it was found that it is no more an endemic country, endemic to those particularly
03:29African country, it was spreading everywhere. And that was a clade 2 virus, which was from
03:35Western Africa, not clade 1. Clade 2 is more infectious. And it was less lethal,
03:42killing less people, but infecting more people, just like Omicron, if we compare them.
03:48Just like Omicron virus.
03:51And then around July, in July, I think, 22, the WHO declared this is the emergency
04:03for the public health emergency of international concern PHEIC. And thereafter,
04:10a couple of months, it went on increasing, then it got controlled. And by May 2023,
04:17WHO declared this as it is no more emergency. So that emergency title was withdrawn.
04:23So for last one and a half year, we have been like there is no emergency. Now, again,
04:30it started spreading, but it is in the Congo area, DRC Congo area and clade 1 B type of virus.
04:38Clade 1 was a virus, which was endemic. Clade 1 B, it got into other countries also,
04:46at least four countries. And that is Uganda, Burundi, Rwanda and Kenya. So currently,
04:52it is in five countries in bigger number. In the other four countries, there are more than 100
04:57cases were there. And if there are around 538 deaths in Congo, DRC Congo area. Now,
05:05we got one case in Pakistan, one case in Sweden, a couple of cases in South Africa. So it is now
05:12growing from there. And good thing that the WHO has declared this as a public health emergency
05:19of international concern, because initially, we thought it will be regional only in Africa,
05:23why international? But now, it's out of Africa. Sweden is a Scandinavian country.
05:31Pakistan is part of Asia. So Pakistan's patient's history is that the patient travelled to Saudi
05:40Arabia. But Sweden patient's history is that the patient travelled to Africa. Now, when people
05:46travel there, only travel history is not helpful. We need to involve the history which is related
05:53to sexuality. Because we played two virus which was spreading all over the world. And totally
06:0190,000, currently 98,000 cases are there, 99,000 cases are there totally. 99% of them are male
06:09sex with male. 1% are female. So it was a, and this is between the age group of 20 to 40.
06:21Now, why so? Because in 1988-89, smallpox vaccination was withdrawn, because nobody
06:30was getting smallpox. Those people who got smallpox, they are immune to monkeypox. Now,
06:37monkeypox is a problem in people's mindset, that people are doing monkey tricks, and therefore
06:42they're getting monkeypox. So I requested even in 2022, that please do not call it monkeypox,
06:50because it is not spread from monkeys. It may have spread in 1970. After that the monkeys,
06:58it is being spread through dormice, or squirrels or some other animals, or domestic or
07:05kind of forest animals, but not through monkeys. So we should not call monkeypox.
07:10So they should reduce it to mpox. Mpox. Mpox can be in mind monkeypox, it can be malepox,
07:17because only males are getting, or main sexual, I don't know what is a mpox meaning, but it is
07:23mpox. So currently we do not call it monkeypox, we call it mpox, so stigma and discrimination
07:29reduces. Secondly, I describe this as the 21st sexually transmitted disease of 21st century.
07:37Till 21st century, we had only 20 infections. Now this is the 21st infection. But somehow it
07:44is not described as STI, I don't know why. When you describe this as STI, then your focus goes on
07:51sexually active people, and those who are indulging in higher sexual activity like
07:58sex workers, male sex with male or trans, then you can focus on them. I do not say that you
08:06stigmatize them, but you prioritize them. So your action to act or prevent is there.
08:12The second issue is that if you do not call it STI, then you keep on talking about HIV control
08:19by doing pre-exposure prophylaxis, post-exposure prophylaxis. But by doing that, it is in addition
08:26to condom, but we don't say that. So if you don't use condom, you prevent HIV by taking those
08:32medicines, but you get other STIs. And that's how in last 10 years, other STIs have increased.
08:38Gonorrhea, chlamydia, herpes, HPV, syphilis, they are increasing. And if they are increasing,
08:47then one more disease is added. And lastly, this is the zoonotic infection. Zoonotic means
08:54in last 40 years, we are seeing most of the infections are new infections, are viral infections.
