Tuesday, August 13, 2019

Science & Medicine: Poles Apart.


Related image

As far as medicine is concerned science has stopped the day the present system of medicine was made a monopoly and governments worldwide were forced to adopt it despite the fact that their indigenous systems of medicine evolving since ages were highly effective and had popular backing. The adverse effects of modern medicine were more than evident and people were unwilling to make the switch and considerable efforts had to be employed to establish this faulty system.

India for example was reeling from the adverse effects of the mandatory small pox vaccine campaign that had made various forms of extremely serious chronic diseases an integral part of society. Ironically those diseases became the base for medical research and research institutions were established for searching the bacteria and virus connection to these vaccine induced conditions.

However science has never backed medicine as it is practiced today. This was the reason why Rockefeller had to set up the Rockefeller Institute of Medical Research to justify the sudden shift from the practice of medicine as an art of observation, study of patients and interactions, and doctors personal experience to a system of mass chemical administration based upon pathological reports that treated patients as a mass that could be experimented upon at will under the guise of the greater good. Today it operates as the Johns Hopkins University that is founded by the Rockefeller Foundation. 

The ultimate miracle medicine that would cure all ills and conquer death was always the promise and that elusive goal still fascinates our practitioners though the majority has realized that it is an illusion best discarded. Moreover what would they do if such a thing really happened? Thus science and medicine proceeded in their own separate ways and today they are 180 degrees apart.

Man is no longer viewed as a machine that is run by the oil of chemicals. Latest developments reveal the body functions as a whole and its biological processes aided by trillions of microbes are perfectly capable of taking care of its needs and prolonging life unless it and its environment are grossly tampered with.

Science today also knows that the mind holds the key to health and its signals can both help and harm the biological set up. The body mind complex is dynamic and its parameters vary from day to day, from situation to situation, from mood to mood and thus no fixed ideas can be formed about its functioning. It is best to observe its functions and aid them by increasing the energy and vitality levels of the body. In case of illness too the same observation process helps and a change of diet and rest are often all that is required.

It must also be ensured that man remains a part of nature and lives in close proximity with it and its elements to remain healthy. Thus doctors like B M Hegde, Manu Kothari, Pravin Chordia and Biswaroop Choudhury are urging populations to depend upon the latest scientific findings rather than the machinations of the industry that desperately needs disease and disease names to survive. They recommend health and wellness based upon safe food and environment, mental and emotional balance, and study of the purpose of life. We are thus heading back to what Charaka, Hippocrates and Hahnemann had discovered and recommended.

Why is homeopathy attacked?


Image result for homeopathy images
The decision to attack homeopathy was a conscious decision by the group of (I am sorry to say) eminent quacks who ruled medicine around the 18th century. They had a roaring practice and were powerful because of their proximity to and membership of secret societies. These people were alarmed when Hahnemann digressed from allopathy and the cream of allopaths followed him.
Many of those who joined Hahnemann were skeptics but being endowed with honesty and integrity they studied homeopathy and practiced as per the principles to find that it worked and was able to cure people who suffered very complex problems. They converted in hordes. This happened in several countries like Germany, USA, India, and UK. Homeopathy was on its way to be the leading treatment modality.
The manner in which allopathy was dominated by quacks and imposters and the fact that it was unable to produce results also made other genuine practitioners of the system study other methods like naturopathy, herbals and chiropractic. Medical colleges started teaching these subjects and hospitals devoted wings to them. The keen doctors observed the results in front of their eyes. The leaders were leading the profession towards an integrated approach that was observant, cautious, empathetic and eager to learn.
However this was bad news for the quacks who formed the American Medical Association to check the exodus. Doctors practicing other systems were threatened with cancellation of licence. They also found an ally in J D Rockefeller the powerful oil Barron who was limping after his initial foray into petrochemical drugs had disastrous results. (It is written about in the book The Story of Aspirin). He himself adopted homeopathy for himself and family and never deviated till the end. To be fair to him he also wanted to back homeopathy but was deterred by the people who wanted him to prop up the collapsing fortunes of allopathy.
He thus took the plunge prodded by one William Gates, a glib talker and master manipulator. However Rockefeller faced a disgruntled profession who were unwilling to drop their ethical considerations. Therefore an old draft of the AMA was sharpened by a retired school teacher called Abraham Flexner as instructed by Rockefeller and the recommendation was that only the flawed chemical model propped by the germ and virus theory proposed by a laboratory assistant of Dr Antoine Beauchamp, MD be followed. The battle between the two is well recorded as Beauchamp vs Pasteur and the book as a pdf available in the internet makes for interesting reading.
The Flexner Report 1910 banned all systems of holistic medicine and Rockefeller used his clout to close down all colleges and hospitals that allowed holistic treatment and took over the rest. Even among them dissenters were sacked and Rockefellers trusted aide's took over. One can read the book "Rockefellers Medicine Men" banned in publication but available on the net. Later Rockefeller was joined by I G Farben the Nazi chemical giant that was behind Auschwitz atrocities and together they set up the medical system that prevails today. You can know about I G Farben from the book "The Hell's Cartel".
Medicine thus took a turn it should never have. Unfortunately these developments came at a time when practitioners were beginning to understand health, and under the leadership of Dr William Osler were appreciative of a holistic and empathetic approach with ethics and the doctor patient relationship as the strong base of medicine.


