Birth control pills may up breast cancer risk

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Birth control pills may up breast cancer risk

Women using hormonal contraceptives have a 20% higher risk of developing breast cancer

A study on all women of Denmark in the reproductive age group has found. The study has been published in the New England Journal of Medicine.

Researchers at the University of Copenhagen assessed associations between the use of hormonal contraception and the risk of invasive breast cancer in a nationwide prospective cohort study involving all women in Denmark between 15 and 49 years of age who had not had cancer or venous thromboembolism and who had not received treatment for infertility. “The risk of breast cancer was higher among women who currently or recently used contemporary hormonal contraceptives than among women who had never used hormonal contraceptives, and this risk increased with longer durations of use; however, absolute increases in risk were small,” the study concluded.

Breast cancer has, for some years now replaced cervical cancer as the commonest cancer among Indian women.

Among 1.8 million women who were followed on average for 10.9 years, 11,517 cases of breast cancer occurred. The relative risk of breast cancer among all current and recent users of hormonal contraception was 1.20, the NEJM article says. After discontinuation of hormonal contraception, the risk of breast cancer was still higher among the women who had used hormonal contraceptives for 5 years or more than among women who had not used hormonal contraceptives.

Breast cancer has, for some years now replaced cervical cancer as the commonest cancer among Indian women. It has an incidence rate of 25.8 per 100,000 women. According to an article published in the Asia Pacific Journal of Clinical Oncology in February this year, “The age adjusted incidence rate of carcinoma of the breast was found as high as 41 per 100,000 women for Delhi, followed by Chennai (37.9), Bangalore (34.4) and Thiruvananthapuram District (33.7). A statistically significant increase in age adjusted rate over time (1982–2014) in all the PBCRs namely Bangalore (annual percentage change: 2.84%), Barshi (1.87%), Bhopal (2.00%), Chennai (2.44%), Delhi (1.44%) and Mumbai (1.42%) was observed.” The commonest hormonal contraceptives are birth control pills. Others are intrauterine devices and also injectable contraceptives.

Traffic pollution can lead to low birth weight: BMJ

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Traffic pollution can lead to low birth weight: BMJ

If the return of Delhi’s smog has left you worrying about its effects on your children, here’s more bad news. The effects start from before birth.

Congested road in Gwalior

English researchers have found that babies of mothers exposed to road trafffic pollution are more likely to have low birth weight. Weight at the time of birth is one of the indicators of a baby’s chances of survival and his/her future health.

“The findings suggest that air pollution from road traffic in London is adversely affecting fetal growth. The results suggest little evidence for an independent exposure-response effect of traffic related noise on birth weight outcomes,” reads the paper published in the peer-reviewed British Medical Journal. In all 671509 births were analysed from municipal registers. In addition maternal residential addresses at the time of birth were mapped to draw correlations with pollution levels. The study was done by researchers from Imperial College, London, King’s College London and the London University.

Low birth weight is defined by the World Health Organization (WHO) as weight at birth of less than 2500 g (5.5 lb). Low birth weight is a significant public health problem globally and is associated with a range of both short- and long term fallouts. Overall, it is estimated that 15% to 20% of all births worldwide are low birth weight, representing more than 20 million births a year.

The  BMJ paper adds: “To our knowledge, this is the largest UK study on air pollution and birth weight, and the first UK study and largest study worldwide of birth weight and noise exposure. We observed that long term exposure during pregnancy to NO2, NOx, PM2.5 overall and specifically from traffic exhaust and non-exhaust sources, and PM10, were all associated with increased risk of LBW at term, across London. There was strong confounding of the relation between road traffic noise and birth weight by primary traffic related air pollutant coexposure.”

A linked editorial advocated personal protection. “With compelling evidence of harm from environmental air pollution, pregnant women should consider how to reduce their risk. Air filtering facemasks might reduce acute exposure to particulate pollution, but there is no evidence that they reduce chronic exposures. Other strategies include changes to walking routes away from major roads and avoiding outdoor activity when air quality is at its poorest. However, the ubiquity of poor air quality in urban areas like London mean that personal behaviour changes are unlikely to result in substantially different long term exposures. Such lifestyle changes are not realistic for many pregnant women, owing to constraints from employment patterns, residential location, and transport options. These constraints are highest in those who are socioeconomically disadvantaged, contributing to health inequalities,” it says.

