Transcript for Dengue: The Hunt For A Vaccine

Transcript for Dengue: The Hunt For A Vaccine

 

 

Clip

 

 

 

SYNC

 

Hospital day

01:00:10:01

VO

 

 

 

01:00:32:04

Opening Music:  ANW1017_27_Oxygen-3

Composers/Performers: Terry Devine-King, Audio Network

 

 

On one day, every year, health workers in the Philippines take a little time out. It’s an opportunity to let their hair down to mark their achievements.

 

But not everyone is taking part. There’s one disease that gives no respite.

 

01:00:39:02

Dr Capeding

 

It’s a major public health concern. It’s one of the most common causes of hospitalisations in the country. A lot of children are suffering.

 

You really don’t know if you will go or she or he will die from the disease.

 

01:00:54:18

Girl in hospital (subtitles)

 

I’ve been nauseous and vomiting a lot.

My stomach aches and I can’t stand up

 

01:01:02:01

VO

GVs Lagos, India, Miami

 

There’s no cure and until recently no vaccine. The disease is spreading. Rapidly. For developing economies, it’s a huge burden. And for the rich – the door is open. Now half of the world’s population is at risk.

01:01:21:20

Marty Baum

I was convulsing with shivers and shakes… I was cold, I was hot, I was wrapped up in blankets… It was actually quite frightening.

 

01:01:31:04

VO

A vaccine is urgently needed. Millions are living in fear.

01:01:37:21

Dr Capeding

If you ask parents or even doctors they will tell you it’s one of the most feared disease, it’s dengue.

01:01:45:02

Various contributors

Dengue.

Dengue.

Dengue.

Dengue.

Dengue.

01:01:48:02

Titles

Dengue

The Hunt For A Vaccine

 

01:01:54:17

Music:  ANW2283_06_Tell-A-Story

Composers/Performers: Alex Arcoleo, Audio Network

 

01:01:56:14

 

 

 

 

For decades, scientists across the world have been racing to find a vaccine for dengue fever.

 

01:02:03:14

Dr Stephen Whitehead

 

 

In the community where I live, lots of people ask me what I work on, I say I work on a vaccine for dengue virus. And they’re like what is dengue virus? They haven’t heard of it.

 

01:02:13:05

VO

But this devastating disease is on the rise. And with every day that passes, more and more of us are going to become familiar with it.

 

01:02:21:21

City GVs

Dr Remy Teyssou

 

In the 70’s only nine countries in the world declared outbreaks, dengue outbreaks. Now more than 120 countries declare dengue outbreaks. To show you the spread of the disease around the world.

 

01:02:39:03

VO

The World Health Organisation has set an aim to halve the number of dengue deaths by 2020. In the last fifty years, there’s been a thirty-fold increase in infections. A vaccine could help meet that goal. But the search has been painfully slow.

 

01:03:00:10

Jean Lang

 

01:03:13:07

Music:  ANW1053_05_Embers

Composers/Performers: Evelyn Glennie, Audio Network

 

After fifty years of sustaining dengue vaccine development, we still have no vaccine, no treatment for a disease that affects nearly four hundred million of person around the world and from every ages from infants to adults.

 

01:03:24:22

VO

Family & photo album

Finally scientists have an answer. But still, the number of dengue victims just keeps going up.

More and more families are left grieving the loss of a loved one.

01:03:38:03

Angelita, Irento & Christian Javier

Angelita (subtitles)

San Pablo, Philippines

Photos

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We took my eldest son to stay

with my mother in law…

 

…because his grandmother had passed away

 

The children were there for eight days,

playing in the river

 

Then one afternoon he came down with a fever

So I took him to the doctor for a check up

 

That night he couldn’t sleep

so we took him to the hospital

 

He was in the hospital for two days,

then he died

 

Dengue

01:04:23:18

Angelita

 

 

He was such a nice boy

 

And he was only with us for such a short time

 

It all happened so quickly

 

It’s hard to accept what happened

 

At 6.00pm he fell into a coma…

… and then by 6.00am he was dead

 

Such a waste

 

He was such a nice child

 

My boy

01:04:56:23

Music:  ANW2343_91_Changing-Patterns-3

Composers/Performers: Jerome Alexander, Audio Network

 

01:04:59:05

VO

Baguio rain GVs

Jakarta rain GVs

Unfortunately, the experience of Angelita and her family is far from isolated.  With nearly 400 million infections every year, as many as 100 million people worldwide get symptoms of dengue.