Saturday, August 10, 2019

Health: What do people want?


Image result for People images

Yesterday one of my posts (reproduced below) received a barrage of protests from doctors who could not find any fault with the post per se but were angry that certain issues were being raised by a person who does not belong to the profession. They asserted they knew better on the subject though many of them could not go beyond dirty expletives. As usual attempts at character assassination and calling practitioners of other modalities quacks was an expected part of the discussion.
This is essentially the core problem facing the medical profession today. They have lost touch with ground reality. This is why I support the move that we should restructure medical education and do away with medical associations who are nothing but mouth pieces of the industry and their interests. With them should go philanthropies and international institutions who are acting as middlemen between governments and the pharmaceutical industry.
Medical education as an MP (Jairam Ramesh?) said in the Rajya Sabha should have health as the base. The first two to three years should teach the students about health and how to achieve it. In short how healthy people can be kept healthy and how those who are sick can be cured.

The excuse of disease management must go. We need doctors who can reduce the number of sick people in society, not a profession that actively adds to disease. We need doctors who can think wisely and independently, ask critical questions and act upon their own knowledge and experience instead of following industry approved protocols. We need doctors who can critically look at environmental factors causing disease, at toxicity that has enveloped society and environment, and can be at the forefront in the fight against them.

This does require courage because the very industry that manufactures "medicines" also manufactures pesticides, industrial chemicals, food additives, and daily use chemical products that are causing diseases. The "medicines" they produce have been proven to cause irreparable damage and irreversible harm by the human microbiome project and advances in the fields of epigenetics, immunotoxicity, pharmacology, cell biology, and toxicology.
People who have entered the profession of medicine should reflect whether they should listen to the members of society and mend the way their profession functions or continue to attack those who call for reforms and remind them of the oath to "first do no harm". To point out the obvious deficiencies is not a crime but the moral duty of every person in a civilized society that is witnessing never before observed epidemics of serious diseases, disabilities and cancers in all sections of society; rich, poor, children, adults and elderly. Such a situation cannot and should not be allowed to continue.
I as a victim of the system am doing my duty despite the threats and repeated character assassination. But dear doctors are you doing yours? Should you work with us or against us? The basic question you should ask every day is, why have I entered the profession? To the juniors who are yet to fathom the intense politics that is medicine, I would say grill your seniors and professors. Ask them critical questions instead of agreeing to whatever they say. Go beyond industry sponsored events, conferences, and industry designed medical curriculums. You have to find your own answers. Not only for the sake of your patients but also for your own health and that of your family members.

This is what people expect from you. Reform the system. Reform yourselves. Break down the corporate and profit seeking culture that characterizes your profession today. Return the society to its former healthy self. Be happy and make others happy.


The post that triggered the outrage. 


The medical profession wants us to believe that without an extensive awareness of modern medical concepts as taught in medical colleges people are not qualified to treat patients. But how much of what is taught is actually scientific? Eminent medical researchers like Dr Richard Horton, Dr Marcia Angell and Prof John Ioannidis who have done extensive research say that about 1 to 15% of medical practices may be scientific. The rest are convenient assumptions to suit industry needs. Prior to modern medicine Vaids and Hakims used to treat us effectively. Naturopathy is as old as civilization. If you you look at medical history in India you will know how much propaganda had to be resorted to in order to destroy the medical system of those days. It would never have been possible without extensive government apathy towards those systems and effectively destroying their base.Today doctors like Dr Biswaroop Roychoudhury, Dr B M Hegde, Dr Pravin Chordia, Dr Manu Kothari and others admit that as man is a product of nature health solutions can only come from nature. They point out that growth in number of diseases and in number of patients is parallel to the growth of the medical industry thus stating very clearly that it is modern medical practice that is behind our current day chronic disease epidemics. This is known as iatrogenic or medicine induced disease. According to the modern doctors all present day diseases are idiopathic or cause unknown! To solve rural health problems all governments in the center have tried to take many steps like having a rural medicine course for rural youth like B.Sc ( Rural Health ), training the local vaids and hakims who are practicing well without licence, allowing nurses and pharmacists to practice etc. There is nothing wrong in these steps as it takes a basic knowledge of health to treat people. The more the professionalization, the more is the propensity to interfere and harm. As Dr Manu Kothari remarks, "A perfectly healthy man goes in for a medical check up and emerges as a patient!". In reality MBBS doctors who need to be provided knowledge about nutrition, lifestyle and genuine public health measures, and AYUSH doctors can do a much better job than specialists who are renowned for creating complications. Today 50 lakh people die every year in our hospitals for medical errors which is actually an underestimate. We should also try to know the number who are dying from unnecessary over prescriptions. And moreover health is not just about doctors and prescriptions - these alone can never lead to health. Health is about safe and nutritious diet, lifestyle, sanitation, hygiene, mental hygiene, avoiding toxicity, and safe eco friendly livelihoods that provide a decent workplace and decent income. Many published studies have proven this time and again. Thus now it is time to come to our senses and rectify imbalances in our society and environment. It is time to ignore what the medical industry and its associations want. What we need is health not "health care" which is an excuse to sell more drugs and devices to profit the industry. We need common sense and not expertise to return to health.