Walking on busy roads may cause more harm than good in elderly, finds Lancet study

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Walking on busy roads may cause more harm than good in elderly, finds Lancet study

If you are ageing and a brisk walk is what keeps you going every day, read on.

As short as a two-hour exposure to soot and dust found in traffic fumes on busy roads could lead to stiffening of arteries and impaired lung function, especially in older people, a study led by researchers at the Imperial College, London has found. The study, published in The Lancet,  strengthens the case to reduce vehicle emissions so that everyone can enjoy the health benefits of physical activity.

“Our findings indicate that in traffic congested streets, like London’s Oxford Street, the health benefits of walking do not always outweigh the risk from traffic pollution. However, this should not be seen as a barrier to many older people for whom walking is the only exercise they do. We suggest that, where possible, older adults walk in parks or other green spaces away from busy roads”, says senior author Professor Fan Chung from the National Heart & Lung Institute at Imperial College London, UK. The effect was particularly marked in people with existing respiratory illness.

Air pollution is responsible for around 5.5 million premature deaths worldwide every year. In India,  a report recently released by the Centre for Science and Environment (CSE) found that air pollution causes 30% of premature deaths in the country. A state level disease burden report released last month had found that household air pollution is responsible for 5% of the total disease burden and outdoor air pollution for 6%. Research shows that exposure to fine particulate matter (with a diameter of 2.5 micrometers or less; PM2.5) found in diesel exhaust fumes increases the risk of cardiovascular disease and death, and can reduce lung function, particularly in the elderly and those with chronic obstructive pulmonary disease (COPD).

The Lancet study was done in 119 older adults (aged 60 or over) including 40 healthy volunteers, 40 individuals with stable COPD, and 39 with stable ischaemic heart disease. Participants were randomly assigned to spend 2 hours walking along the western end of London’s Oxford Street where traffic is restricted to diesel-powered buses and cabs, or through a traffic-free section of Hyde Park, London.Participants abstained from smoking. Levels of traffic-related air pollutants (black carbon, particulate matter, ultrafine particles, and nitrogen dioxide) and measures of lung function and cardiovascular responses were taken before and during each walk.

In healthy participants, walking in Hyde Park led to an improvement in measures of lung capacity and arterial stiffness that persisted for up to 26 hours. In contrast, walking on Oxford Street led to only a small transient increase in lung capacity, and substantial worsening of arterial stiffness associated with greater exposure to black carbon soot and ultrafine particles from diesel exhaust.

The detrimental health effects of pollution were particularly marked in participants with COPD who experienced a narrowing (obstruction) of the small airways—reporting more respiratory symptoms including cough, sputum production, shortness of breath, and wheeze—and increased arterial stiffness after walking in Oxford Street compared with Hyde Park.

Haryana Govt to file FIR against Fortis on dengue death

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Haryana Govt to file FIR against Fortis on dengue death

Haryana government is all set to lodge an FIR against Fortis Hospital Gurugram for alleged irregularities in the case where a seven-year-old girl died of dengue and the parents were handed a Rs 15 lakh bill.

“In simple words, it was not a death, it was a murder,” Haryana health minister Anil Vij alleged. There were many irregularities, unethical practices and the protocol for diagnosis and medical duties was not followed, Vij, flanked by the members of the probe committee, alleged. The Haryana health department will file an FIR against the private hospital while the license of its blood bank will also be cancelled, he said. Its land lease may also be looked into, he added.

The hospital made a hefty profit on medicines given, which works out to 108 per cent and for some consumables it was

as high as 1,737 per cent, he claimed adding that costly medicines were used when cheaper substitutes were available. Just before Aadya Singh, who had suffered more than 70% brain damage was taken off the ventilator after two weeks of hospitalisation, her father was billed Rs 1559322, including the price of 611 syringes – the figure would mean Aadya was given 43 injections every day – and 1546 pair of gloves. The massive accumulation of fluid in her body meant that Aadya would not fit into the clothes that she had come to the hospital in. Also included in the bill is Rs 900 as the cost of the hospital gown the little girl wore when she was taken out of Fortis to a different hospital where they would issue her a death certificate.

Vij said that the hospital also overcharged for platelets. Platelets were given on 25 occasions, out of which Rs

400 per unit was charged on 17 occasions while eight times Rs 2,000 per unit was charged, Vij claimed. “The death of the girl happened due to not following the LAMA protocol, which is the Leave Against Medical Advice. The

girl was on a ventilator, but she was put in an ordinary ambulance, ventilator was withdrawn and an ambu bag was not

provided in that, which became the cause of her death, which is a very serious irregularity,” the minister said.

