April 20, 2018, 12:39 pm
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1 Philippine Peso = 0.07053 UAE Dirham
1 Philippine Peso = 1.99923 Albanian Lek
1 Philippine Peso = 0.03418 Neth Antilles Guilder
1 Philippine Peso = 0.38677 Argentine Peso
1 Philippine Peso = 0.02467 Australian Dollar
1 Philippine Peso = 0.03418 Aruba Florin
1 Philippine Peso = 0.03841 Barbados Dollar
1 Philippine Peso = 1.59228 Bangladesh Taka
1 Philippine Peso = 0.03034 Bulgarian Lev
1 Philippine Peso = 0.00724 Bahraini Dinar
1 Philippine Peso = 33.62742 Burundi Franc
1 Philippine Peso = 0.0192 Bermuda Dollar
1 Philippine Peso = 0.02503 Brunei Dollar
1 Philippine Peso = 0.13175 Bolivian Boliviano
1 Philippine Peso = 0.06526 Brazilian Real
1 Philippine Peso = 0.0192 Bahamian Dollar
1 Philippine Peso = 1.26032 Bhutan Ngultrum
1 Philippine Peso = 0.18403 Botswana Pula
1 Philippine Peso = 384.48243 Belarus Ruble
1 Philippine Peso = 0.03837 Belize Dollar
1 Philippine Peso = 0.02421 Canadian Dollar
1 Philippine Peso = 0.01858 Swiss Franc
1 Philippine Peso = 11.41406 Chilean Peso
1 Philippine Peso = 0.12052 Chinese Yuan
1 Philippine Peso = 52.12791 Colombian Peso
1 Philippine Peso = 10.7778 Costa Rica Colon
1 Philippine Peso = 0.0192 Cuban Peso
1 Philippine Peso = 1.71039 Cape Verde Escudo
1 Philippine Peso = 0.39282 Czech Koruna
1 Philippine Peso = 3.39601 Djibouti Franc
1 Philippine Peso = 0.11551 Danish Krone
1 Philippine Peso = 0.94891 Dominican Peso
1 Philippine Peso = 2.1798 Algerian Dinar
1 Philippine Peso = 0.24262 Estonian Kroon
1 Philippine Peso = 0.33916 Egyptian Pound
1 Philippine Peso = 0.52276 Ethiopian Birr
1 Philippine Peso = 0.01551 Euro
1 Philippine Peso = 0.03865 Fiji Dollar
1 Philippine Peso = 0.01348 Falkland Islands Pound
1 Philippine Peso = 0.01349 British Pound
1 Philippine Peso = 0.08525 Ghanaian Cedi
1 Philippine Peso = 0.89975 Gambian Dalasi
1 Philippine Peso = 172.80584 Guinea Franc
1 Philippine Peso = 0.14089 Guatemala Quetzal
1 Philippine Peso = 3.95007 Guyana Dollar
1 Philippine Peso = 0.15072 Hong Kong Dollar
1 Philippine Peso = 0.45249 Honduras Lempira
1 Philippine Peso = 0.11491 Croatian Kuna
1 Philippine Peso = 1.24505 Haiti Gourde
1 Philippine Peso = 4.8093 Hungarian Forint
1 Philippine Peso = 264.60534 Indonesian Rupiah
1 Philippine Peso = 0.06739 Israeli Shekel
1 Philippine Peso = 1.26727 Indian Rupee
1 Philippine Peso = 22.73862 Iraqi Dinar
1 Philippine Peso = 806.60649 Iran Rial
1 Philippine Peso = 1.91031 Iceland Krona
1 Philippine Peso = 2.37565 Jamaican Dollar
1 Philippine Peso = 0.01361 Jordanian Dinar
1 Philippine Peso = 2.06171 Japanese Yen
1 Philippine Peso = 1.92145 Kenyan Shilling
1 Philippine Peso = 1.32194 Kyrgyzstan Som
1 Philippine Peso = 76.97331 Cambodia Riel
1 Philippine Peso = 7.61206 Comoros Franc
1 Philippine Peso = 17.28442 North Korean Won
1 Philippine Peso = 20.40042 Korean Won
1 Philippine Peso = 0.00575 Kuwaiti Dinar
1 Philippine Peso = 0.01575 Cayman Islands Dollar
1 Philippine Peso = 6.25043 Kazakhstan Tenge
1 Philippine Peso = 158.93989 Lao Kip
1 Philippine Peso = 28.9034 Lebanese Pound
1 Philippine Peso = 2.99693 Sri Lanka Rupee
1 Philippine Peso = 2.50451 Liberian Dollar