Vaccines, Antibiotics & Pornography.


Porn Key with trap on keyboard, 3D rendering Stock Photo - 72690658

Strange topic, is it not? However the link is well known. The fear of sexually transmitted diseases and their consequences had traditionally forced communities to lead moral lives. Homeopaths who treated venereal diseases found that they converted into the dreaded chronic body states when suppressed - known as sycosis and syphillis miasms - and devastated generations as they are hereditary.

Earlier these diseases were 'treated' with mercury preparations and the results were horrific as the patients took on the additional burden of mercury poisoning which again mimicked the syphillitic miasm. Then came penicillin and the Rockefeller gang urged the populations to indulge without fear. "Do anything you want and we are there with our antibiotics to treat you and profit from it." Within a short period it became known that antibiotics too drove the disease deeper and resulted in serious inheritable physical and mental disease states but this knowledge was kept away from the general public.



Vaccines contain heavy metals which are known to affect the mind in myriad ways. Heavy metals must never be used in their untreated form and here we are injecting them! Entire civilizations have been known to disintegrate due to the adverse effects of heavy metals. The Roman Empire fell as it used lead plumbing. The word Mad Hatter came about as the lead lining in hats made workers mad. In Japan and Iraq accidental mercury poisoning led to populations and even animals displaying strange autism like symptoms. Those have been external or ingested influences.

Thanks to vaccines, metals like aluminium, mercury are being recklessly injected into pregnant mothers, infants and children in doses far higher than even the industry deems 'safe' to save their own skin. Vaccines also contain other metals and animal and human serum. Consequently vaccinated population suffer 'vaccinosis' a chronic body state that is akin to sycosis. It makes the mind vicious and cruel.

Doctors like Dr Compton Burnett and medical historians like Dr Harris Coulter have written books about these resultant mental states. Porn and sexual deviations are not a choice for the vulnerable poisoned populations but an addiction they cannot do without. Our Government has a "Health Intelligence" department which appears to be in coma. They cannot notice the simple cause and effect relationship.

Do human beings have roots?


Image result for Human roots images


Do human beings have roots? Well trees have roots and they are thus visibly connected to the earth which is a treasure house of microbes and nutrients. The leaves receive energy from sunlight. Plants are also affected by light and temperature that rules their behaviour and internal mechanisms. Throughout the day and night a clock work like precision rules them.

This was first recognized in the West in 1729 by the French astronomer De Mairan. Thus the flora are connected to the earth and are nourished by it making them a wonderfully resilient species.



What about living beings? The biological clock operates in living beings too and the term Circadian (day time) rhythm applies equally to them. Thus this could be the beginning of the human root, or connection with nature that Indian Ayurveds discovered many thousands of years ago. They connected the biological clock to the mind, body, emotions, and organs.

The rules of ayurveda revolve around this vital clock work. A fully healthy body and mind works smoothly without any trouble when it is aligned with this clock; the human root. Today cellular biology has observed that the circadian clock affects each cell of the body.

Ayurveda went beyond this and studied the effects of various planets on health and thus developed the health branch of astrology. They discovered the finer bodies; the karana sharira (causal body), the sukshma sharira (the finer body) and the sthula sharia (the visible body). They found that the visible body is guided by the finer body (which extends beyond the physical body as the aura) and both are based on the causal body. Diving deep they discovered the Atman (the soul), a subtle entity that moves from one body to another just like a worm moves by holding on to one tuft of grass, leaves it and then catches another tuft of grass.

All of this knowledge led to various methods of treatment; gross, subtle, and ethereal; each affecting the body at various levels. Today there is news that a therapy called whole body vibration can affect the microbiome to have therapeutic benefits. Yoga and pranayama is such a vibrational therapy when combined with repetitions of mantras. While Indians have neglected this wonderful science to fall for western commercial motives, ironically mantra and tantra therapy are fascinating researchers from all over the globe. They are finding the pattern and network that was revealed to ayurvedic sages aeons ago.