He said that the IMA protocol says that if a patient is discharged against medical advice, then proper arrangements

should be made to transfer him or her to another hospital. This can be done by the hospital or it can advise the kin

of the patient to do so, but the ambulance in which she was taken did not have the required facilities, he alleged

releasing the contents of the inquiry report. Fortis had earlier said that all medical protocol had been followed in the case and all consumables are transparently reflected in records and charged as per actuals.

Indo-UK project to study pollution effects on Delhiites using tiny sensors

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Indo-UK project to study pollution effects on Delhiites using tiny sensors

A team of researchers from nine institutes of India and the United Kingdom, led by the University of Edinburgh will examine links between long-term exposure to air pollution and health over a four-year period. They will use tiny sensors attached to the body to find out the amount of pollutant a Delhiite inhales everyday.

“The Delhi Air Pollution: Health and Effects (DAPHNE) project brings together best-in-class researchers from India

and the UK to address the pressing problem of the health effects of sustained exposure to high levels of air pollution. We believe this innovative research, funded by the UK research councils over the past 15 years, could eventually

help millions of people in Delhi and countless other global cities,” Professor D K Arvind of the University of

Edinburgh, who is leading the study, said.

The multidisciplinary team of researchers includes computer scientists, doctors and exposure scientists. According to a statement by the University of Edinburgh, air pollution levels in Delhi reached more than 16 times the safe limit, prompting the local government to declare an emergency situation. The DAPHNE project involves 760 pregnant women, who will wear the air pollution monitors attached as adhesive patches and scientists will record the health of the mothers and their children following birth. The researchers will also focus on 360 young people with asthma in order to examine the level of exercise they can tolerate amid air pollution. A UNICEF research paper released on Wednesday shows that air pollution, like inadequate nutrition and stimulation, and exposure to violence during the critical first 1,000 days of life, can impact children’s early childhood development by affecting their growing brains.

DAPHNE researchers would use battery-powered respiratory monitors, known as ‘RESpecks’ and the air pollution monitors, called ‘AIRSpecks’, utilise ‘Speckled Computing’, a technology being pioneered by scientists at the University of Edinburgh.”‘Specks’ are tiny devices that can be placed on everyday objects, and people, in order to sense, compute and communicate data. In the DAPHNE project, these sensors transmit each person’s data wireless to their mobile phone, enabling the user to monitor their individual exposure to pollution,” reads the University of Edinburgh statement.

The Indian partners include Sri Ramachandra University, Chennai, AIIMS, Delhi, Delhi University College of Medical

Sciences, IIT Delhi, IIT Kanpur and INCLEN, which is a ‘not for profit’ research organisation conducting multi-disciplinary studies on high priority global health issues. The UK Partners include the University of Edinburgh (Centre for Speckled Computing, School of Informatics and Centre for Cardiovascular Science), Imperial College (National Chest and Heart Institute) and the Institute for Occupational Medicine.

Shashi Kapoor was on dialysis, many Indians with chronic kidney disease can’t afford it

Dr O P Choudhury
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Shashi Kapoor was on dialysis, many Indians with chronic kidney disease can’t afford it

The death of yesteryear Bollywood charmer Shashi Kapoor a couple of days ago was a grim reminder of how a large number of Indians are falling prey to kidney diseases. Kapoor had been on dialysis for several years.

The 2016 budget announcement of a National Dialysis Programme too was testimony to the growing disease burden. Some estimates suggest that every year there are 2.2 lakh new patients of End Stage Renal Disease (ESRD) in India. The recently released State Level Disease Burden Study for India shows that Chronic Kidney Disease (CKD) shows the fifth largest increase in prevalence (26.1%)  between 1990 to 2016. The other diseases that showed a sharper spike in that period are diabetes (64.3%), cerebrovascular disease (CVD) (53.9%), ischaemic heart disease (IHD) (53%) and chronic obstructive pulmonary disease (29.2%). Incidentally diabetes and hypertension (that also leads to CVDs and IHDs) are known risk factors for kidney diseases, accounting, by some estimates,  for 40-60% cases of Chronic kidney disease in India today.

What is Chronic kidney disease?

