July 23, 2018, 3:04 pm
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1 Philippine Peso = 0.06891 UAE Dirham
1 Philippine Peso = 1.99812 Albanian Lek
1 Philippine Peso = 0.03452 Neth Antilles Guilder
1 Philippine Peso = 0.51726 Argentine Peso
1 Philippine Peso = 0.02526 Australian Dollar
1 Philippine Peso = 0.0334 Aruba Florin
1 Philippine Peso = 0.03752 Barbados Dollar
1 Philippine Peso = 1.57017 Bangladesh Taka
1 Philippine Peso = 0.03144 Bulgarian Lev
1 Philippine Peso = 0.00709 Bahraini Dinar
1 Philippine Peso = 32.85141 Burundi Franc
1 Philippine Peso = 0.01876 Bermuda Dollar
1 Philippine Peso = 0.02546 Brunei Dollar
1 Philippine Peso = 0.12871 Bolivian Boliviano
1 Philippine Peso = 0.07076 Brazilian Real
1 Philippine Peso = 0.01876 Bahamian Dollar
1 Philippine Peso = 1.29362 Bhutan Ngultrum
1 Philippine Peso = 0.19433 Botswana Pula
1 Philippine Peso = 375.60976 Belarus Ruble
1 Philippine Peso = 0.03748 Belize Dollar
1 Philippine Peso = 0.02466 Canadian Dollar
1 Philippine Peso = 0.01861 Swiss Franc
1 Philippine Peso = 12.39231 Chilean Peso
1 Philippine Peso = 0.12694 Chinese Yuan
1 Philippine Peso = 53.79925 Colombian Peso
1 Philippine Peso = 10.56379 Costa Rica Colon
1 Philippine Peso = 0.01876 Cuban Peso
1 Philippine Peso = 1.76454 Cape Verde Escudo
1 Philippine Peso = 0.41373 Czech Koruna
1 Philippine Peso = 3.33021 Djibouti Franc
1 Philippine Peso = 0.11925 Danish Krone
1 Philippine Peso = 0.92946 Dominican Peso
1 Philippine Peso = 2.2063 Algerian Dinar
1 Philippine Peso = 0.2502 Estonian Kroon
1 Philippine Peso = 0.3349 Egyptian Pound
1 Philippine Peso = 0.51238 Ethiopian Birr
1 Philippine Peso = 0.01599 Euro
1 Philippine Peso = 0.03929 Fiji Dollar
1 Philippine Peso = 0.01427 Falkland Islands Pound
1 Philippine Peso = 0.0143 British Pound
1 Philippine Peso = 0.08965 Ghanaian Cedi
1 Philippine Peso = 0.8925 Gambian Dalasi
1 Philippine Peso = 169.1182 Guinea Franc
1 Philippine Peso = 0.14047 Guatemala Quetzal
1 Philippine Peso = 3.89268 Guyana Dollar
1 Philippine Peso = 0.14725 Hong Kong Dollar
1 Philippine Peso = 0.44908 Honduras Lempira
1 Philippine Peso = 0.11833 Croatian Kuna
1 Philippine Peso = 1.26435 Haiti Gourde
1 Philippine Peso = 5.20544 Hungarian Forint
1 Philippine Peso = 271.57598 Indonesian Rupiah
1 Philippine Peso = 0.06798 Israeli Shekel
1 Philippine Peso = 1.28997 Indian Rupee
1 Philippine Peso = 22.32645 Iraqi Dinar
1 Philippine Peso = 817.63602 Iran Rial
1 Philippine Peso = 1.99062 Iceland Krona
1 Philippine Peso = 2.44371 Jamaican Dollar
1 Philippine Peso = 0.01329 Jordanian Dinar
1 Philippine Peso = 2.09036 Japanese Yen
1 Philippine Peso = 1.88462 Kenyan Shilling
1 Philippine Peso = 1.27979 Kyrgyzstan Som
1 Philippine Peso = 75.96623 Cambodia Riel
1 Philippine Peso = 7.86454 Comoros Franc
1 Philippine Peso = 16.88555 North Korean Won
1 Philippine Peso = 21.13321 Korean Won
1 Philippine Peso = 0.00568 Kuwaiti Dinar
1 Philippine Peso = 0.01538 Cayman Islands Dollar
1 Philippine Peso = 6.50019 Kazakhstan Tenge
1 Philippine Peso = 157.69231 Lao Kip
1 Philippine Peso = 28.24578 Lebanese Pound
1 Philippine Peso = 2.99906 Sri Lanka Rupee
1 Philippine Peso = 2.82176 Liberian Dollar
1 Philippine Peso = 0.25122 Lesotho Loti