The human body is not only nature dependent but also contains the universe within it, just as the planetary system trajectory is observed within every atom. Jaha brahmande, taha pinde. The universe is reflected in the human body was a finding made by tantric masters. Those connections have not gone but are obscured by our present day thinking, lifestyle, habits, and technology thrust on us. Thus those who seek the truth tend to retire to the hills.

Health is a simple subject.

Image result for Indian tribal images


The body and mind complex is designed to enjoy physical, mental and spiritual health. It does not take truckloads of wealth or world destroying economic development to achieve it. The wild animals in the forest are happy, the birds flying in the sky are happy, the insects chirping on the ground are happy. They will continue to be happy if we allow them to remain in their environment and not destroy it.

What medical science ought to do is study health and how it is maintained by the body in the environment it is in. When the environment within the body and the environment external to it are in sync the result is health. The doctor’s job is not limited to prescriptions. The ayurveds, naturopaths and yoga teachers know this very well. If you care to study what they have to say, they lay down laws for the body, mind and environment; very simple laws. They are called natural laws and in scientific terms the term circadian rhythms comes close.

Then what is disease? Disease is about toxicity that results when these laws are violated. Even the ordinary working of the body creates toxins that are expelled through stools, urine and sweat. Often there still is accumulation of toxic load that is periodically shed through the process of acute illnesses like colds, coughs, fevers, diarrhoea, skin rashes and the like. Would you give medicines to stop stools, urine and sweat? Foolish is it not? Similarly it is not wise to not understand acute illnesses and suppress them. The toxins then further accumulate and affect the person at physical, mental and emotional levels creating chronic disease.

Then there are moral laws which when broken lead to diseases like sexually transmitted diseases. Suppressing these lead to even more serious diseases that can travel generations. They can also be transferred through blood and serum transfusion.

I oppose vaccination. It tremendously complicates matters and interferes with common childhood illnesses that are the body's attempt to throw out the inherited disease load. That is why the infant immune system is differently built. It is passive. Vaccines also deal with extreme toxins and inject human, animal and avian serum. God alone knows what kind of harm we have done through this procedure. What human and animal diseases we have introduced into society besides the toxic impact.

The body can work and heal itself only if we cease to interfere in vital growth and development periods like pregnancy, childbirth, infancy, childhood and adolescence. Today's medicine however profits from interventions in these very vital periods but we like to call it scientific. The best of doctors, as Sir William Osler says is one who observes a lot but interferes the least. There are many greats who understood the value of compatibility with nature and condemned the battlefield approach against disease and supposedly disease based pathogens like bacteria and viruses.

Today the microbiome project has proven the lie, derived the fact that microbes and parasites are the most vital part of health, and laid bare the consequences of interfering with them. The science of epigenetics declares we are condemned to carry this damage for 14 generations even if we stop today. We ourselves create the emergencies we then love to treat in the name of "saving lives".

Unless we stop and allow the detoxification process to begin anew by allowing the acute diseases to return chronic diseases will be there to stay, complicating things more and more with each passing day. The increasing rates of infertility and development of suicidal tendencies in people are signs that the body is fast losing the capability to cope and seeks to end the painful existence. When will these simple facts percolate to the members of the profession? When will they stop the harm and start the healing process?

Rural Health: Requires Heart Based Approach.

Image result for Indian tribal images

I attend mainstream discussions on rural health. Sometimes I happen to be a panelist. What is interesting is that the discussions are always dominated by three issues; the dearth of doctors, the conditions they face in rural areas, and what sort of incentives they need to accept rural postings. Nobody touches the subject from any other angle. It is all about doctors, medical colleges, and drug and vaccine delivery. It is assumed that these are the solutions and once provided they will result in health.

When I get to speak I always point out, these are really secondary issues. What we should be worried about is the abysmal state of health we see all around us. We always talk about increasing the number of doctors. Why? What about decreasing the number of sick people? What about talking about genuine public health needs like safe food, environment, housing, waste management, and eco friendly livelihoods? What about the medical errors and misadventures that are causing disease epidemics? What about the rural people falling prey to pesticides and herbicides used abundantly in agriculture and DDT mix sprays that are targeted at malaria control? What about the drugging of pregnancy, caesarians, use of vaccines and drugs in infancy and childhood?



Thus these discussions are absolutely meaningless. Let us set right agriculture, set right our views about health, allow AYUSH (holistic) practitioners the first access during pregnancy, childbirth, infancy and childhood. In remote tribal pockets we are doing just that. We are replacing chemical agriculture with organic agriculture, ensuring irrigation, crop rotation and diversification, encouraging millets, vegetables, and tubers, setting up household level backyard organic kitchen gardens, setting up SHG's, Farmers Clubs and Federations to allow farmers get organized, get access to markets and hence ensure good incomes. Health comes from food. Food comes from a nutrient rich soil.