09:00And of them, more than 40% are zoonotic, means coming from animals. So they are Ebola,
09:07Zika, Nipah, HIV, SARS, then even the COVID virus that came from bats, now the monkeypox or mpox.
09:19So they are all coming from animals. And this is the reason where human beings for their own
09:24survival, they start eating any kind of flesh, whether it's a domestic animal or forest animals,
09:32or into the atmosphere of those animals, and they pick up those infections from there.
09:38And then from there, it gets transmitted to other human beings. And that is a big problem where
09:43we cannot be selfish, we have to live and let live. Symbiosis means you also survive,
09:50we also survive. If for your survival, you want to kill somebody, then you get into problem.
09:56And that's how is ecology is also disturbing the world, that everywhere we are going and
10:01we are building buildings, concrete, in forest, in hills, in everywhere, then we get into problem,
10:08same thing happened, why not? So these two issues, ecology, and going in the domain of
10:13other animals, other plants, or other insects, we are creating problem for ourselves.
10:20We should not intrude in others atmosphere. So more or less, we should not, I mean, we should
10:27not get indulged with them that much. And we should have their own space. Mr. Girata,
10:34another question, World Health Organization declared it as a health emergency,
10:38we got two or three as reported by the media of Pakistan cases there. What's that regarding India?
10:45How do you believe that what could be the situation in India? And can it get worse here?
10:51You see, it is a matter of time, which we'll tell. But India is not different than Pakistan
10:58geographically and in human behavior. So we cannot say that, just like in cricket,
11:06it is not like that. It is only incidentally, it is noted in Pakistan, it may be in India,
11:12if we test some people, we will find out. Your other question was, how do we find out?
11:18Here, there are three things. Number one is the person, whether the person is indulging in
11:24sexuality, male to male, in multiple places, without condom. Number two, if a person is
11:31getting fever, kind of skin pox marks, or some kind of ulcers or wounds, which may not be in
11:39sexual area, it can be on face and hand also. Then lethargy, body ache, then lymph node
11:47enlargement, lymph gland become bigger. And then some people get systemic infection where
11:53respiratory attack is involved. You get into the ARDS, acute respiratory distress syndrome,
11:59you can die. So in current scenario in Africa cases, 4.7% is a death rate. So whatever number
12:07of people are getting infected, 4.7% people have died. And overall in last two years,
12:14whatever cases are seen, death rate is between 0 to 10%. In some places, high death rate,
12:20in some places, low death rate. So, but it is not as lethal as Ebola, Zika. So we need to be
12:29watchful. We need to keep on doing the study. So how do we find out the history of the person?
12:35Secondly, whether the person is having any kind of symptoms? And thirdly, we are able to do
12:40MPOGS test, PCR test, if that test is positive. Okay. Mr. Gilada, when we talk of coronavirus,
12:49COVID-19 and then monkeypox situation, if we, I mean, if we draw parallels between the both of
12:55these health concerns, so what exactly is the striking difference between the two? I mean,
13:01you have already tell that. But sir, is monkeypox more lethal than COVID-19 as you
13:09told about the death rate. But I think that's still higher than COVID-19 right now.
13:16See, we cannot compare COVID and MPOGS for two reasons. MPOGS is transmitted through sexual
13:23contacts, intimate body contacts, whereas COVID was transmitted through droplet infection,
13:30surface transmission, through aerosols, which is not the case with MPOGS.
13:38So in COVID, the infection was back then because you travel in public transport, you travel in
13:44train, you are going in market, you're going to the hospital, you go to school, you pick up
13:48infection from anywhere. MPOGS is limited to 20 to 45 years of age, because above 45, the people
13:57are vaccinated by a smallpox, they are immune to getting this MPOGS. Number two, it is only
14:03through sexual activity. So it becomes limited. It is not to every children or old people or
14:10everybody is going to get. So in COVID, what happened, if it is infecting any age group,
14:17then people who are above the 60, who are comorbidities, uncontrolled diabetes,
14:23renal problems, they were at more risk. Here, that case is not there. And therefore, we need
14:29to have a different strategy here. And I suggested that MPOGS should be handled, managed,
14:35prevented only through NACO, National AIDS Control Organization, because NACO has got a good
14:41equation with community groups of MSM, male sex with male, or trans population or sex worker
14:48population, the intervention projects are there. You need to add only one component that you
14:52prevent MPOGS. But if you give it to a new agency, new organization, you are creating whole awareness
14:59in the whole country of over 1.4 billion people, 140 crore people. It is not important.
