Towards an Immune India – The Long Journey Ahead!

Be it the epic battles of the Mahabharata, the arcane wars of the Bible’s Old Testament, or present day high-tech wars using missiles and drones, it is the fight between good and evil that holds sway. Our conscience is ridden with contrasting images of Ram versus Ravan, Angel versus Devil, God versus Satan, Friend versus Foe, Bush versus Sadaam, Obama versus Osama, Good versus Evil and so forth. I think you get the idea. We are so obsessed with the concept of a constant war being fought between good and evil, that it is the only way we understand anything and everything!

Ever wondered what happens to our body when we get the ‘flu’. Let me tell you. Our body turns into a bloody battlefield, metaphorically speaking, and our immune system goes into a hyper drive causing all the snorts and sniffles in an effort to drive out the culprit. To understand what goes on behind the scenes, let us learn a thing or two about immunity by dwelling on our obsession of epic battles set in the pre-renaissance period between two warring kingdoms!

[box type=”note”]Imagine a war scenario during the pre-renaissance period – a glorious age of kings and queens, of knights and gladiators, of archers and cavalry, of swords and daggers, of arrows and spears and of sweat and blood.[/box]

Similarly, a war is raging inside you right now and your precious body is a busy battlefield. Constant battles are being fought over gaining control of this or that part of your body – your skin, nose, ears, intestines, lungs, heart, liver and other organs. There is mayhem out there. The enemy is strong and your defences have to hold!

Every day, thousands, if not millions of miniscule microbes such as bacteria, viruses, fungi and parasites use stealth to sneak inside your body, and if that fails, they use brute force to gain access to your body having breached your defences. The skin and mucous membranes of the body form the first line of defence, like the mighty walls of a fortress. When these formidable walls are breached, it is the puny warrior cells within your body’s immune system that does all the fighting.

In this war, some battles are won making you fit, while others are lost making you sick. Well, that’s how your body works! It is when these tireless warriors within you fail due to your negligence or against formidable forces of the enemy that you fall sick – you catch a cold, run a temperature, frequent the loo, or occasionally, develop a more serious illness! Actually, you are under siege by an army of microorganisms attacking membranes inside your body.

However strong a fortress might be, the ultimate outcome of a war depends on brave soldiers, dedicated warriors trained for battle within the walls of the fortress. Training your body for war against germs is very much the same. Each soldier has a specific role in the army and is trained to do his particular job – there are blacksmiths, foot soldiers, archers, cavalry, and of course, there are mighty cannon handlers.

Your body’s first line of defence is a physical one, just like the walls of a fortress – the skin and mucous membranes form a barrier good enough to defend most attacks! The enemy has to breach this first line of defence to dominate. Once these mighty walls are breached, the onus is upon multifarious warriors with different skills to fight and defend your body. Your body’s internal defences, known as the immune system, is made up of warrior cells that kill, cells that recognize the enemy, cells that produce the ammo, cells on a suicide mission, cells that resist invasion, cells that fend off germs and cells that cause diversion. This huge army of cells defend your body from invasion by any enemy. Anything foreign entering your bodies is suitably neutralised or destroyed by the immune system before it can cause damage to your bodies. But if your army is weak, you will lose ground and thus fall sick.

Sometimes, I like to think of health as a game of cards. The moment you have a weak hand, you lose. Similarly, when your immune system is weak and worn out, you lose and the germs win. Result – illness!

What is Immunity?

Immunity is a specific defensive response of a host when a foreign substance or organism invades it. Simply put, it is the body’s inherent ability to defend itself from any foreign substance or organism. An army of B cells, T cells, and natural killer cells trained for the job, and other parts of the immune system, counterattack, ripping any adventurous microbes to pieces.

I couldn't resist putting this kids video to show you how the immune system works.

You must have seen the devastating effects of a decreased number of CD4+ T-cells among PLWHA, who are prone to myriad infections. The lack of immunity makes one realise its importance.

There are 2 types of immunity, namely:

1. Innate Immunity: This is like a general insurance cover, one cover for all purposes. The skin and mucous membranes make up most of it like the walls of a fortress keeping out all enemies, no matter what shape or size.
2. Acquired Immunity: It is specific to the threat and is acquired after exposure to a particular enemy, and hence the name. A minor attack by a particular enemy signals the body to prepare for a major invasion by the same foe and is the very principle upon which immunization is based.

Can you Improve your Body’s Immunity to Fight Diseases?

