'Malaria exposure may be our Sars shield'

MUMBAI: Although it is now six months since the first Severe Acute Respiratory Syndrome (Sars) case was reported in the Chinese province of Guangdong, India has still not recorded a single Sars death. Neither has the majority of the so-called confirmed Sars cases in the country demonstrated the virulent clinical symptoms of the disease seen in other Sars-affected countries. In Hong Kong and China, patients developed acute respiratory distress and inflammation of the lungs within five days. But a majority of the Sars suspects in India has not demonstrated such acute deterioration.Most cases in India have only shown mild symptoms—fever, cough, headache or diarrhoea—that could be associated with a number of other tropical illnesses, such as malaria. So, why is the condition of Sars-affected persons in India not deteriorating like that of patients in East Asia? Many doctors believe this could be because Indians already have been exposed to an infection that is providing protection. Health experts say this question is relevant in view of the hysteria being witnessed in some communities seeking to expel suspected Sars cases from housing colonies and hospitals, as in Pune and Kolkata last week. This panic reaction of the public and the government's failure to create awareness are worrying,'' said N.S. Deodhar, former additional director-general, health, government of India, and member of the International Epidemiological Association. He is especially concerned about the health authorities' failure to apply epidemiology—the branch of medicine that deals with the study of causes, symptoms, distribution and control of disease. Instead of relying on agencies like the World Health Organisation, India should have sent epidemiologists to Sars-affected countries to study the local patterns and compare it to the Indian situation, Dr Deodhar said. Such information is vital in deciding the public health response,'' he said. We don't know how Sars is spreading, but I doubt that its infectiousness is high in India.'' Although it may still be early days, he feels that Indians are being spared the worst because of previous exposure to other infections. This view is supported by James da Costa, a Mumbaibased clinical pathologist and expert in tropical disease diagnostics, who has been studying falciparum malaria for the last nine years. He believes exposure to falciparum malaria could be giving Indians some protection against the virulent manifestation of Sars.