 

01:05:21:12

Female Dengue victim (subtitles)

My head was pounding, I had severe pain

behind the eyes and I felt dizzy.

I heard everyone talking about Dengue.

01:05:31:17

Second female dengue patient (subtitles)

I think it was the worst illness I’d ever had.

I’ve never felt so much pain,

felt so tired or so weak.

I’ve never experienced anything like it.

01:05:43:11

VO

Children stay at home. Adults can’t go to work – family income is lost. Half a million get the severe kind of the disease that can be fatal.

 

And it’s in the rainy season when things are worst.

 

At this time, right across the tropical world, hospitals are overwhelmed with cases of this debilitating disease.

 

In many places, dengue is the leading cause of hospitalisation.

 

For paediatrician Dr Ruth Tugawin, dengue provides the bulk of her workload.

01:06:35:19

Dr Ruth Tugawin

Baguio General Hospital, Philippines

 

 

For the department of paediatrics we have a lot of cases, admitted cases of dengue for this month and most of the hallways are occupied with dengue patients.

 

Since the rainy season, dengue it boom.

01:07:00:22

Dr Alexei Marrero

Dept. of Health, Philippines

About 180 - 250,000 cases of dengue occur here in the Philippines so that’s a lot…. and out of this about 500 or more are dying because of dengue.

01:07:17:03

Dr Ferdinand Guzman

 

 

 

Actually when the rains come it’s the number one disease. It’s the number one problem of the government of the department of health.

 

Nose-bleeding, vomiting, abdominal pain – these are severe signs of dengue, so they have to be admitted.

01:07:37:09

VO

Patient GVs

Sometimes these wards are three to a bed with dengue cases.

 

01:07:43:11

Mother

My son is vomiting and vomiting, vomiting blood, nosebleed. I’m so scared because he’s my son and then he’s crying and cry.

01:08:00:07

VO

In the most severe cases, the patient goes into shock with internal bleeding. Fast medical attention is then critical.

 

01:08:10:11

Dr Ruth

 

 

The worst thing that can happen with dengue is they can bleed to death. They’ll be in irreversible shock. That’s when dengue’s so severe, that we cannot manage, we cannot, even though we give full support the patient might die.

01:08:28:08

Woman lying on bed with child (subtitles)

People are dying from dengue 

We’re all really scared of it

01:08:37:15

Dr Stephen Whitehead

 

 

 

 

I’ve travelled to areas in Vietnam, in Thailand, in India, where I see hospitals that are full of young children who have dengue fever.

 

I’ve seen a lot of people coming in every day for treatment. It’s heartbreaking.

 

01:08:56:00

Dr Remy Teyssou

Partnership for Dengue Control

 

Lagos GVs

 

 

 

 

 

For dengue there is of course a human impact, which is hugely important. But there is also an economic impact, which is important as well.

 

And when you have an outbreak of dengue in a city for example in a big city, everything stops.

 

Economy, public health structures collapsed, because of the number of patients, and the economic impact of such outbreaks are very, very important, especially in emerging and developing countries.

01:09:32:13

 

 

Beggar

 

01:09:45:14

Music:  ANW1227_32_The-Lab-2

Composers/Performers: Igor Dvorkin / Duncan Pittock, Audio Network

 

Mosquito CUs

Water GVs

 

The cost of dengue globally to healthcare systems is almost $9 billion, which is a huge burden for developing countries. 

 

And it’s Asia, and Latin America that are seeing the biggest outbreaks.

 

Like malaria, dengue is a mosquito-borne infectious disease. But the dengue mosquito – Aedes aegypti – bites in the daytime, making prevention more difficult. It thrives in wet, tropical regions and breeds in stagnant water, feeding off people as a source of blood.

 

Without a cure or vaccine, people have been suffering from dengue for decades – natives and visitors alike.

01:10:27:02

Medicine in Action:

Breakbone Fever Dengue (archive)

Casualties, victims of attack. The enemy: dengue fever.

 

01:10:45:05

VO

It was when American troops started falling ill in the Second World War that efforts to develop a vaccine started.

 

01:10:53:02

Archive

 

 

Carried by the female Aedus mosquito. Striking down large groups of men with blasting violence. Ten dengue casualties for every combat injury.

 

A few at first then more, then still more. Long lines of them. Out of action when we needed them most, with success or failure of our mission in doubt as a result.

01:11:16:10

VO

01:11:23:04

Music:  ANW2343_143_Passing-Eyes-3, Composers/Performers: Jerome Alexander, Audio Network

WHO archive

 

 

In the seventy years since, vaccines for other infectious diseases have made a huge impact across the world.