1 Philippine Peso = 0.22892 Lesotho Loti
1 Philippine Peso = 0.05855 Lithuanian Lita
1 Philippine Peso = 0.01192 Latvian Lat
1 Philippine Peso = 0.02543 Libyan Dinar
1 Philippine Peso = 0.17577 Moroccan Dirham
1 Philippine Peso = 0.31452 Moldovan Leu
1 Philippine Peso = 0.94968 Macedonian Denar
1 Philippine Peso = 25.52333 Myanmar Kyat
1 Philippine Peso = 45.86134 Mongolian Tugrik
1 Philippine Peso = 0.15521 Macau Pataca
1 Philippine Peso = 6.76013 Mauritania Ougulya
1 Philippine Peso = 0.64144 Mauritius Rupee
1 Philippine Peso = 0.29902 Maldives Rufiyaa
1 Philippine Peso = 13.70175 Malawi Kwacha
1 Philippine Peso = 0.35007 Mexican Peso
1 Philippine Peso = 0.07459 Malaysian Ringgit
1 Philippine Peso = 0.22915 Namibian Dollar
1 Philippine Peso = 6.87536 Nigerian Naira
1 Philippine Peso = 0.59554 Nicaragua Cordoba
1 Philippine Peso = 0.14884 Norwegian Krone
1 Philippine Peso = 2.01652 Nepalese Rupee
1 Philippine Peso = 0.02629 New Zealand Dollar
1 Philippine Peso = 0.00739 Omani Rial
1 Philippine Peso = 0.0192 Panama Balboa
1 Philippine Peso = 0.06176 Peruvian Nuevo Sol
1 Philippine Peso = 0.06241 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.21836 Pakistani Rupee
1 Philippine Peso = 0.06459 Polish Zloty
1 Philippine Peso = 106.04187 Paraguayan Guarani
1 Philippine Peso = 0.0699 Qatar Rial
1 Philippine Peso = 0.07223 Romanian New Leu
1 Philippine Peso = 1.16816 Russian Rouble
1 Philippine Peso = 16.22066 Rwanda Franc
1 Philippine Peso = 0.07202 Saudi Arabian Riyal
1 Philippine Peso = 0.14768 Solomon Islands Dollar
1 Philippine Peso = 0.25792 Seychelles Rupee
1 Philippine Peso = 0.34667 Sudanese Pound
1 Philippine Peso = 0.161 Swedish Krona
1 Philippine Peso = 0.02513 Singapore Dollar
1 Philippine Peso = 0.01349 St Helena Pound
1 Philippine Peso = 0.42646 Slovak Koruna
1 Philippine Peso = 146.53351 Sierra Leone Leone
1 Philippine Peso = 10.79316 Somali Shilling
1 Philippine Peso = 380.06338 Sao Tome Dobra
1 Philippine Peso = 0.16804 El Salvador Colon
1 Philippine Peso = 9.89015 Syrian Pound
1 Philippine Peso = 0.22917 Swaziland Lilageni
1 Philippine Peso = 0.599 Thai Baht
1 Philippine Peso = 0.04602 Tunisian Dinar
1 Philippine Peso = 0.04292 Tongan paʻanga
1 Philippine Peso = 0.07736 Turkish Lira
1 Philippine Peso = 0.12961 Trinidad Tobago Dollar
1 Philippine Peso = 0.56365 Taiwan Dollar
1 Philippine Peso = 43.7488 Tanzanian Shilling
1 Philippine Peso = 0.50259 Ukraine Hryvnia
1 Philippine Peso = 70.84694 Ugandan Shilling
1 Philippine Peso = 0.0192 United States Dollar
1 Philippine Peso = 0.54158 Uruguayan New Peso
1 Philippine Peso = 154.65719 Uzbekistan Sum
1 Philippine Peso = 1139.831 Venezuelan Bolivar
1 Philippine Peso = 437.43038 Vietnam Dong
1 Philippine Peso = 2.00538 Vanuatu Vatu
1 Philippine Peso = 0.04922 Samoa Tala
1 Philippine Peso = 10.16881 CFA Franc (BEAC)
1 Philippine Peso = 0.05185 East Caribbean Dollar
1 Philippine Peso = 10.16881 CFA Franc (BCEAO)
1 Philippine Peso = 1.83983 Pacific Franc
1 Philippine Peso = 4.79931 Yemen Riyal
1 Philippine Peso = 0.2292 South African Rand
1 Philippine Peso = 99.66391 Zambian Kwacha
1 Philippine Peso = 6.95026 Zimbabwe dollar