1 Philippine Peso = 0.0572 Lithuanian Lita
1 Philippine Peso = 0.01164 Latvian Lat
1 Philippine Peso = 0.02582 Libyan Dinar
1 Philippine Peso = 0.17712 Moroccan Dirham
1 Philippine Peso = 0.31191 Moldovan Leu
1 Philippine Peso = 0.98124 Macedonian Denar
1 Philippine Peso = 27.07317 Myanmar Kyat
1 Philippine Peso = 45.94747 Mongolian Tugrik
1 Philippine Peso = 0.15166 Macau Pataca
1 Philippine Peso = 6.66041 Mauritania Ougulya
1 Philippine Peso = 0.64259 Mauritius Rupee
1 Philippine Peso = 0.29212 Maldives Rufiyaa
1 Philippine Peso = 13.38537 Malawi Kwacha
1 Philippine Peso = 0.35681 Mexican Peso
1 Philippine Peso = 0.07617 Malaysian Ringgit
1 Philippine Peso = 0.25131 Namibian Dollar
1 Philippine Peso = 6.73546 Nigerian Naira
1 Philippine Peso = 0.58799 Nicaragua Cordoba
1 Philippine Peso = 0.1534 Norwegian Krone
1 Philippine Peso = 2.06473 Nepalese Rupee
1 Philippine Peso = 0.02754 New Zealand Dollar
1 Philippine Peso = 0.00721 Omani Rial
1 Philippine Peso = 0.01876 Panama Balboa
1 Philippine Peso = 0.06142 Peruvian Nuevo Sol
1 Philippine Peso = 0.06111 Papua New Guinea Kina
1 Philippine Peso = 1 Philippine Peso
1 Philippine Peso = 2.40338 Pakistani Rupee
1 Philippine Peso = 0.06911 Polish Zloty
1 Philippine Peso = 107.46904 Paraguayan Guarani
1 Philippine Peso = 0.06831 Qatar Rial
1 Philippine Peso = 0.07438 Romanian New Leu
1 Philippine Peso = 1.1907 Russian Rouble
1 Philippine Peso = 16.006 Rwanda Franc
1 Philippine Peso = 0.07036 Saudi Arabian Riyal
1 Philippine Peso = 0.14815 Solomon Islands Dollar
1 Philippine Peso = 0.25182 Seychelles Rupee
1 Philippine Peso = 0.33678 Sudanese Pound
1 Philippine Peso = 0.16626 Swedish Krona
1 Philippine Peso = 0.02554 Singapore Dollar
1 Philippine Peso = 0.01428 St Helena Pound
1 Philippine Peso = 0.41662 Slovak Koruna
1 Philippine Peso = 157.41088 Sierra Leone Leone
1 Philippine Peso = 10.69418 Somali Shilling
1 Philippine Peso = 392.12008 Sao Tome Dobra
1 Philippine Peso = 0.16417 El Salvador Colon
1 Philippine Peso = 9.66191 Syrian Pound
1 Philippine Peso = 0.25104 Swaziland Lilageni
1 Philippine Peso = 0.62495 Thai Baht
1 Philippine Peso = 0.04951 Tunisian Dinar
1 Philippine Peso = 0.0442 Tongan paʻanga
1 Philippine Peso = 0.0899 Turkish Lira
1 Philippine Peso = 0.12621 Trinidad Tobago Dollar
1 Philippine Peso = 0.57388 Taiwan Dollar
1 Philippine Peso = 42.58912 Tanzanian Shilling
1 Philippine Peso = 0.49568 Ukraine Hryvnia
1 Philippine Peso = 70.09381 Ugandan Shilling
1 Philippine Peso = 0.01876 United States Dollar
1 Philippine Peso = 0.58555 Uruguayan New Peso
1 Philippine Peso = 145.53471 Uzbekistan Sum
1 Philippine Peso = 2245.77861 Venezuelan Bolivar
1 Philippine Peso = 432.49531 Vietnam Dong
1 Philippine Peso = 2.06942 Vanuatu Vatu
1 Philippine Peso = 0.04922 Samoa Tala
1 Philippine Peso = 10.49099 CFA Franc (BEAC)
1 Philippine Peso = 0.05066 East Caribbean Dollar
1 Philippine Peso = 10.49099 CFA Franc (BCEAO)
1 Philippine Peso = 1.90938 Pacific Franc
1 Philippine Peso = 4.68762 Yemen Riyal
1 Philippine Peso = 0.25122 South African Rand
1 Philippine Peso = 97.36398 Zambian Kwacha
1 Philippine Peso = 6.78987 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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