 

Small pox has been eradicated, polio largely wiped out. Huge advances have been made against measles.

 

But year after year, dengue continued to outwit the best scientists.

 

01:11:44:16

Dr Whitehead

 

 

The field has spent forty, fifty years trying to develop a vaccine

to dengue. There has been some small successes, there has been some small failures. We finally can accomplish this goal, it will be a scientific breakthrough.

 01:12:01:04

VO

The scientists here at the National Institutes of Health in Washington DC think that they have made significant inroads.

 

It’s been years in the making, but now their vaccine is being tested in volunteers.

 

01:12:17:18

Dr Anna Durbin

 

We are currently conducting early phase vaccine trials for the prevention of dengue, either, first in human trial, so the first time a vaccine has been given to humans, or early evaluation looking primarily at the safety of a vaccine, so what kind of side effects does the vaccine cause in people.

 

01:12:36:19

VO

The trials for this vaccine are small, involving about twenty to fifty people. The idea is that they should give early signs of whether or not a vaccine is safe to use on humans and whether or not the results look promising enough for a bigger trial in an endemic country.

 

01:12:56:05

Music:  ANW1780_26_Her-Heart-Growls-2, Composers/Performers: Paul Ressel, Audio Network

Lyon GVs

 

 

 

Sanofi GVs

 

Around the world, other teams of scientists have also been battling to find a working vaccine – using different approaches to tackle the complex disease.

The city of Lyon in France is home to one of the world’s largest vaccine producers - the pharmaceutical company, Sanofi Pasteur. Experts here have spent decades working on a vaccine for dengue. 

 

Jean Lang a director of research has dedicated his professional life to it.

 

01:13:36:11

Jean Lang

Sanofi Pasteur

 

 

01:13:57:14

Music:  ANW2014_02_Mystery-Train, Composers/Performers: David O'Brien, Audio Network

 

We are here to make an impact on people and really that is what drives me and the team because, you know, we are hundreds of people working along this twenty two years on that.

 

That’s been long and we really keep this resilience with the team, so that we keep our objective in mind that we wanted to bring this vaccine to population.

01:14:03:14

VO

But why has finding a vaccine for dengue been such an immense challenge?

 

01:14:08:17

Dr Whitehead

 

 

A vaccine for dengue has been a very hard nut to crack. Mostly because you need to make four vaccines because there are four different types of dengue. You can’t just make a vaccine for dengue 1, dengue 2, dengue 3, or dengue 4, it’s got to be a four in one vaccine.

01:14:25:22

Jean Lang

 

You have to develop basically a four combination vaccine from the start, because all four dengue viruses are responsible for dengue epidemics and even the severe form of the disease that could lead to hospitalisation and death.

01:14:43:19

Anna CU

 

 

To find a vaccine against one virus can take ten years, we are trying to find a vaccine against four viruses, and then we are trying to have those four individual vaccines be put together into one vaccine and still work as well.

01:14:59:17

VO

 

 

 

AP archive

 

 

 

As scientists struggled to outwit the virus dengue has continued to spread.

 

From Asia, through Africa…

 

Now it’s exploded in Latin America.

 

An epidemic in Brazil in 2015 led to at least one and a half million people coming down with dengue.

 

01:15:20:05

Dr Enrique Rivas

Sanofi Pasteur

(subtitles)

 

AP archive

 

 

 

 

 

 

 

 

 

 

Dengue in Latin America is a very

Important public health issue

 

because in recent years it has erupted

not only for the number of cases

 

but the number of severe cases

of the disease.

 

In the last 20 years, there has been a

dramatic increase in cases

that require hospitalisation, in important

outbreaks in cities in Brazil,

Mexico, Colombia, Honduras

now constitutes a major public health problem.

 

01:16:04:04

Dengue patients of all ages need constant monitoring, saline drips, blood tests and possibly blood transfusions.

 

01:16:15:16

Dr Guzman

 

01:16:27:01

Music:  ANW2014_02_Mystery-Train, Composers/Performers: David O'Brien, Audio Network

 

It will really make a big difference if there’s a vaccine available, because these patients would not be here in the first place,

 

and of course, if a vaccine is available, less burden on the families.

 

01:16:31:19

VO

Without a vaccine the patients have kept coming. And unlike with other infectious diseases, having had the illness once is no guarantee you won’t find yourself back in hospital with an even worse infection.