Chronic kidney disease (CKD) is  progressive loss in kidney function. Kidneys are responsible for removing excess fluid and waste from the body – both can be toxic for the body if they are not got rid of. Damage to kidneys because of a range of factors including exposure to high blood pressure and high blood sugar can, over time reduce its ability to perform that function. For some time that impaired function is compensated for but after a point the kidneys essentially shut down. This is CKD.

What are the symptoms of CKD?

A person can lose up to 90% of their kidney functions before experiencing any symptoms. Inability to remove excess fluid from the body leads to swelling of legs, face and in advanced cases fluid accumulates in the lungs causing difficulty in breathing. Accumulation of toxins in the body leads to fatigue, nausea, hiccups and loss of appetite. Healthy kidneys secrete the hormone erythropoietin (or EPO), which stimulates red blood cells to form. But as kidney function declines, production of this hormone is impaired and anaemia (low red blood cell count) can occur. Kidneys are also pivotal in maintaining calcium and phosphate levels in the blood, so failing kidneys can lead to increased phosphate levels leading to severe itchiness and low calcium levels leading to fragile bones, also known as osteoporosis. Chronic kidney disease can indirectly lead to rise in blood pressure due to accumulation of fluids in the body.

Who are at risk?

People with Diabetes, high blood pressure, smoking, obesity, high cholesterol level, heart disease, stroke and those who are over 60 years of age  are at increased risk. People with a family history of kidney disease are also particularly vulnerable to it. Repeated use of painkillers, called NSAIDS (Non steroidal anti inflammatory drugs) and less commonly infections too have been implicated. More rarely, kidneys may be damaged by someone’s own immune system called autoimmune disorders. Acute kidney injury, a form of completely reversible kidney damage also increases the chances of chronic kidney disease in future. Growth of multiple cysts in the kidneys, known as polycystic kidney disease,which are present since birth and other structural defects of urinary passage causing reverse pressure on the kidneys (reflux nephropathy) are common causes.

How to test for kidney functions?

A simple blood test called KFT /RFT (Kidney Function test/Renal function test) that measures levels of urea, creatinine, uric acid, total protein ,albumin and electrolytes (sodium, potassium, phosphate and calcium level) in the urine can estimate kidney function. The main indicator of kidney function is  blood level of creatinine, a waste product of the body produced by muscles and excreted by the kidneys. If kidney function is reduced, creatinine accumulates in the blood leading to an elevated level when a blood test is checked. Kidney function is best measured by an indicator called GFR (Glomerular Filtration Rate) which measures the blood filtration rate by kidneys. This indicator allows doctors to determine if the kidney function is normal, and if not, to what level the reduced kidney function has deteriorated. GFR can easily be estimated (eGFR), from measurement of the blood creatinine level, and taking into account, age, ethnicity and gender. Usually, kidney disease starts slowly and silently, and progresses over a number of years. Not everyone progresses from Stage 1 to Stage 5. Stage 5 is also known as End-Stage Renal Disease (ESRD).

What are the available treatments?

There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing. In early stages, keeping blood pressure near normal (120/80 mmHg), strict control of diabetes and blood cholesterol, quitting smoking, regular exercises, low protein and low salt diet, avoiding over the counter painkillers and certain antibiotics which pass through kidneys like aminoglycosides can halt the progression of the disease for many years.

In late stages, when wastes and fluid accumulate in our body and kidneys fail to remove them, then one needs dialysis to remove these wastes and excess fluid from blood. Dialysis is the process in which the blood from the body is circulated through a membrane which filters out excess water and toxins. It can be done either by machine (hemodialysis) or by using fluid in abdomen (peritoneal dialysis). Each session can cost Rs 2-3000 per session, patients usually need three sessions a week. In end stage renal disease, a kidney transplant operation may be required. Transplant  is considered the best treatment for many people with severe CKD because quality of life and survival are often better than in people who use dialysis.

India had refused trial waiver for dengue vaccine now under probe in Philippines

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India had refused trial waiver for dengue vaccine now under probe in Philippines

The makers of vaccine admit that it may aggravate dengue symptoms

India must have heaved a sigh of relief as disturbing revelations about a dengue vaccine marketed by the French pharmaceutical giant Sanofi unfolded last week and Philipines ordered a probe into the vaccination of 7,30,000 children with a vaccine that its makers now admit may aggravate dengue symptoms. Sanofi had, last year applied for a phase III clinical trial waiver in India which the government turned down despite an expert committee of the drug controller general of India having been in its favour.