We are also now trying to reintroduce cows in agriculture and trying to restrict the use of hormones, antibiotics and vaccines for livestock and poultry despite opposition from vested interests. But we are unable to come full circle because of the greatest stumbling block. The Anganwadi workers (rural health workers) are trained to sicken children and people with drugs and vaccines which are target driven. The mothers do not get benefits unless they agree to this system. The PHC's and CHC's (local health units) do not have AYUSH (holistic) doctors and therefore people are ultimately being poisoned.

You cannot push poisons into people, ensure a highly toxic environment, ensure toxic food, a directionless education system that makes rural mostly tribal folk turn away from traditional eco friendly livelihoods, introduce fast foods into rural markets and expect people to stay healthy. That is foolishness at its level best.

The tribal people were the most healthy on earth. Their diet consisted of a diverse food basket comprising millets, a wide range of vegetables, tubers and forest produce. They also had access to plenty of meat. Hunting and other group exercises kept them healthy. Their traditional culture, song and dances kept them happy. They had extensive knowledge of herbal and natural medicines which they transferred to the next generation. They had tradition medicine men and women in charge of health. Living with nature and elements in itself the most effective way to preserve health. But in discussions around rural health these vital elements are always missing. 

Vaccination: A Matter of Faith


Image result for vaccine images

The problem with vaccination is that nobody can explain how it works. The common notion that weakened disease agents are injected or orally given to induce antibodies to protect against diseases is not scientifically valid on many counts. It was an 18th century assumption that has today been proven scientifically wrong.

Edward Jenner who invented vaccines was not a doctor though he pretended to be a surgeon. His intention was to promote something novel, get a grant from King George III and become famous. So he picked up the idea of cow pox preventing small pox (which too was not his idea but the idea of a farmer proposed several decades earlier to him and abandoned because it was found that dairy maids who suffered cow pox were not immune to small pox). But that did not deter Jenner who despite serious objections of genuine doctors of the day decided to pursue his fallacy and after obtaining a six month diploma in medicine (which again was completed by a friend of his as admitted by him in a correspondence), he managed to get the grant from King George and thus began the process of vaccination.

The very serious adverse effects (ranging from small pox, deaths, tetanus, diphtheria, syphilis, leprosy, cancers of various kinds, tuberculosis, eczema, sepsis, necrosis, and various kinds of neurological and mental disorders) made both public and doctors angry and they fought him tooth and nail. But the quacks of the day pursued the practice as the promise of lifetime immunity reduced to six months and they gained a lot of money from the six monthly vaccination process. Even geniuses like the second Hippocrates Sir William Osler denounced the practice and declared it to be a superstition.

In 1942 when Dr Merrill Chase, MD discovered the concept of cellular immunity and thus proved that antibodies alone did not offer any kind of protection, many thought that the process of vaccination would be stopped for good. But by that time the Oil Barron Rockefeller was firmly in charge of medicine and he had realized that vaccination was a good way to induce disease in society so that the petrochemical and chemical products introduced by him could sell well and bring him profits and global domination.

Immunology has progressed in leaps and bounds since then. Today we know that the infant does not have the ability to produce antibodies, a capacity that somewhat develops by the age of five. Thus the antibody theory falls flat when it comes to childhood illnesses (which again have been today demonstrated to be a necessity and a pathway to health). The supposedly adult illnesses like diphtheria, tetanus, and rabies do not fall into the "immunity" category as even natural experience of these illnesses do not produce immunity. You can suffer these diseases despite having suffered them earlier. The tuberculosis vaccine was proven to be 0% effective in a 15 year old trial by ICMR but it continues because stopping it was disturbing for the industry.

The notion that only weakened pathogens are injected via vaccination is a hoax. The mixture of heavy metals, extreme neurotoxins, genotoxins, endocrine disruptors, high range antibiotics, brain and foetal barriers invading chemicals, emulsifiers, aborted human and bovine foetal cells, dog, monkey, chicken, and insect cells, human, bovine, monkey, and avian serum is so intensely toxic and damaging it ought not to be in the building where you can venture let alone be injected or administered to anyone.

Today officially vaccines are connected to 292 diseases, disorders, disabilities including death of which 158 cannot be denied as the link to various diseases have been proven beyond doubt. The vaccination package inserts themselves admit to 152. Studies by the Institute of Medicine too points to a figure beyond 150. This is despite the unofficial diktat by industry and lobbyists not to study vaccines and the intense persecution of those that still do.

When in the early phase of my campaign (sometime in the 90's) I had asked the renowned immunologist Dr Herman Fudenberg the list of vaccine induced diseases, he had responded with a single sentence, "All diseases in internal medicine." When I had asked Dr Pushpa Mittra Bhargava (a vaccine developer himself) he had said, "All diseases today can be described as autoimmune, inflammatory and immunotoxic. No other medical intervention can induce such a state better than vaccines." They and doctors like Shiv Chopra have confirmed my worst suspicions.