 

01:16:47:14

Dr Jeremy Farrar

Wellcome Trust

 

With any infectious diseases, we have a degree of protection afterwards, so we don’t get disease again and we are protected. In dengue after your first infection, which in many countries is as a child, you then get a second infection a few years later, and that second infection is more severe. That’s very unusual and it’s specific to dengue.

 

01:17:08:16

Anna Durbin

 

 

01:17:26:13

Sanofi animation

 

It’s really a very, very interesting virus.

 

When you are infected with dengue, dengue one, you make antibodies to that dengue one virus. Those antibodies can kill the dengue one virus, but if you’re then infected with a dengue 2, or a dengue 3, or a dengue 4 virus, those antibodies sort of recognize that virus as part of the dengue family, but they can’t kill the virus.

 

01:17:37:13

VO

In any potential vaccine for dengue, the strains compete, with one tending to become dominant. So getting the balance right is extraordinarily hard.

 

01:17:48:13

Anna Durbin

Dengue is really unique in that, and it makes it very interesting to study, but also very challenging for vaccine development.

 

01:17:58:17

Music:  ANW2343_91_Changing-Patterns-3

Composers/Performers: Jerome Alexander, Audio Network

 

01:18:02:12

 

 

 

In the meantime, the problem is intensifying. Because of climate change, in many areas of the tropics – Indonesia, for example - the dengue season is getting longer and longer.

 

01:18:18:00

Budi Haryanto

University of Indonesia

(subtitles)

 

In the past it usually happened

during the rainy season

 

Around November, December, January

and at the latest March

 

That was twenty years ago

Now it has all changed,

 

and it is very much related to

the changing climate.

 

The rainy season lasts virtually

throughout the year.

 

01:18:45:14

Music:  ANW2343_91_Changing-Patterns-3

Composers/Performers: Jerome Alexander, Audio Network

 

01:18:57:13

VO

 

 

 

And more rain means more breeding places for the mosquitoes.

01:19:02:19

Dr Jaime Montoya

Manila, Philippines

 

 

 

Well just this morning we had a thunderstorm, so we had a flash flood, but it’s the remaining water that takes some time to disappear and maybe, maybe can also be a breeding ground for mosquitoes.

 

Especially if it stays long in an area, it doesn’t move, it’s still and it’s clean – relatively clean – because these are the areas the breeding spots that the particular vector for dengue loves to breed. This particular water – clean, stagnant.

 

01:19:39:05

VO

Manila GVs

Water GVs

City GVs

In urban areas there is plenty of stagnant water.  Every puddle, every flowerpot, every barrel and paint pot is a potential breeding ground for the dengue mosquito.  

So the growing cities of the developing world are like a magnet to them and from there it spreads – thanks to us.

 

01:20:04:24

Dr Farrar

 

 

 

I think it’s a classic disease of the 21st century. It’s driven by a mosquito that loves living in big cities, where lots of people are congregated in a small space. Environmental changes is undoubtedly having an impact on where the mosquito lives, and the disease is spreading, through travel, through migration, and urbanization.

 

01:20:26:00

Dr Alexei

 

 

 

 

 

If I have the dengue, maybe I have a low-grade fever, I still feel well, for example, but the dengue infection is in me. I’m infected. So I go around and the mosquitoes in that area will bite me and they can thus transmit the disease to other people in that area. So I’m the one that’s spreading it actually.

 

It’s easier nowadays to travel from one place to another and if you’re infected of dengue that you don’t know you’ll be spreading the disease to other places that you go to.

01:21:05:10

VO

City GVs

Without a vaccine, dengue has been free to spread. Anywhere that is home to the aedus aegyptai mosquito is at risk. And with climate change, the mosquito is at home in an ever-increasing area of the world.

 

And this means it’s no longer just a tropical disease. More and more of us are going to become familiar with the diagnosis – dengue fever.

 

01:21:37:24

Music:  ANW2081_01_Duck-Call

Composers/Performers: Lincoln Grounds/Thomm Jutz, Audio Network

 

01:21:45:08

Miami GVs

Marty pics

 

 

 

Here in American state of Florida life is far removed from the megacities of the developing world.

 

For three years, Marty Baum has worked as keeper of the Indian river. More than most, he’s familiar with mosquitoes in the area. But they’ve never been anything but harmless. Until now.

01:22:12:02

Capt. Marty Baum

 

 

 

 

 

 

 

 

Well my wife and I had recorded a Miami dolphin football game, and we propped up in bed, we were going to watch it, and at 9 o’clock I was perfectly fine. By 10 o’clock I had 102 fever, 102.5, and I was convulsing with shivers and shakes, and I looked just like one of those WW2 malaria, yellow fever movies. I was sweating, I was cold, I was hot,

 

I was wrapped up in blankets, my wife was wrapped around me. It was actually quite frightening given that there was no – there was no clue as to why I was sick.

