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In the 21st century, we are all connected. Population growth, mass urbanization, deforestation, climate change and increased travel have dramatically increased the risk that familiar diseases will spread and mutate, and new ones will emerge. As people enter new spheres of biodiversity, they come in closer contact with other species, increasing the risk of viruses jumping from animals to humans, and then spreading more widely.

It all sounds scaring, but it is stark reality facts on the ground which are almost ready for such a grim situation if corrective measures are not affecting in time.

She is not a wizard in crystal grazing to forecast future events, but certainly, she is a visionary and envisions that the spectre of diseases will loom over the planet earth in future. She is no one else but Janet Tobia who has won laurels for her documentary ”Unseen Enemy”.

The Emmy award-winning filmmaker Janet Tobia told InnoHEALTH Magazine that her movie Unseen Enemy examines why in the 21st century we are experiencing a rash of diseases that were once only outbreaks but have now become full-blown epidemics.

This year, the world recalls nightmarish memories of 1918 pandemic of influenza and screen through a popular movie “Unknown Enemy” on its first anniversary. “I had a little bird, its name was Enza, I opened the window, and in–flu-enza, was a popular rhyme for children while skipping ropes in those outrageous days.

Informatively, the 1918 flu pandemic (January 1918 – December 1920) was an unusually deadly influenza pandemic. Researchers say it infected 500 million people around the world, including people on remote Pacific islands and in the Arctic, and resulted in the death of 50 to 100 million (three to five percent of the world’s population).

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Disease had a greatly limited life expectancy in the early 20th century. Most influenza outbreaks disproportionately kill juvenile, elderly, or already weakened patients; in contrast, the 1918 pandemic predominantly killed previously healthy young adults. There are several possible explanations for the high mortality rate of the 1918 influenza pandemic. Some research suggests that the specific variant of the virus had an unusually aggressive nature. One group of researchers recovered the virus from the bodies of frozen victims and found that the transinfection in animals caused a rapid progressive respiratory failure and death through a cytokine storm (overreaction of body’s immune system).

More recent investigations, mainly based on original medical reports from the period of the pandemic, found that the viral infection itself was not more aggressive than any previous influenza. But that the special circumstances (malnourishment, overcrowded medical camps and hospitals, poor hygiene, etc.) promoted bacterial superinfection that killed most of the victims typically after a somewhat prolonged deathbed.

To maintain morale, wartime censors minimized early reports of illness and mortality in France, Germany, United Kingdom and the United States. Examining the recent epidemics of Ebola, Influenza and Zika; unseen enemy makes it clear that epidemics bring out the best and worst of human behaviour, and that their effect goes far beyond the terrible tolls of sickness and death.

‘‘We are all connected to any person, animal, and insect that may have an infectious disease incubating in them. And that connection is either incredibly dangerous or a powerful force for good. It is our choice which of those becomes true.’’

She says political leaders all over the world should address the problem. And play a key role in combating pandemics threats. There must be early detection and warning systems in place to detect outbreaks faster. Countries must work in close rapport both in the field of vaccines and drugs distribution, availability of diagnostic tools and research work in the discipline. Leaders will have to chip in together. Make strong health architecture at a global level – as a threat is looming on everyone.

We also need to use new mobile technology to reach out to affected and vulnerable populations, mobilize healthcare and make long-term investments in scientific research.

Finally, it is critical to invest in flu research both to improve the effectiveness of the current vaccine. And, more importantly, to develop a universal flu vaccine – one that would work against all types of flu, including potentially a new pandemic strain.

She recalls that the 1918 influenza pandemic killed more than 50 million people around the world. In India alone, 17 million lost their lives and so her movie cameras rivet around a potential global scenario. Emerging epidemics have a propensity to burst anywhere and anytime because of the fast changing global environment.

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She visualizes a scenario where India can play a major role because of its expertise in carrying out past massive health care programmes. Smallpox eradication and polio vaccination programme vindicate the fact about country’s efficacy to turntables. It is the need of the hour that such an expert was implemented for the elimination of infectious diseases to stave off the threat of the outbreak of pandemics in the global village.

In addition to urbanization and living in a highly connected world, deforestation is leading to closer contact with animals, which may infect us with deadly viruses. With climate change, vectors like mosquitoes are moving up north into newer regions. Suppose, antimicrobial resistance is added to this mix, and then there will be a new virus and drug-resistant infections. If we don’t have antibiotics that work, then you would be infected and untreatable.

The Director of the film minces no words to articulate her views on the unseen enemy. Ebola, for example, may have emerged in West Africa, a new part of Africa, because of deforestation there. AIDS moved out of the forests of Africa to spread around the world. Today there are over 20 million people living with HIV-AIDS. In addition to the new virus, we now also have new drug-resistant strains of once badly feared tuberculosis and malaria developing.

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She says reports are in circulation that new strains of influenza are infecting birds in China. But the day might not be far away. When these microbes may learn the clandestine art of migrating from birds to human beings.

In populous countries, people live in dense pockets in the overburdened urban swathes. Not only that they travel in crowded public transports and if an infected, suffering from a contagious infection, sneezes or coughs, there is an instant spreading of the infection. The virus, the unseen enemy, infects people who are generally oblivious of the lurking threat.

During the outbreak of such epidemics, people are advising to be cautious to mount their own defence to protect themselves. In India, a sea of humanity moves every day from one place to another. And in case of the outbreak of such diseases, travelling of infection can be very fast.

In case of India, there is a heavy burden of noncommunicable diseases and chronic diseases that often compromise immunity. Deaths from flu are higher in diabetics than the general population.

The seasonal flu shot is the best tool. There is some evidence to show that taking the flu shot two years in a row gives you more protection than if you skipped a year. There is also some evidence on how people receiving a flu shot for the first time. And have the strongest immune protection reaction, while other studies say this isn’t true.

India’s smallpox eradication campaign is the most successful healthcare drive in history. During the time more than 100,000 health workers visited over 100 million households to eradicate smallpox. So, India has a blueprint to deal with a future pandemic.

Filmmakers had looked at previous epidemics and infections. AIDS was lurking in their minds. But the sudden spurt of Ebola and Zika virus’ cases turned the film into a real-time saga. And both AIDS and SARS slipped into the background.

In the global village narrative, every citizen is open to risk factors in case of pandemics. The diseases assail everything whatever comes into their way – may it be health or wealth. When a pandemic happens, people don’t work, economies collapse, and the even social fabric is dismembered. People attempt to avoid their own infected close relatives and friends. Out of fear that they will be the next seizure if precautions were not clamped.

In case of pandemics, whatever happens on the front line in Liberia affects people in Europe and North America. We all share knowledge platforms, travel frequently and export and import cheaper goods so microbes also travel freely. For her, Ebola is the test case. According to the Director, Ebola was not handled swiftly at the stage of the outbreak. Otherwise, it could have been bridled at that stage rather it turned into the epidemic.

She recalls that Zika virus too had sprung a surprise. It was never visualized. No one thought that a virus first identified in the 1940s in Uganda would travel halfway across the world. First to the South Pacific and then to South America, and now to North America. We are still trying to understand, why this virus that particularly dangerous would in Brazil produce such terrible birth defects.

Zika is essentially a pandemic as it affects so many countries and continents. It could affect more because the mosquitoes will be able to move further north as the globe warms up.

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