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Published on: Apr 04, 2020
3 minute read
By: Dr Rajan Choudhary

Developing A Vaccine For COVID-19? Part 1

It is often stated vaccination has made the greatest contribution to global health of any human discovery, other than clean water and sanitation, and their impact on everyday life is immediately evident. We have managed to completely eradicate two major infections from existence (smallpox and rinderpest) , and the WHO are working towards adding polio to that list.

In these cases the numbers speak for themselves. It is estimated that the eradication of smallpox in 1980 has saved 5 million lives per year, adding up to 150 to 200 million by 2018. Common vaccination programmes for polio, measles, mumps, rubella, rabies and hepatitis A have prevented nearly 200 million cases from occurring in the US alone over the past 50 years, and 4.5 billion instances of the diseases worldwide.

We have achieved a 99% immunisation rate against polio, preventing children from suffering crippling paralysis, and only 3 countries remain. Sadly, around 1.4 million children under 5 still die from preventable diseases each year as they do not have access to these life saving vaccines, but charities and public health organisations around the world are working hard to improve access.

So what are vaccines? And how will they help is in the face of the latest pandemic? Here we will go into the challenges behind making vaccines, and why a vaccine against COVID-19 is unlikely to be ready in the next few months, or even this year.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024226/ contribution of vaccination

https://www.who.int/features/factfiles/polio/en/ polio eradication

https://www.sciencedaily.com/releases/2017/03/170303163208.htm study article

WHAT IS A VACCINE

The human body’s immune system is incredibly smart. It is able to distinguish between infective organisms, such as bacteria, viruses and parasites, from our own body’s cells, target these invaders for destruction and keep our bodies healthy. Even better, the body remembers any previous infections it has had before, recognise these previous infections even quicker and even eradicate the disease before we know we are infected.

Vaccines target the immune system’s memory by presenting them with pieces of these infective diseases. The small amounts do not cause any infective symptoms, but if the person is infected later in life their body will mount a quicker response and prevent them from falling ill. These vaccines can contain broken up parts of the organisms, “dead” organisms or “live” versions that have been severely weakened so they cannot cause any harm.

In summary, medicines treat us when we get an infection. Vaccines make sure we never suffer from an infection in the first place.

https://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/how-are-vaccines-made Making Vaccines

THE HURDLES WE FACE IN RESEARCH

Making a vaccine is a difficult process, one that can take 3–5 years and cost hundreds of millions of dollars, sometimes billions of dollars. This is because there are many difficult steps to be taken in the process of creating a vaccine that is effective, but more importantly one that is safe.

To start with the troubling organism has to be identified. For COVID-19 it took a few weeks to recognise the virus responsible, and some time more to understand its genetic code and grow the virus in lab conditions. We then have to understand the virus, how it infects, how it causes symptoms, and how it has mutated compared to the coronaviruses responsible for SARS and MERS.

After this, we have to isolate parts of the virus our immune system will recognise. This is usually the outside coat of the virus. The DNA responsible for making these parts need to be found in the virus’ genetic code, and put inside other “skeleton” viruses. This will force the dummy virus to look like coronavirus, without the ability to infect and kill someone.

These dummy viruses can be injected into animals to see if it causes an immune reaction, whether the immune system recognises it as the coronavirus responsible for COVID-19, and whether it will protect the animal from the real COVID-19. Up to now the research has likely cost a few million dollars. The next step is when the price inflates up to billions.

If the vaccine appears safe in animals, it can be tested in humans. This can be dangerous at first, since we don’t know whether a vaccine that works in an animal will work in a human. And we don’t know if there will be any side effects to the vaccine. Human testing has to be very thorough, very careful, and safe for use. If you give too much of the virus it might make the person sick, too little and it wont immunise the person. These clinical trials can take years, and if the vaccine fails at this point its back to the drawing board, to try another step.

https://www.theatlantic.com/politics/archive/2014/10/how-to-make-an-ebola-vaccine-5-simplified-steps/454443/ ebola vaccine

Now we have a basic understanding of what vaccines are and why it takes so long to make a vaccine. In the next part we will look at why viral vaccines can cause even more problems, and how far we have come with the COVID-19 vaccine,

Dr Rajan Choudhary, London UK

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Tuberculosis Symptoms and Treatment: Early Signs, Diagnosis, and Recovery

Tuberculosis (TB) is one of the oldest known infectious diseases and continues to be a major public health concern, especially in developing countries. India accounts for a significant proportion of global TB cases, despite advances in diagnosis and treatment. The good news is that tuberculosis is preventable, treatable and curable when detected early and managed properly.