01:22:48:03

Music:  ANW2061_01_West-Of-Texas

Composers/Performers: Lincoln Grounds/Thomm Jutz, Audio Network

01:22:51:03

VO

 

 

This was something quite new for Marty. He had never experienced anything like it before.

01:23:00:13

Marty Baum

 

 

Usually you have a twinge when you are getting the flu; an ache, a gland, something tells you you are about to get it, but there was none of that. So to be caught cold like that, and to have a fever jump so high out of nowhere, was kind of frightening. I told her; if it gets any higher than this, take me to the hospital. It was a long night.

01:23:18:09

Music:  ANW2061_01_West-Of-Texas

Composers/Performers: Lincoln Grounds/Thomm Jutz, Audio Network

 

01:23:18:22

VO

 

 

 

When the fever got worse, Marty’s wife rushed him to hospital. He was there for the next ten days. And he was very surprised to hear that he had dengue fever.

01:23:31:02

Marty Baum

 

 

It’s not something that you normally see here, in the States, in Florida. Sometimes you see it down south where there’s a lot of immigration from the Caribbean, you know, Dade County and Broward County, but it just really shocked me.

 

01:23:47:23

Dr Whitehead

01:24:03:14

Music:  ANW2061_01_West-Of-Texas

Composers/Performers: Lincoln Grounds/Thomm Jutz, Audio Network

 

People always want to know is dengue coming to this country is dengue coming to that country. An example would be the United States. So in Florida, along the Texas-Mexican boarder, the mosquito that transmits dengue is already there.

 

01:24:10:01

Edhelene Rico

Dept. of Health, Florida

 

 

 

 

 

 

Florida, and also Miami we have the type of mosquitoes that transmit the virus. So its naturally occurring in Florida, and it just would take a traveller coming infected with the virus and then being bitten by one of our local mosquitoes, and then the mosquito gets infected, and infects someone else.

 

We can’t let out guards down because we have the mosquito here anyways, and the travellers will always be coming to visit Miami.

01:24:36:24

VO

With global travel ever increasing, more and more mosquitoes are becoming infected.

 

As Marty found to his cost.

 

01:24:45:07

Marty Baum

There was really no relief for the pain. When they called this thing the bone breaker fever, they got it right.

 

01:24:52:04

Jeremy Farrar

 

It used to be thought of as a purely south East Asian disease. It’s now in India, its in south America, its in southern Europe, its increasingly in sub Saharan Africa, and the middle east. In Florida and recently in Japan. So dengue is becoming one of the truly global infectious diseases.

 

01:25:10:05

Music:  ANW2343_91_Changing-Patterns-3

Composers/Performers: Jerome Alexander, Audio Network

01:25:13:23

 

 

Jakarta spraying

 

 

 

 

 

In Florida, the state has resorted to spraying insecticide daily in high-risk areas to kill the mosquitoes.

 

In the developing world, this has long been a tactic. Here in Jakarta, Indonesia, so-called fogging is used regularly when there’s been a severe outbreak in a particular neighbourhood.

 

It does have a short-term affect, but it tends to just push the problem to another area.

 

01:26:17:01

Dr Alexei

 

 

Right now the strategies that we have against dengue is very difficult to implement. All of these are taking a toll on the environment and it’s very expensive also.

 

01:26:29:18

Larvae

 

In fact, about $6 billion is spent globally every year trying to control the mosquito population.

And until now it’s been the only weapon against dengue fever.

 

01:26:42:17

Dr Montoya

 

Dengue is a vector driven disease, so it’s logical that we have to control the mosquito vector. Hopefully if we bring down the mosquitoes then we also decrease the number of the possible transmission and consequently the number of cases of dengue.

 

01:26:59:22

Music:  ANW1306_08_Falling-Snow

Composers/Performers: Paul Mottram, Audio Network

GVs, school

01:27:06:04

01:27:15:04

Music:  ANW1053_05_Embers

Composers/Performers: Evelyn Glennie, Audio Network

 

 

 

This school in the Philippines has nearly 4000 pupils.  Even here the children are at risk from the disease.

 

01:27:19:16

Teacher 1

 

A few students here died because of dengue mosquito. We don’t want other pupils to be affected also.  We are really afraid of it.

 

01:27:29:05

VO

The teachers do what they can to prevent the children getting bitten.