My own experience has been horrific. The vaccine given to me had exploded like a phosphorous bomb within my body. It was a miracle that I survived though I am still suffering its intense effects.

Our energy today must be devoted against this heinous practice that is destroying children in front of our eyes. In the USA in the year 2011 it was declared that 54% of the children suffer from serious chronic disorders with several suffering more than one. The figure in India could be around 70 to 80%. Diseases like autism are today 1 in 59. Serious neurological disorders 1 in 8. Cancers are spreading like wildfire among children as are diseases like insulin dependent diabetes. Let us now think how we can unitedly raise our voice to protect our children.

Friday, August 09, 2019

Is India Polio Free?

In a post-polio world, India cannot sit still
No central Indian agency is tracking non-polio causes of paralysis in India, even though other pathogens can be as deadly. With polio gone, experts say it is high time to begin such surveillance
30/07/19

PRIYANKA PULLA
The global initiative to eradicate polio had big dreams for 2019. It was the latest deadline for the eradication of the polio virus in both Afghanistan and Pakistan. Reports in July, however, indicate that 2019 can be added to a growing heap of missed deadlines. Not only is polio still rife in both countries, but its prevalence seems to be increasing. 
Pakistan has seen four times as many cases of polio thus far in 2019 as it did in the same period last year. Set against this backdrop, the situation in India seems comparativelysanguine. The World Health Organisation (WHO) declared Indian polio-free in 2014, and it has stayed that way since.
But while polio may be in India’s rearview mirror,  other viruses may be rushing to fill the niche left by its eradication. Back in 2015, reports emerged of 208 children in Uttar Pradesh, India’s most populous state, developing polio-like symptoms. Given that the World Health Organization had declared India polio-free scarcely a year ago, the news triggered panic. Had the dreaded virus made a comeback? 
Eventually, a 20 June press release from the Ministry of Health and Family Welfare calmed these apprehensions. It said that even though the cases looked like polio, samples from the children were negative for the virus. What the children had was Acute Flaccid Paralysis (AFP), a broad basket of symptoms with causes other than polio. “India is polio-free,” the press release assured.
Four years later, it isn’t clear what happened to these children. Did they recover—many cases of AFP are transient, and patients make a full recovery. Did some remain paralysed for life? What caused their illnesses, if not the polio virus? No central or state agency knows the answer. This is because India has no systematic program to investigate non-polio AFP cases, even though 36,338 cases were recorded in 2018. 
The lack of research in this critical area is “very tragic,” says C Durga Rao, a microbiologist at Bengaluru’s Indian Institute of Science. Rao has studied viruses associated with AFP in the past.
Even though no central agency investigates every case of AFP, sporadic studies conducted by Rao and other scientists point to the role of some troubling viruses. Many children with paralysis are infected by members of the genus enterovirus, to which polio belongs. This genus has microbes like EV71 and EVD-68, which have been dubbed “the next polio” because of the crippling disease they can cause. 
For example, EV71, which circulates widely in East and Southeast Asia, kills or paralyses a large number of the children it infects. A study by Rao between 2007 and 2009 and another by Mumbai’s Enterovirus Research Centre between 2008 and 2012 found EV71 among AFP cases in India.
Meanwhile, EVD-68—which attracted global attention for being linked to major AFP outbreaks in the USA and Europe recently—was identified in a 2-year-old Maharashtrian child with respiratory illness in 2017.
But these viruses are merely the headline-makers; there are around 70 other enteroviruses capable of harming humans. Out of these, researchers have also identified echovirusesand coxsackieviruses in the stools of India’s AFP-afflicted children. These studies are not definitive proof that the viruses are causing the AFP (the viruses may be present in the children’s bodies without causing harm), but they provide a reason to look deeper. 
Such deeper investigations may reveal that many AFP culprits are not enteroviruses at all. For example, the West Nile Virus and Epstein Barr virus are also known to trigger paralysis. The botulinum toxin, which contaminates foods like milk, can cause a similar syndrome. Finally, some vaccines, such as the influenza jab, trigger an autoimmune illness called Guillain-Barre Syndrome, which looks a lot like AFP.  Nobody has tried so far to pick apart this grab-bag of AFP causes in India systematically. But experts say it is high time to do so.  
The double-edged victory over polio
AFP was first used as a surveillance tool in 1985 when the Pan American Health Organization decided to end polio in the Western Hemisphere. Polio is a difficult disease to diagnose; many other afflictions look a lot like it. So, instead of leaving it to doctors and ill-trained medical workers to spot its symptoms, a decision was made to collect stool from every case that looked like polio. Basically, every AFP case. WHO soon recommended the same strategy, and India followed suit in 1997.
But things didn’t go as expected. Since polio was the biggest cause of AFP in the nineties, the assumption was that the AFP burden would shrink as polio declined. The WHO even estimated the number it would drop to: non-polio AFP cases for every 100,000 children under 15 years (NPAFP rate) ought to shrink to around 1-2 each year, it said.