Understanding tuberculosis symptoms and treatment is critical for reducing disease spread, preventing complications and achieving complete recovery.

What Is Tuberculosis?

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also involve other parts of the body such as:

lymph nodes
bones and joints
kidneys
brain

TB spreads through the air when an infected person coughs, sneezes or speaks.

Why Tuberculosis Remains a Major Health Issue

According to the World Health Organization and ICMR data:

millions of new TB cases are reported annually
delayed diagnosis increases transmission
incomplete treatment leads to drug resistance

Early detection and treatment are key to TB control.

Common Tuberculosis Symptoms

TB symptoms often develop gradually and may be mild in the early stages, leading to delayed diagnosis.

Persistent Cough

A cough lasting more than two to three weeks is a hallmark symptom of pulmonary TB.

The cough may:

be dry or productive
worsen over time
sometimes produce blood

Fever and Night Sweats

Low-grade fever, especially in the evenings, is common.

Night sweats that soak clothing or bedding are a classic TB sign.

Unexplained Weight Loss

TB increases metabolic demand and reduces appetite, leading to significant weight loss.

Fatigue and Weakness

Persistent tiredness and reduced stamina occur due to chronic infection.

Chest Pain

Chest discomfort or pain may occur during coughing or breathing.

Symptoms of Extra-Pulmonary TB

When TB affects organs outside the lungs, symptoms depend on the site involved and may include:

swollen lymph nodes
bone or joint pain
headaches or neurological symptoms
urinary issues

Why TB Symptoms Are Often Ignored

Many TB symptoms resemble common infections or general weakness.

This leads to:

delayed medical consultation
prolonged transmission
disease progression

Awareness improves early detection.

How Tuberculosis Is Diagnosed

Diagnosis involves a combination of:

sputum tests
chest X-ray
molecular tests such as CBNAAT
blood tests and imaging for extra-pulmonary TB

Early and accurate diagnosis is essential for effective treatment.

Tuberculosis Treatment Explained

TB treatment involves a combination of antibiotics taken over a fixed duration.

Standard TB Treatment

For drug-sensitive TB, treatment typically lasts:

6 months

The regimen includes multiple antibiotics taken in phases to ensure complete bacterial clearance.

Importance of Treatment Adherence

TB bacteria are slow-growing and resilient.

Stopping treatment early can result in:

incomplete cure
relapse
drug-resistant TB

Completing the full course is essential.

Drug-Resistant TB

If TB bacteria become resistant to standard drugs, treatment becomes longer and more complex.

Drug-resistant TB requires:

specialised medications
longer treatment duration
close medical supervision

Prevention of resistance depends on correct treatment from the start.

Side Effects of TB Treatment

Some individuals may experience side effects such as:

nausea
loss of appetite
mild liver enzyme changes

Most side effects are manageable with medical guidance and do not require stopping treatment.

TB and Public Health

TB is not just an individual health issue but a community concern.

Effective TB control requires:

early diagnosis
treatment adherence
contact tracing
public awareness

India’s national TB elimination programmes focus on these strategies.

Preventing Tuberculosis

Preventive measures include:

early detection and treatment of active TB
improving nutrition and immunity
adequate ventilation in living spaces
screening close contacts

BCG vaccination offers partial protection, especially in children.

Living With and Recovering From TB

With proper treatment:

symptoms gradually improve
infection becomes non-contagious
normal life can be resumed

Regular follow-up ensures complete recovery.

When to Seek Medical Help

Consult a healthcare provider if experiencing:

cough lasting more than two weeks
unexplained weight loss
persistent fever or night sweats
blood in sputum

Early action saves lives and prevents spread.

Long-Term Outlook After TB Treatment

Most individuals who complete treatment:

recover fully
regain normal lung function
return to daily activities

Long-term complications are rare with timely care.

Conclusion

Tuberculosis symptoms and treatment must be understood clearly to combat this preventable and curable disease. Persistent cough, fever, night sweats and weight loss should never be ignored. Early diagnosis, complete treatment adherence and regular follow-up are essential for curing TB and preventing transmission. With proper medical care and public awareness, tuberculosis can be effectively controlled and eliminated as a public health threat.

References

Indian Council of Medical Research (ICMR) – Tuberculosis Epidemiology and Treatment Guidelines
World Health Organization (WHO) – Global Tuberculosis Report
National Tuberculosis Elimination Programme (NTEP) – Government of India
Lancet Infectious Diseases – TB Diagnosis and Treatment Outcomes
National Family Health Survey (NFHS-5) – Infectious Disease Indicators
Statista – Global Tuberculosis Burden and Trends

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