 

At 4 o’clock every afternoon, the pupils are set an important task – to rid the school of any standing water.

01:27:42:13

Teacher 1

 

They’re looking for stagnant waters and those places where mosquitoes can hide. The sweeping, so that mosquitoes will be swept away.

01:27:54:03

VO

At another school, rather than getting rid of standing water, they’re using it to deliberately lure the mosquitoes.

 

01:28:01:02

Teacher 2

01:28:16:10

Music:  ANW1053_05_Embers

Composers/Performers: Evelyn Glennie, Audio Network

This is an OL trap - ovicidal or larvicidal trap – and the purpose of this is to catch mosquitoes so that the mosquito will lay eggs inside the trap. The smell of that chemical attracts the mosquito so that it will lay eggs inside.

 

01:28:19:22

These initiatives are educational for the children. The effect of them might be limited, but the fear of dengue means that there’s an over-riding feeling to do something.

 

01:28:31:14

Teacher 2

 

 

For the past ten years we have victims of dengue here in school.

 

Look at our place. During rainy season our place is flooded area so we can stop the mosquito that lay eggs by putting this trap.

 

01:28:54:03

Teacher 1

We have to be involved. We have to act. We don’t just sit on the problem. We need to act on it – right children? Yes!

 

01:29:08:21

Dengue storytelling

VO

Acting on the problem includes educating the children about dengue from a very young age.

 

And nothing sticks in the mind more than a song about the most famous aedus aegyptai, Moskee the mosquito.

 

01:29:37:08

VO

Archive film

 

01:29:50:08

Archive

 

 

 

Education, raising awareness and attempting to control the mosquito population are nothing new. It’s what the Americans were doing seventy years ago.

 

Water collected in rubbish heaps. On fuel drums, in ruts. Each pool and puddle was a mosquito nursery. Millions of wrigglers hatched, took off, visited nearby native villages, fed on dengue infested native blood. Then it was that simple. Multiply it by thousands and you got what we got – trouble. Lots of it.

 

01:30:14:00

VO

01:30:14:23

Music:  ANW1306_08_Falling-Snow

Composers/Performers: Paul Mottram, Audio Network

 

 

 

01:30:30:03

Music:  ANW1988_36_Sonar-So-Good-3

Composers/Performers: Nik Kershaw, Audio Network

Getting rid of standing water was the policy the Americans were advocating back then. It’s important for the immediate area, but, as with education, it can never be the whole answer. The mosquitoes will remain free to breed elsewhere.

So scientists are experimenting with other more innovative ways to control the mosquito population.

01:30:40:01

VO

They are looking into biological control – from genetic modification to infecting the mosquitoes with a common bacterium to stop them transmitting deadly diseases. They are even developing new odours based on human body odour to foil the insects. And these mosquitoes have been infected with deadly fungi.

 

01:31:08:22

Jeremy Farrar

 

 

I think these other measures, mosquito control, genetically modified mosquitoes, community participation, getting the community involved in dengue control, the way we design cities – all of these are going to be very important in controlling dengue infection in the next twenty years.

 

But it’s also true that a vaccine would be truly transformative for this disease.

 

01:31:28:18

Music:  ANW1053_05_Embers

Composers/Performers: Evelyn Glennie, Audio Network

01:31:31:06

VO

 

 

 

 

Angelito and Irento who lost their fist son to dengue were given the opportunity to help develop that vaccine.

Two more of their children went on to be hospitalized with the disease so the family were anxious to find a solution.

 

01:31:49:06

Angelita (subtitles)

 

 

 

 

 

 

 

01:32:12:05

Music:  ANW1988_36_Sonar-So-Good-3

Composers/Performers: Nik Kershaw, Audio Network

One of our neighbours works for

the Department of Health….

 

…and they were going from house to house

looking for people to take part

 

Because of our experience, I was happy

for my child to be involved ….

 

..so he could help find a vaccine

 

01:32:15:16

VO

Their son Christian was enrolled in trials for the Sanofi Pasteur vaccine. The tests have been on a much larger scale than the ones in Washington. Volunteers in ten dengue endemic countries have taken part and the vaccine has now been tested on over 30,000 people.

Christian has to have regular checks at his local health centre.

 

01:32:38:23

Irento (subtitles)

 

 

It means a lot to us because

we live with this fear

 

We experienced a loss and that’s something

that should be prevented

 

That’s why we’re taking part

 

01:32:58:10

 

He and hundreds of other children have been vaccinated as part of the trial looking at both the safety and effectiveness of the injection.