Sanofi, in a statement last week, urging health authorities to update the product label said: “Based on up to six years of clinical data, the new analysis evaluated long-term safety and efficacy of Dengvaxia in people who had been infected with dengue prior to vaccination and those who had not. The analysis confirmed that Dengvaxia provides persistent protective benefit against dengue fever in those who had prior infection. For those not previously infected by dengue virus, however, the analysis found that in the longer term, more cases of severe disease could occur following vaccination upon a subsequent dengue infection.” One day later, World Health Organisation which had earlier recommended the vaccine, recalibrated its position.

Yet, the Indian health ministry, earlier this year did not give Sanofi the waiver – a decision that now stands vindicated after an announcement by the company that the vaccine could aggravate dengue symptoms in some cases and Philippines ordering a probe into largescale vaccination of children. World Health Organisation which had earlier approved the Sanofi vaccine, too has now recalibrated its position. “Following recommendations made by the Strategic Advisory Group of Experts (SAGE) on immunization, WHO’s advisory body on vaccination, a position paper was published in July 2016 based on the data available at that time. The position paper makes a conditional recommendation on the use of the vaccine for highly endemic areas. Based on considerations of superior efficacy and, possibly, safety and duration of protection in seropositive individuals, SAGE recommended seroprevalence thresholds as the best population-level strategy. Based on mathematical modeling, an optimal seroprevalence in the age group targeted for vaccination was defined in the range of ≥70%. At that time theoretical elevated risk of dengue in vaccinated seronegative individuals was noted, and research into this was considered high priority. WHO thus called on Sanofi Pasteur to provide more data on efficacy and safety in baseline seronegative vaccine recipients,” WHO said in a statement

Till November 26, 146377 cases of dengue had been reported in India and 221 people had succumbed to the disease. Yet, in May, the government of India turned down the recommendation of the Subject Expert Committee (SEC) of the Drug Controller General of India (DCGI) and told Sanofi that if it wanted to market the vaccine in India it would have to conduct phase III trials (that establish the safety and efficacy of a drug in a large population) on Indian subjects. Sanofi had submitted published data of Phase III trials from other Asian and Latin American countries (Thailand, Brazil, Mexico etc.) based on which the vaccine has been approved in Mexico, Philippines and Brazil but the Union ministry of health remained unimpressed.

This despite the fact that the subject expert committee constituted by the Drug Controller General of India had recommended: “Although, the vaccine does not qualify the requirements of waiver of clinical trial, considering the fact that Dengue is a health problem of major concern in the country and can be life threatening in certain cases, the committee recommends for Market Authorization of the vaccine in the age group of 18-45 years only with the condition to conduct Phase IV clinical trial in time bound manner (Protocol submission within 3 months of marketing of the product).”

Pollution affects kids’ brains: UNICEF paper

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Pollution affects kids’ brains: UNICEF paper

Breathing in polluted air can damage brain tissue and undermine cognitive development

A new UNICEF paper estimates that almost 17 million babies under the age of one live in areas where air pollution is at least six times higher than international limits – conditions that can damage their lungs and brains. More than three-quarters of these young children – 12 million – live in South Asia.

The report “Danger in the Air: How air pollution can affect brain development in young children notes that breathing in particulate air pollution can damage brain tissue and undermine cognitive development – with lifelong implications and setbacks. “Not only do pollutants harm babies’ developing lungs – they can permanently damage their developing brains – and, thus, their futures. Protecting children from air pollution not only benefits children. It also benefits their societies – realized in reduced health care costs, increased productivity and a safer, cleaner environment for everyone,” said UNICEF Executive Director Anthony Lake.

The East Asia and Pacific region is home to some 4.3 million babies living in areas that exceed six times the limit

Satellite imagery reveals that South Asia has the largest proportion of babies living in the worst-affected areas, with 12.2 million babies residing where outdoor air pollution exceeds six times international limits set by the World Health Organization. The East Asia and Pacific region is home to some 4.3 million babies living in areas that exceed six times the limit.

The paper shows that air pollution, like inadequate nutrition and stimulation, and exposure to violence during the critical first 1,000 days of life, can impact children’s early childhood development by affecting their growing brains. It outlines urgent steps to reduce the impact of air pollution on babies’ growing brains, including immediate steps parents can take to reduce children’s exposure in the home to harmful fumes produced by tobacco products, cook stoves and heating fires.