15:05Right. Mr. Gilada, just one more last question. This is regarding the health system. I mean,
15:15that's a very great thing that monkeypox is not such a virus that can spread like COVID-19. But
15:21at one point of time, when it was happening, when the COVID-19 virus was spreading,
15:26it was also believed that it is not going to spread into human with that speed,
15:31what happened with the Delta, then after even Omicron. If I'm taking the worst case here,
15:38if monkeypox spreads like that, it somehow gets airborne or like the aerosols you told about.
15:45So is the Indian medical infrastructure ready to handle another pandemic? What's your take?
15:52I'm not sure about that, but I want to know your take on this.
15:55Yeah, you see, basically, there is called pandemic preparedness. Pandemic preparedness
16:00doesn't wait for some new disease to come. And then we decide whether we need to do something.
16:08You need to have well before you get thirst.
16:10So your pandemic preparedness says that you be prepared whether A disease come, B disease come,
16:15C disease come. Or if any natural calamity, catastrophe come, cyclone come, you're prepared.
16:20What is that preparedness? You need human manpower, doctors, nurses, technicians,
16:25ward boys, IR. Number two, you need beds, ICU, ventilator. So if somebody needs bed,
16:33bed should be available. If somebody is sick, sicker than other people should be sent to ICU.
16:38If patient is cannot breathe, you are able to put a ventilator. All these three things were
16:45in short supply prior to COVID, particularly before Delta wave. Now we know how we are prepared for
16:52that, that our preparedness can be used in the long term. So we need to be prepared for that.
16:59Prepared for that, that our preparedness can be used for any disease. And thirdly,
17:05our capacity to do research to track the virus, whether it's a clade A, clade B, that was,
17:13if you talk about this PCR lab or genome sequencing lab, there are hardly three,
17:18four labs before COVID. Then after we had more than 10,000 labs doing PCR test. We are not 30,
17:2640 labs which can do genome sequencing. So we are definitely on all fronts better prepared,
17:31but it doesn't mean that you have a helmet and you have a bike and because helmet will not allow
17:37you to get a head injury, you will still get injured. But we don't want to poke in. So
17:47when we are prepared, it doesn't mean that we avoid infections. We can control,
17:52we cannot avoid infection. And some infections are being avoided by human beings
17:57because of intrusion into the animal atmosphere. And that we need to look at because mad cow disease
18:03or bird flu or SARS, how did it come? Avian influenza, how did it come? They come from the
18:09animal. So then straight from animals, it comes from animals. Then you kill the animal, you kill
18:14the cow, you kill. Why you intrude other's atmosphere? Let them live, you also live.
18:24Only then there will be symbiotic relationship in world and world can go on properly. If we try to
18:30poke in another's atmosphere, they are going to create problem for you. Because sometimes we
18:34human beings think that we are extra smart, over smart. And we also have our intelligence as well
18:40as artificial intelligence. We can overcome everybody in the world. Then we are in fool's
18:45paradise. Everybody is intelligent. All animals are intelligent. All viruses are
18:49extra intelligent. They can also ruin us. We have seen that. Well, Mr. Gilada, once again,
18:58thank you for this special space, this time for yours, for this interview, because many viewers
19:04and even from today morning, there was kind of a debate around the social media that
19:09another pandemic is coming, another pandemic is coming. So we decided for this interview,
19:13and most of us thought that no one can be better than you to talk about this. So once again,
19:18sir, thank you. And we hope that monkey box situation doesn't goes out of hand, just like
19:24the COVID-19 and other pandemic situations. But sir, once again, a big thank you for this
19:29special space and this exclusive talk. So thank you. Thank you so much. Thank you.