Dr Maria Capeding, who is in charge of the study, is checking to see how the children are doing.

 

01:33:14:18

Dr Capeding

 

 

We have children coming here for their yearly visit. These children have been vaccinated with the dengue vaccine about 3 years ago and they are coming here for going to ask have there been a hospitalisation has there been febrile illness. This is called the surveillance phase.

01:33:34:08

Christian going through the process

 

 Some children have been given the new vaccine and others a placebo. And they are being closely monitored.

 

If any of these children get dengue, the clinic is immediately informed.

 

To get to this stage has been a long, hard journey.

 

01:33:54:19

Jean Lang

 

 

 

 

01:34:19:07

Music:  ANW1893_02_Midnight-Cafe Composers/Performers: Michael Craig/Dave James, Audio Network

The team faced so many challenges but each time we have to innovate, because with a classical infectious disease or target you can say ‘Look at the book, look at the experts’, - here we were writing on a white page. So each time, when I start, you can say ‘well, you can not try and cure dengue, it’s not possible’. And I say why? Because we simply never did that before.

 

01:34:30:00

Square GVs

 

With Latin America showing the most rapid increase in dengue cases, doctors here were keen to take part in tests for a new vaccine. As the disease spreads northwards, Mexico is now in the frontline of the fight against dengue.

01:34:49:20

Dr Rivas (subtitles)

 

 

 

 

 

We have evidence of very important outbreaks.

 

In Mexico for example,

in 2014 there were more than 63,000 cases .

Around 34,000 were severe cases.

 

01:35:07:12

Dr Sandra Villagomez (subtitles)

in car

 

 

 

GoPro car pics

I’m Sandra Villagomez, a paediatrician.

 

I’m in charge of the dengue vaccine tests.

 

We’re on our way to the clinic

where the vaccine trials took place.

In Mexico as a whole the study has 1,350 kids.

 

This area was picked because it’s highly populated

and has a high prevalence of Dengue.

 

01:35:37:11

VO

Throughout Latin America, over 20,000 children and young people have taken part in these tests.

 

01:35:44:16

Dr Sandra (subtitles)

in car

 

The children and teenagers have been participating

in this for four years.

 

There was no difficulty in finding recruits,

everyone here has a history of

the illness in the family.

 

So all the kids were keen to take part.

 

01:36:09:19

VO

 

The state of Morelos has the highest level of dengue. Here over twenty schools got involved. High school student Aida Gomez had a particular reason to volunteer. She knows how awful dengue can be.

 

01:36:27:16

Aida Gomez (subtitles)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01:36:52:14

Music:  ANW1893_02_Midnight-Cafe Composers/Performers: Michael Craig/Dave James, Audio Network

I felt really weak

 

I had ready bad headaches and

I couldn’t get out of bed

 

I couldn’t look up, because my

headaches were so bad

 

My bones ached, I had fever

I couldn’t sit, I couldn’t stand

 

I felt really tense

 

It was as if my head was exploding

 

So when I heard about this vaccine…

 

..I thought that it’s something

that should be tried…

 

..to see if it really works and how effective

 it is, and what results it has

 

01:37:07:16

VO

Dr Arredondo set ups

 

 

Dr Jose Luis Arredondo was in charge of the study. He has over forty years of experience working with infectious diseases in children. He has seen the benefits that vaccinations have brought over the years. And at the same time, he’s seen the problem of dengue spiralling out of control.

 

01:37:26:24

Dr Arredondo (subtitles)

 

The problem of dengue in Mexico

has been increasing year by year

 

And everything we’ve done to try to control

the mosquito population…

 

..hasn’t solved the problem

 

Hence the need to look for alternatives

 

01:37:44:01

Music:  ANW1893_02_Midnight-Cafe Composers/Performers: Michael Craig/Dave James, Audio Network

01:37:48:12

 

 

 

 

 

 

 

The results of the worldwide trials have been encouraging, cutting in half the number of expected cases. More significantly the results show an even greater drop in the number of most severe cases to less than a fifth of what would have been expected.

01:38:04:19

Dr Capeding

 

 

The most important thing I think from the clinician point of view and also from the parents’ point of view that this vaccine protect around 88% from having the severe type of dengue and also from being hospitalised. About 67% against hospitalisation from dengue.

 

01:38:25:20

Dr Arredondo (subtitles)

 

Personally I feel very optimistic,

In the sense that we will be able to

Considerably reduce the number of cases

the severity of cases, and the number of deaths.