RSS affiliate writes to PM Narendra Modi opposing cervical cancer vaccine

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RSS affiliate writes to PM Narendra Modi opposing cervical cancer vaccine

After having accused the Niti Ayog of pursuing anti-poor policies and trained guns on the Bill and Melinda Gates Foundation, Swadeshi Jagran Manch, the economic wing of the Rashtriya Swayamsewak Sangh now has the cervical cancer vaccine in its crosshairs. It has written to prime minister Narendra Modi that the human papilloma virus vaccine (HPV) should not become a part of the routine immunisation programme as there are safety issues and also such a move would entail a huge financial commitment.

“It is our concern that this programme will divert scarce resources from more worthwhile health initiatives diverting it to this vaccine of doubtful utility and that its adverse effects will erode confidence in the national immunization programme and thereby expose children unnecessarily to the risk of more serious vaccine-preventable disease. Swadeshi Jagran Manch requests you to stop this move to introduce Human Papilloma Virus (HPV) vaccine in India and we recommend the strongest action against groups that pervert science, which brings ignominy to the scientific community in the country and sells the country to vested interests,” SJM has written in the letter.

HPV is associated with more than 80 per cent cervical cancers — not all HPV infections go on to become cancerous. As one oncologist puts it, HPV is a necessary but not sufficient condition for cervical cancer. Data from the national cancer registry shows that in 2013,92,731 cases of cervical cancer were reported in India, a figure that is projected to go up to 1,00,479 in 2020.

The vaccine is recommended for girls at the age of 11-12 years though it can be administered to both boys and girls of that age. The US National Cancer Institute recommends “vaccination of females aged 13 through 26 years and of males aged 13 through 21 years who have not been vaccinated previously or who have not completed the three-dose vaccination series. Males aged 22 through 26 years may be vaccinated”.

The SJM letter comes days before the National Technical Advisory Group on Immunisation (NTAGI) is slated to take up a recommendation of one of its subgroups that HPV should be a part of the universal immunisation programme. NTAGI was scheduled to meet on December 6 but the meeting had to be postponed because it clashed with a meeting in the PMO. However whenever the next meeting happens NTAGI, which is the highest decision making body on vaccines would take up HPV, say sources in the Union health ministry.

Zika vaccine shows promising results in Phase I trials

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Zika vaccine shows promising results in Phase I trials

US scientists have zeroed in on a promising candidate for a Zika vaccine after an investigational Zika purified inactivated virus (ZPIV) was found to be safe and also generated an immune response in participants during three Phase 1 clinical trials. Scientists at the Walter Reed Army Institute of Research (WRAIR), part of the U.S. Department of Defense, are developing the vaccine and leading one of the trials, according to communication from the National Institutes of Health.

“A vaccine is urgently needed to help prevent Zika infection, which can cause birth defects and other developmental abnormalities in babies born to infected women, as well as a constellation of other health problems in infected adults and children. We are encouraged by initial clinical trial results that indicate the ZPIV vaccine is safe and immunogenic, data that support additional clinical testing of the vaccine to determine its ability to prevent Zika virus infection.,” says National Institute of Allergy and Infectious Diseases director Anthony S. Fauci.

Zika is spread mostly by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus). These mosquitoes bite during the day and night. It can be passed from a pregnant woman to her child and can cause birth defects, the most well known of which is microencephaly or babies born with small heads and resultant brain deficiencies. There is currently no medicine or vaccine for Zika. Earlier this year, the NDA government in India was accused of deliberate suppression of facts when a World Health Organisation press statement in May revealed how for months the fact that three cases of Zika virus infection had been detected in Gujarat, was kept under wraps. One case dated back to November 9, 2016, one was detected during routine surveillance between January 6-12 2017 and one between February 10-16, 2017. The suppression was unusual because Zika requires a number of public health measures and awareness is key to their implementation.

Meanwhile, the ZPIV vaccine candidate contains whole Zika virus particles that have been inactivated and therefore cannot replicate and cause disease in humans. However, because the protein shell of the inactivated virus remains intact, it can be recognized by the immune system. Of the 67 adult participants in the initial studies, 55 received the investigational vaccine and 12 received a placebo. The investigational vaccine was administered with an adjuvant (a compound that helps induce a stronger immune response) containing aluminum salts. All participants received two intramuscular injections of the same dose four weeks apart. The trial was double-blinded, meaning neither the investigators nor the participants knew who received a placebo.

Investigators tested participants’ blood samples periodically and detected antibodies to Zika virus in more than 90 percent of individuals who received the experimental vaccine, within four weeks after the last dose.

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