Vaccines and Disease Control in India: Notes and PYQs

The correct answer is B, bacteria. Typhoid is caused by the bacterium Salmonella Typhi, which spreads through food and water contaminated with human waste, and it is prevented both by sanitation and by the typhoid conjugate vaccine. Option A is wrong; the viral diseases of this group are polio, measles, hepatitis, dengue and influenza, not typhoid, and candidates choose it because typhoid produces a long fever much like a viral one. Option C is wrong because fungi cause surface infections such as ringworm and athlete foot rather than a systemic fever of this kind. Option D is wrong; the protozoan diseases are malaria, kala azar and amoebic dysentery. The safest way to hold this group is to memorise the bacterial list as typhoid, tuberculosis, cholera, tetanus, diphtheria, leprosy and plague, since that list answers several questions at once.

The correct answer is C, protozoa. Malaria is caused by the protozoan Plasmodium and carried by the female Anopheles mosquito, and kala azar, also called visceral leishmaniasis, is caused by the protozoan Leishmania donovani and carried by the sandfly. Both are handled by the national centre for vector borne diseases, which is why they appear together in papers. Option A is wrong because the bacterial group holds typhoid, tuberculosis, cholera and plague. Option B is wrong; fungal infections are of the skin, hair and nails and none of them is spread by a mosquito or a sandfly. Option D is wrong although it is the commonest error, since dengue, chikungunya and Japanese encephalitis are indeed viral and are also spread by insects, so candidates assume every insect borne disease is a virus. Fix malaria and kala azar firmly on the protozoan side.

The correct answer is B, swine flu. Swine flu is an influenza infection of the type first recognised in pigs, and the name itself records the animal in which the virus circulates before it passes to people; once it is in a human population it spreads from person to person by droplets. Option A is wrong because Nipah virus infection is linked to fruit bats, which contaminate date palm sap and fruit, although pigs did act as intermediate hosts in an early outbreak in South East Asia. Option C is wrong; Zika is a virus carried by Aedes mosquitoes, the same group that carries dengue and chikungunya. Option D is wrong because plague is a bacterial disease carried by the flea of the rat. Learn the animal attached to each name, since the paper may ask for the animal, the vector or the kind of germ.

The correct answer is B, Edward Jenner, against smallpox. In 1796 Jenner used material from cowpox, a mild disease of cattle, to protect a boy against smallpox, and the word vaccine itself comes from vacca, the Latin for cow. Option A is wrong in its order rather than in its facts: Louis Pasteur did make a rabies vaccine, but in 1885, almost ninety years later, and he named the method vaccination in honour of Jenner. Option C is wrong because Robert Koch identified the tuberculosis bacterium in 1882 and did not make its vaccine; the BCG vaccine was developed later by Calmette and Guerin, whose names it carries. Option D is wrong; Alexander Fleming discovered penicillin, an antibiotic and not a vaccine, in 1928. Keep the triple of Jenner with 1796, Pasteur with 1885 and Fleming with 1928.

The correct answer is A, tuberculosis. BCG stands for Bacillus Calmette Guerin, a live attenuated strain of a bovine tuberculosis bacterium, and it is given at or soon after birth under the Universal Immunization Programme to guard against severe forms of childhood tuberculosis. Option B is wrong because tetanus is prevented by a toxoid, a toxin made harmless, given in the childhood series and again after a wound. Option C is wrong; hepatitis B is prevented by a recombinant subunit vaccine that carries only one surface protein of the virus, and a birth dose of it is also part of the programme, which is why it is a strong distractor. Option D is wrong because measles is prevented by a live attenuated viral vaccine given later in infancy, usually combined with rubella. Learn each vaccine with its type as well as its disease.

The correct answer is B, 1985. The Universal Immunization Programme was launched in 1985 and remains the backbone of child immunisation in India, covering tuberculosis, diphtheria, whooping cough, tetanus, polio, measles, rubella and hepatitis B, with further vaccines in selected states. Option A is wrong but names the right predecessor, since the Expanded Programme on Immunization began in 1978 and was replaced by the universal programme seven years later. Option C is wrong because 1995 is the year the Pulse Polio Programme began, with its national immunisation days and the familiar drop of oral vaccine. Option D is wrong; 2005 is the year India achieved the elimination of leprosy as a public health problem, and it is also the year the National Rural Health Mission was launched. Learn the four years as a sequence and the question answers itself.

The correct answer is B, 25 December 2014. Mission Indradhanush was launched on 25 December 2014 to reach children who had received no vaccine or only some of the prescribed doses, and its name refers to the rainbow of vaccines then in the programme. Option A is wrong; 2 October 2014 is the launch date of the Swachh Bharat Mission, a sanitation programme that supports disease control indirectly but is not an immunisation drive. Option C is wrong because no immunisation mission of this name was launched on Independence Day 2015. Option D is wrong, though the year matters, since Intensified Mission Indradhanush followed in 2017 with a district by district and city by city push in the areas of lowest coverage. Remember the pair of Mission Indradhanush in 2014 and its intensified phase in 2017.

The correct answer is C, 2014. The World Health Organization certified the South East Asia Region, India included, as free of wild poliovirus in March 2014, three years after the last case in the country, because certification requires three consecutive years without a case. Option A is wrong but names the other date worth knowing, since India recorded its last case of wild poliovirus in January 2011, in West Bengal. Option B is wrong; by 2012 India had been removed from the list of polio endemic countries, but formal certification of the region had not yet come. Option D is wrong because 2016 belongs to a different achievement, the declaration that India was free of yaws. Keep the two polio dates as a pair, 2011 for the last case and 2014 for certification, and remember that the Pulse Polio Programme of 1995 made both possible.

The correct answer is B, the tetanus vaccine. A toxoid vaccine uses the toxin of a microbe rather than the microbe itself, treated so that it can no longer harm the body but still provokes antibodies; the tetanus and diphtheria vaccines are the two standard examples, and they work because in those diseases it is the toxin that does the damage. Option A is wrong because the oral polio vaccine is a live attenuated vaccine, containing weakened poliovirus. Option C is wrong; BCG is also live attenuated, made from a weakened bovine tuberculosis bacterium. Option D is wrong because the hepatitis B vaccine is a recombinant subunit vaccine, carrying a single surface protein of the virus produced in yeast. Group the vaccines by type once and every question of this shape becomes a recall exercise rather than a guess.

The correct answer is B, Pune. The National Institute of Virology is at Pune in Maharashtra and works under the Indian Council of Medical Research; it began in 1952 as the Virus Research Centre and it isolated the virus strain used in developing the indigenous whole virion inactivated vaccine Covaxin. Option A is wrong; New Delhi houses the National Institute of Immunology and the headquarters of the Indian Council of Medical Research, but not this institute. Option C is wrong because Hyderabad is the home of major vaccine manufacturers, Bharat Biotech among them, rather than of the National Institute of Virology. Option D is wrong although Kasauli in Himachal Pradesh holds the Central Research Institute, a vaccine laboratory dating from 1905, and the national laboratory that tests vaccine batches. Note also that the Serum Institute of India, among the largest vaccine makers in the world, is at Pune as well.