This happened in countries such as the US and Sri Lanka. But in India, AFP numbers rose. Between 2001 and 2011, for example, India’s NPAFP rate grew 
from 1.88 to 16.14. Total AFP cases, which include NPAFP as well as confirmed and suspected wild poliovirus infections, jumped from over 7,000 to 60,000 per year. And the numbers still haven’t fallen to WHO’s estimate. Even in 2018, polio-free India had an NPAFP rate of 9.73.
Polio experts have proposed several explanations for this spike. The most common one is that India has an exceptionally intensive AFP surveillance network—one of the best in the world. And around 2003, already struggling with a huge number of cases, India dialled its surveillance up a notch, counting even borderline cases as AFP. Further, it began increasing the number of centres that reported AFP cases—from over 20,000 in 2004 to over 35,000 in 2012. And some of the reporting sites weren’t hospitals at all, but even temples and quacks, where families often took stricken children.
The consequence of this was that a number of mild cases, and cases which weren’t even paralysis, were caught in the AFP net, some experts say. “Even a slight injury, which leads to 2-3 days of limping, gets reported by hospitals because surveillance is intense,” says Jagadish M Deshpande, who previously headed the Enterovirus Research Centre and worked on poliosurveillance systems in India. This would mean that a number of AFP cases may not be paralysis at all.
Yet, there are other children who do become permanently disabled. And neither the NationalPolio Surveillance Project (NPSP), nor any other Indian agency has any idea of how many cases fall in this category. This is because of a blindspot in India’s AFP monitoring. “Once the sample is negative for polio, the story ends,” says Govindakarnavar Arunkumar, a virologist at the Manipal Centre for Virus Research in Karnataka. The negative samples are typically not investigated further by NPSP, although external researchers like Durga Rao have conducted occasional studies. 
The patchy data that exists, however, suggests that a significant number of AFP cases end in permanent paralysis.
A critical blindspot
Over a decade ago, C Sathyamala, a researcher from Delhi’s Council for Social Development, sought information on the number of children with long-term symptoms under India’s Right to Information Act. She found that in 2006, NPSP had tracked some 2,043—around 18%—AFP cases in Uttar Pradesh. Out of these, 989 had residual paralysis and 244 died. 
Based on this, Sathyamala argued in a letter to the Indian Journal of Medical Research that intensive surveillance systems couldn’t fully explain the high number of AFP cases in India.
Of course, the information received by Sathyamala pertains to UP alone; nothing is known about NPAFP elsewhere. This paucity of information even when NPSP collects samples from all paralysis cases is disturbing, says T Jacob John, a Vellore-based virologist known for his work on polio. “Doing AFP surveillance from late 1990s, and not knowing the exact clinical diagnosis of every case even in 2019 is diagnostic of a paralysed health management system,” he says.
When asked why no systematic attempt was made by India to uncover top causes of NPAFP, Deshpande said the NPSP had been geared towards polio, because it was the most common illness.  Identifying the reason behind every other case of AFP would be expensive and difficult, given the hundreds of viruses, bacteria and other factors involved, according to him. “If there are ‘n’ number of causes, every cause may not get investigated in the program because the program has to focus on something.”
“Doing AFP surveillance from late1990s, and not knowing the exactclinical diagnosis of every caseeven in 2019 is diagnostic of aparalysed health managementsystem,”
—T JACOB JOHN, VIROLOGIST
Varun Sagar, a resident of Karnataka’s Tumkur district, is one of the children permanently crippled by AFP. Two years ago, Sagar, a six-year-old with a shy, milk-toothed smile, lost the use of his right arm after a bout of fever. “He woke up one morning and his arm was hanging loose,” says N Gangaiah, his father. Sagar has now begun attending upper kindergarten and is learning to write with his left arm.
In August 2017, after consulting many doctors, Gangaiah took his son to paediatric neurologist Vykuntaraju KN of Bengaluru’s Indira Gandhi Institute of Child Health. The doctor diagnosed the child with Acute Flaccid Myelitis (AFM), a type of AFP in which the myelin—the protective sheath around nerves—is damaged.
Sagar was not the only child with AFM who came to see Vykuntaraju that month. During July and August 2017, nine others with strikingly similar symptoms visited the hospital– an unusual occurrence, says the neurologist. Such a cluster of cases typically points to an outbreak, and so Vykuntaraju conducted further investigations to identify the cause. But despite testing for dozens of pathogens, including West Nile Fever and Zika, the group wasn’t able to identify the culprit, as they reported in a 2018 paper.   
The spectre of the next polio
While Sagar’s family may never know what was behind his illness, one emerging AFM cause that has attracted global attention recently is EVD-68. Around five years ago, the US and Europe saw a sudden rise in children with severe respiratory illness, with a fraction developing AFM. Investigations revealed that the cases were likely due to EVD-68, an enterovirus first isolated over 50 years ago. 