That’s a million dollar, if not a billion dollar question considering the money spent on researching just that question. In concept, immunity is bolstered by a healthy mix of proper diet, good personal habits, health supplements, and of course good old immunization!

What if you change your diet, or take health supplements, or exercise regularly? Will it improve your immune system? Speculations are rife, and so are misconceptions. Researchers have failed to find sufficient data to adequately prove that any of these perceived immunity-boosters actually improve our immunity.

So, does it mean that the numerous health products on the shelves of departmental stores, claiming to boost immunity take you for a ride? I don’t think that assumption would be justifiable. We should not discount the benefit offered by this herb or that tonic just on pure speculation, without valid evidence to the contrary. Probably, there must be some modulation of the immune system by ingredients within such preparations and should be taken into consideration before writing them off. All that can be said as of now is that, efficacy and uniformity of results produced by them, is yet to be proven and will need further research.

Based on recent research by various health experts, following recommendations may boost your immunity, if not improve your general health and wellbeing:

1. Eat lots of fruits and veggies: Studies show that a diet rich in fruits and veggies help in preventing illnesses due to the vitamins and minerals in them. You might be thrilled to know that certain veggies of the brassica group have anti-cancer properties.
2. Sleep adequately: Decreased sleep increases stress levels putting more burden on your immune system. I would be surprised if you haven’t seen it during your tests at school or college.
3. Exercise Regularly: Regular exercise promotes the feel-good hormones that are good for your immune system. But, don’t overdo it as it may be more harmful than not exercising at all.
4. Reduce Stress in your life: Stress causes a gush of stress hormones into the blood stream either pushing the disease-fighting immune cells in hyper-drive or completely switching them off. Understandably, both are bad.
5. Quit Smoking: Smoking causes a number of illnesses and some studies comparing susceptibility of smokers with non-smokers to certain infectious diseases might serve as a good deterrent.
6. Drink alcohol in moderation: Alcohol abuse is closely related to immunodeficiency making you susceptible to infections such as bacterial pneumonia and tuberculosis.
7. Take Health Supplements: Natural health supplements such as Dabur chyawanprash may have some immune modulating effects and are thought to prevent illness and promote health and general wellbeing.
8. Immunize against Preventable Diseases: Don’t forget to get your shots. Remember that the shots you took during your childhood might be ones keeping you alive. Immunization boosts immunity against specific killer diseases.

[box type=”note”]Of all the recommendations, I like the last one the best. Read on and you will know why![/box]

Training the Immune System – Preparing for Battle

Billions of live bacteria and viruses are injected across the globe on a daily basis, into clueless children, in the hope that they will prevent the very diseases they cause.

Sounds creepy, doesn’t it?

Well, that is exactly what you do when you take your little boy or girl for immunization. Of course, they are tempered versions of the bacteria or virus, and usually don’t cause disease. The saying, “What doesn’t kill you, only strengthens you” makes good sense while trying to understand the concept of immunization better.

Germs fighting germs is a concept that has caught our fancy. Look at immunization and more recently, probiotics. They have changed the way we think of microbes and how they can be used as weapons against other microbes. Like spies sent out to destroy the enemy by stealth, germs are sent out looking like the enemy themselves for tuning our immune system to respond to a possible attack or by simply competing with and eliminating the enemy.

The origin of immunization is one of serendipity, a coincidence or chance discovery that has changed the concepts of prevention, the way we think about germs and the diseases they cause. It has given us an entirely new meaning to the old saying, “Prevention is better than Cure”. This time-tested adage holds true even today in spite of the rapid growth of modern medicine and the development of innovative technologies. In fact, it has become the slogan of the present generation.

The idea of immunity is nothing new, even though it was in the 18^th century that the concepts of immunity were studied in great detail and exploited for prevention of killer diseases that had plagued humanity for thousands of years. Various killer diseases had ravaged humanity during this period and the world was battered by constant wars and epidemics. Smallpox single-handedly was responsible for 8-20% of all deaths in several European countries in the 18th century. Billions died with no cure in sight, and many more maimed for life. In recent times, we have seen what the pandemic flu virus (swine/bird flu) can do. The US has a dedicated Flu Website to tackle this menace. Number of deaths could be high. The U.S. death toll during the 1918 flu pandemic was approximately 6,75,000. The root word “pandemonium,” for pandemic rightly expresses it.

The recent outbreak of polio in Syria made it to the front page of newspapers and televised news across the globe. The whole of Europe is panic-stricken and rightly so. In the past, polio was a major disabling disease that had maimed millions for life.