 

01:38:41:07

Music:  ANW1893_02_Midnight-Cafe Composers/Performers: Michael Craig/Dave James, Audio Network

 

01:38:49:23

Sandra (subtitles)

in clinic

 

 

 

 

 

We’re expecting good things from this vaccine.

 

People here are always getting Dengue.

Then being able to count on an

Effective way of controlling Dengue

is very important, both for doctors and the public.

 

01:39:11:04

Aida Gomez (subtitles)

 

I think it’s really good,

being part of something that’s good to

be positive for so many people.

 

01:39:22:00

Music:  ANW2343_143_Passing-Eyes-3, Composers/Performers: Jerome Alexander, Audio Network

 

01:39:24:19

VO

 

 

 

Sanofi Pasteur are already building a huge production facility dedicated solely to the dengue vaccine.

 

01:39:32:09

VO

 

 

 

London GVs

The vaccine might not be effective in every case, but still, news of its approval by several countries is causing excitement across the medical world.

 

At last, after seventy long years, a vaccine against dengue is available.

 

01:39:48:08

Dr Farrar

 

 

We have been used to having vaccines, which are unbelievable – 100% effective, safe in everybody – and that’s what we’ve got used to. We’re moving into a world now where those vaccines may be less effective but can still have a major impact on public health, and I think we shouldn’t be too disappointed with something which we say is 65-70% effective, because that may actually reduce the burden of the disease, such that less people go to hospital, less people have time off school, less people have time off work, and would have a big public health impact.

 

01:40:23:10

Dr Remy Teyssou

 

 

When you look at complex diseases like dengue, you could not expect to have immediately 100% effective vaccine. So you come with a vaccine with 50, 60% efficiency of protection. So it is really in my opinion a public health tool that could be very efficient.

 

01:40:52:19

VO

A vaccine that is 60 – 70% effective could well swing the balance in the fight against dengue - as long as it’s a part of an integrated approach to fighting the disease.

 

01:41:04:07

Dr Whitehead

 

It’s not the only component in the control of dengue, because you also have mosquito control, you have education and you have vaccination. You are not going to be able to control it solely by having a vaccine, you are not going to be able to control dengue solely by having mosquito control.

 

01:41:25:15

Dr Remy Teyssou

 

 

So everything, you know, using everything of each of these elements will, in our opinion, allow to control dengue. In other words, if you are only using one tool it will be not possible to control dengue for a long-term control.

 

So we have to find a synergy between vaccination and mosquito control.

 

01:41:49:20

VO

 

Researchers around the world continue to search for other effective injections against dengue and more work will be done assessing the impact of the new vaccine.

 

01:42:00:10

Dr Whitehead

There’s going to be a lot of players in this and we don’t need just a single dengue vaccine. There’s room for many players. No one can produce all the vaccine that’s going to be necessary to take care of the dengue problem worldwide.

01:42:14:19

VO

 

01:42:22:09

Music:  ANW2343_91_Changing-Patterns-3

Composers/Performers: Jerome Alexander, Audio Network

But the first vaccine is a start in meeting the World Health Organization’s ambitious goal. 

A fifty percent reduction in dengue deaths is a step closer.

 

01:42:35:22

Jean Lang

 

 

 

 

What we have in hand is a vaccine that could do the work and meet these objectives and I think this is really an exciting time. We are close to the end and all the efforts at the end, will  make an impact and  we all hope to make dengue a vaccine prevented disease.

 

01:42:56:02

Dr Remy Teyssou

 

 

Everybody in the dengue community is excited about the dengue vaccine.

We are entering a new era in which we will have new hope.

 

01:43:07:13

Dr Capeding

As a mother, as a clinician, as a doctor to children, and also as an individual residing in a dengue endemic country, I am very happy. Yeah, very happy to be part of this journey.

 

01:43:24:14

Angelita (subtitles)

If there’s a solution to this problem with

 a new vaccine against dengue…

 

..then that would be a huge help

to our community

 

01:43:36:03

Irento (subtitles)

 

 

To stop children getting sick

 

To stop the problem getting worse

 

That’s why we joined this programme

 

01:43:50:22

Christian (subtitles)

 

I’m happy to involved…

 

..because it’s helping fight this disease

01:44:00:07

VO

Christian has played his part in helping to make medical history. With the first vaccine against dengue fever now available, there is hope that its relentless spread can at last be curbed.

 

01:44:17:08

Music:  ANW2283_06_Tell-A-Story

Composers/Performers: Alex Arcoleo, Audio Network

END CREDITS

 

 

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