The sudden spike in severe EVD-68 disease was a surprise because this microbe had historically caused only a mild cough and cold. But the AFM outbreaks kept coming. After dying down in 2014, they recurred in 2016 and in 2018, too.
To some researchers, the unexpected emergence of EVD-68 after decades echoes polio’s rise as a global scourge. Before the twentieth century, paralytic polio occurred sporadically, causing small outbreaks. Then, driven by a combination of factors, the disease exploded onto the world scene, afflicting tens of thousands of children at its peak in the mid-twentieth century.
Nobody knows what trajectory EVD-68 will take, but it does look a bit like polio. “It is clear that EV-D68 has increased in pathogenicity since 2014,” says Nicholas M Grassly, an epidemiologist at the Imperial College of London. According to one estimate, EVD-68 attacks neurons and causes AFP in roughly 1 in 100 symptomatic cases. But what made the virus shift its behaviour so dramatically? Some studies suggest that specific mutations that occurred since 2006 may have helped EVD-68 target neurons instead of just the respiratory system.
It is impossible to say if EVD-68 will ever become as widespread as polio. “The simple answer to this is that we don’t know,” says Grassly. But, he adds, it is important to track emerging enteroviruses so that vaccines can be developed to keep them in check.
India’s Pandora’s box
In India, however, such tracking doesn’t happen, so it isn’t even clear if EVD-68 is circulating here. It is present, however, as the Pune-based National Institute of Virology’sfinding of the virus from a child in Maharashtra shows. Vykuntaraju, who has treated children with AFM, says his team couldn’t test for EVD-68 because they didn’t have the lab facilities to do so. 
Mumbai’s Enterovirus Research Centre also looked for EVD-68 in an as-of-yet-unpublished study of over 4,500 stool samples from NPSP in 2014 and 2015, says VK Saxena, the scientist who led the study. They didn’t find the virus, but this doesn’t mean much because EVD68 is difficult to isolate from stool, and requires respiratory samples. 
Meanwhile, India has several other concerning viruses. Take EV71, whose historical trajectory has also reminded scientists of polio. The virus has caused large outbreaks of hand, foot and mouth disease in China and other east Asian countries, with a fraction developing AFP or dying. 
Studies by IISc’s Durga Rao and Mumbai’s Enterovirus Research Centre have found this virus in the stools of AFP patients across India. The mere presence of EV71 in stools doesn’t mean it has caused paralysis—enteroviruses are widely found in the stools of healthy children too, and scientists typically compare the prevalence in healthy children with sick children to find out if the virus is really causing the disease. However, it’s reason enough to stay alert. 
Scientists are not very sure why India hasn’t yet seen massive outbreaks of hand, foot and mouth disease like neighbouring China has, given that EV71 is here too. But according to Saxena, this could be due to the milder varieties of the microbe circulating in India. This situation may change quickly, though. 
In their 2014-15 study, Saxena’s team found a virulent variety of EV71—the genogroup B, linked to hand-foot and mouth disease in Southeast Asia—among AFP-afflicted children in Mizoram. “This is very bad news,” Saxena said. “If the virus spreads to the rest of India, we will be in deep trouble because we are not prepared for anything like that,” he said.   
State of surveillance
The only way to be ready is surveillance. It may not be possible to diagnose all, “but it will be nice to know the top five reasons for AFP in India,” says Gagandeep Kang, a microbiologist and the executive director of Delhi’s Translational Health Science and Technology Institute. 
Such surveillance will neither be straightforward nor cheap. AFP is a huge basket of diseases, under which distinct syndromes like Guillain-Barre and AFM are lumped. So, the first step will be for doctors to identify these syndromes based on a child’s symptoms, says Arunkumar. Merely identifying the virus in stool without correlating it with symptoms is misleading because healthy children excrete viruses too.
Once symptoms are mapped, hospitals can send their samples to a network of well-equipped labs, which will use this data to decide which viruses to test for. For example, a cluster of Guillain-Barre cases could point to zika, while a cluster of AFM incidents could indicate EVD-68 or West Nile. 
This two-step process is important, says Arunkumar, who runs a surveillance project to identify causes of fever across several Indian states. “We need to sub classify cases and investigate appropriately because otherwise it is a very huge investment and you won’t get anything for it,” he says. The fever surveillance project run by Arunkumar was started with a 4-year grant of $9 million from the US’ Centres for Disease Control and Prevention.

Expensive or not, such a system could help identify AFP’s biggest causes and prevent further cases like Varun Sagar’s. At the very least, it will allow the families of affected children to understand why the paralysis occurred. Today, in the absence of a known cause, Sagar’s mother wonders if the cellphone tower next door was the culprit. They will keep guessing at the reasons for years to come.