Current Status of Immunization in India – Are we there yet?

According to World Health Organisation (WHO) statistics of 2008, an estimated 1.5 million of deaths among under-5 children were due to diseases that could have been prevented by routine vaccination. You should be alarmed, as this represents 17% of global total mortality among children under 5.

Immunisation is probably the single most cost effective way of improving survival in children in developing countries like India. Despite solid evidence to this effect, about two to three million people die from vaccine-preventable diseases annually.

India provides free immunization services through its public health care system under the Universal Immunization Programme, but only 44% of children aged 1-2 years receive the basic package of immunisations (BCG, Diphtheria, Pertussis, Tetanus, Poliomyelitis, Measles and Hepatitis-B) recommended by WHO and UNICEF, based on research data provided by the National Family Health Survey (NFHS-3). A recent study published in the Lancet shows very similar results. Worse still, this is a skewed figure which does not reflect figures across all cross-sections of the society. The figure dips to an abysmal 22% in some rural areas of the country where penetration of immunisation programmes is poor.

Despite these dismal figures, India officially became a polio-free nation on 25^th February, 2012 after being struck off the list of polio-endemic countries by WHO. India had previously gained the notoriety of harbouring almost half of the world’s polio cases until very recently in 2009. Kudos to nation-wide efforts under the guise of Pulse Polio Immunization programme, an era of this crippling disease is finally over. Polio had previously crippled an estimated 2,00,000 children annually in India before the launch of Global Polio Eradication Initiative.

Now, only three countries in the world, namely Afghanistan, Nigeria and Pakistan, remain afflicted by endemic poliomyelitis.

Let this brilliant success serve as a beacon of light and as a hope for other vaccine-preventable diseases. Let us hope for effective immunization penetration across all cross-sections of our society for a more healthy and immune India for our children.

Armageddon is at Hand – Are you ready?

My idea of an Armageddon is a world filled with totally antibiotic resistant germs, superbugs that cause one pandemic after another – where no antibiotics work, and no cure in sight! The battle rages on, and to win, we will need the right weapons. What weapons will you choose? Whom will you trust your life with?

[box type=”blue”]I choose immunization! I can picture my little boys cringe and nod in disagreement. Come on kiddos, shots are good![/box]

Immunisation is the only weapon that will redeem us in the long haul, particularly with the advent of superbugs that are resistant to almost all known antibiotics. Well, let’s not forget age old wisdom and give Ayurveda a chance to prove that we have more to hope than just immunisation, to save the day. And hey, did you know that the tradition of inoculation, a crude form of vaccination, is ensconced in Ayurvedic texts and may have originated in India in 1000 BCE.

Now, who are you with against these formidable enemies? I bet you are thinking vaccines.

Immunization Delivery Systems – A painful saga ends?

[box type=”blue”]My kids would love to hear this part, but it might be a little too late for them.[/box]

Mark my words; your next vaccine might be delicious! Hmm, edible vaccines? Exactly, who likes painful shots? Oral Polio Vaccine and Oral Typhoid Vaccine are just starters to the whole menu of edible vaccines still cooking in the kitchen. You might just as well have vaccines for dinner or a yummy vaccine snack during lunch hour. “Waiter, vaccines on a platter please!”

Let us hope that the painful saga of injectable vaccines ends soon enough, and then, you can have live bacteria for breakfast, attenuated viruses for lunch and microbial cocktail for dinner. Just kidding!

Final Words on an Immune India

Disease Prevention is a buzzword that has been making the rounds among common people, as much as among the scientific community, especially after outbreaks of multi-drug resistant bugs that are resilient to the latest antibiotics. Some forward thinkers are even predicting a pre-antibiotic era, wherein antibiotics are sitting ducks against deadly superbugs. Are we prepared for this? The question is whether our body’s immunity is up to the task.

Let’s work together so that we make our country’s immunization programme a success and save many more lives in the process. 100% immunization coverage is possible if we give our 100%! The least we can do is to free our country of vaccine-preventable diseases, and then truly, we can have an Immune India.

Let’s do our part – spread awareness about immunization, volunteer for immunization camps and projects, share our knowledge and resources about universal immunization and thus protect our children’s future, the future of India.

Jai Hind!

As fellow bloggers and Medical Island fans, do your part by sharing this article to as many of your friends as possible. Then, thank yourself for saving a child!

This article is part of the contest “An Immune India,” an initiative by Indiblogger and https://www.daburchyawanprash.com. Wishing everyone all the best for the contest!