Warnings ignored

Media helped spread the fear. Daily, on national television, as news of the Dengvaxia scandal was reported, in the background, horrifying images of young children undergoing an autopsy to determine causes of death juxtaposed a parent’s worst fears with a nagging feeling of responsibility and helplessness that they had perhaps surrendered their children’s lives to politicians, gambled it and lost. Fear sold TV time. The ensuing anger, newspapers.

The scandal was a question of trust, or its betrayal. Had the Dengvaxia vaccination program been rolled out properly, gradually phased through physicians, creating a doctor-patient relationship with requisite prescreening and informed consent, rather than recklessly en masse as the Department of Health had done, the fears, feelings of betrayal and trauma would have been mitigated.

Fortunately, the numbers are sobering, albeit now overwhelmed, manhandled by PR operators and politicians playing to public opinion.

The fact is that not all vaccinated seronegative children will develop severe dengue. The drug maker’s data is four out of every thousand. That’s 0.40 percent. Compare that to the unvaccinated seronegative’s chance of contracting severe dengue of 0.20 percent. 

Sanofi Pasteur’s numbers double the risk but the probability remains small and this doubling applies only to the probable 20 percent seronegatives vaccinated with Dengvaxia --  a percentage of prevalence culled from only two areas, and thus could be wildly extrapolated and statistically unrepresentative. Fortunately, the rest will be protected by the vaccine at varying efficacy rates depending on age, serostatus and other factors.

Apart from Sanofi’s numbers, in a paper published on Dec. 21, 2016 by Maíra Aguiar, Nico Stollenwerk and Scott B. Halstead entitled “The Impact of the Newly Licensed Dengue Vaccine in Endemic Countries,” they wrote “The vaccine mimics the immunological effect of a primary dengue infection sensitizing them to a more severe secondary infection...These sensitized individuals when naturally infected for the first time have a 10 percent higher probability of hospitalization as compared to individuals acquiring the natural secondary dengue infection. Thus, when seropositive individuals are vaccinated the result is protection while vaccinated seronegative individuals becoming infected for the first time have higher chance to develop severe disease and being hospitalized.”

Note that the vaccine mimics a “primary (first) infection” by employing a cocktail of attenuated or weakened viruses producing antibodies for the four types of dengue. For the first two years these protect those vaccinated. But for the vaccinated seronegatives, as antibody levels decline these same antibodies create an unusual reaction that causes severe dengue should the child be bitten by a dengue-infected mosquito. If treated correctly in a timely manner the reported mortality rate is less than 1 percent. If not, it can reach 20 percent.

These are what face seronegative children recklessly vaccinated with Dengvaxia en masse and sans serotype screening. A curse that will threaten them for the rest of their lives. All because warnings were ignored.

In the field of dengue research, of the authors of the 2016 paper, the foremost authority and the most notable is Dr. Halstead.

Almost 50 years ago to the this month in April 1970 Halstead wrote in the Yale Journal of Biology and Medicine under a section entitled “Mechanisms in Altered Dengue” that “Normal dengue infection response is altered toward more severe disease in individuals with pre-infection dengue antibody, passively acquired or endogenously produced. In secondary infection DHF (Dengue Hemorrhagic Fever), the first dengue infection sensitizes and the second elicits an altered infection response.”

Halstead referenced dengue among hospitalized victims in Thailand between 1962 and 1964 over half a century prior to the Dengvaxia scandal in the Philippines and a third of a century prior to the start of Dengvaxia’s development by its manufacturer.

In 1977 Halstead suggested reasons for the severity of a second infection based on anti-dengue serums administered to rhesus monkeys. In a co-authored paper entitled “Dengue viruses and mononuclear phagocytes. I. Infection enhancement by non-neutralizing antibody,” Halstead specifically wrote on type two dengue -- the type prevalent in the Philippines. 

By 1994, in his article  “Antibody-dependent Enhancement of Infection: A Mechanism for Indirect Virus Entry into Cells,” Halstead identified the phenomenon as “antibody-dependent enhancement (ADE).”

While alarms sounded as early as 1977 for drug makers researching on dengue, specific reference was made clearer in a paper entitled “Neutralization and antibody-dependent enhancement of dengue viruses” published in 2003.

From 2003 onward there would be a profusion of tests, trials, and studies warning of severe dengue from ADE that any drug maker cannot ignore. 

In 2008 one study discussed secondary infections and its “chaotic behavior” over wider regions. In 2009, the different serotypes were discussed in a study entitled  “Immunological serotype interactions and their effect on the epidemiological pattern of dengue.”  Indeed there is no shortage of research and data. And warnings.

Unless these are ignored.

By 2010 to Nov.  9, 2014, when Benigno S. Aquino III met with the makers of a then still unlicensed and incompletely tested Dengvaxia, the harmful effects of an anti-dengue drug had become clearer.

In 2010, one study entitled “Cross-Reacting Antibodies Enhance Dengue Virus Infection in Humans“ minced no words.

In 2012, prior to meetings with Sanofi Pasteur, Halstead published “Dengue hemorrhagic fever: two infections and antibody dependent enhancement, a brief history and personal memoir”.

In that Halstead’s prose and style are fairly understandable, albeit occasionally technical. It should have been required reading for health officials interested in an anti-dengue vaccine or drug makers peddling it.

In 2014, before officials met with Sanofi Pasteur, a paper was published entitled “Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomized, observer-masked, placebo-controlled trial.” The paper demonstrated Dengvaxia’s efficacy, but was not definitive on differences between seronegatives and seropositives due to inadequate sample sizes.

Cumulatively  the direst warnings could not have been louder and the reference to healthy children more ironic. Unfortunately there are none so blind as those who will not see, or have ears, but hear not.
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