CDC Plagiarizes Indian Scientist’s Litchi Diagnosis

Yet more evidence of the extent of brazen IP theft from non-Western, especially developing Asian countries,  in elite Western institutions, this time involving Western and Indian-origin scientists at the Center for Disease Control in the US, deploying the resources of the Indian government to poach from Indian scientists:

The story began in 2013 when, faced with recurrent deaths of children due to a mysterious brain disease in litchi-harvesting belts of Muzaffarpur, the Bihar government and the health ministry of the central government turned to veteran virologist Dr T Jacob John. They could not have got a better expert: Dr John, since his MBBS way back in 1958, followed by a PhD in 1976, has a long and distinguished career in public health. In a way, he was the brain behind the polio vaccination campaign.

What could be the cause of deaths? The prime suspect was some yet-to-be-identified virus. The next suspect was the fruit itself, that is, some substance in it – it could be a toxin in litchi or something in the pesticide used. Other suspects were bats which were eating litchis and hence probably passing on some disease to children who ate the bat-eaten litchis. The common factor to all deaths was that the children were dying in the litchi-belt during the litchi harvesting season of May and June, recalls Dr John.

He camped at Muzaffarpur, met villagers and began his work. He ruled out the virus angle and was zeroing in on a chemical within litchi. “A similar disease was caused by another fruit called ackee that belongs to the same plant family as litchi. This disease was metabolic and was called hypoglycaemic encephalopathy, or ‘Jamaican vomiting sickness’. So I was able to rule out virus in the very beginning,” he says.

His hunch was that it was worth looking for a toxin within the fruit. He suggested this in a report in May 2014 – in the leading journal of its kind in India, Current Science, published by the Current Science Association in collaboration with the Indian Academy of Sciences. He and his co-researcher, Mukul Das, wrote:
“In animal experiments, MCPA (the hypoglycin found in ackee) and MCPG (the hypoglycin in litchi) have been shown to induce encephalopathy and hypoglycaemia. Encephalopathy is explained by the mitochondrial inhibition of fatty acid-oxidation and accumulation of toxic metabolites. Our hypothesis is that the Muzaffarpur AES is caused by MCPG in lychee. However, we do not know if it is present only in the seed or also in the edible fruit flesh and if unripe lychee has more MCPG than ripe fruits.”
Their conclusion: “…tightly  restricted seasonality and geographic distribution as well as sparing of children below 2 years support the diagnosis of acute non-infectious encephalopathy as against viral encephalitis.”

In September 2014, doctors John, Das and Arun Shah published further findings on the toxin hypothesis in the same journal.
They, however, were in for a shock when they found the same findings reproduced in an American journal a few months later – without any credit, acknowledgement or reference to their research.

Akash Srivastava, who is with the National Centre for Disease Control of the health ministry, along with a team of researchers published this set of findings in the Morbidity and Mortality Weekly Report (MMWR), a journal published by the Centers for Disease Control and Prevention (CDC) of the US government. The March 2015 report arrived at the same conclusion, that the brain disease among children in Muzaffarpur was not caused by a virus but by some toxin within litchi seeds or fruit, and the condition was hence not a viral disease but a metabolic disorder called hypoglycaemic encephalopathy.

Dr John and his co-authors took up the matter in a letter published in Current Science in September 2015. It asked: “Publishing on hypoglycemic encephalopathy, borrowing information without giving credit: Is Current Science invisible?”

They noted, “Annual seasonal outbreaks of what was popularly called acute encephalitis syndrome in Muzaffarpur, Bihar were clinically diagnosed in 2013 by us as non-infectious, toxic, hypoglycemic encephalopathy… The toxin was pinpointed as methylenecyclopropylglycine (MCPG). Thus, our first publication in May 2014 in Current Science was a breakthrough after many groups of investigators had failed for many years to diagnose the disease or provide any plausible causative associations.

“In 2014, we confirmed with clinical evidences that the disease is indeed hypoglycemic encephalopathy and the patients could be saved with prompt correction of hypoglycemia. These results were published, again in Current Science, in August 2014.” But in January 2015, MMWR came out with a report by a large group of investigators, stating that the disease is acute hypoglycemic encephalopathy with putative association with litchi, as if they were the first to arrive at such a conclusion.”

“Our 2013 investigations which appeared in May 2014 in Current Science were a watershed. But the studies of Shrivastava et al published in January 2015 in MMWR have not cited our earlier contributions – one reason could be that Current Science is invisible in the usual biomedical literature surveys. However, when we conducted a simple literature search through a popular search engine, we found references to both our papers.”

When Governance Now contacted  MMWR, its executive editor Charlotte Kent replied promptly on December 2 saying that matter would be investigated. “We received your two emails from today about the MMWR report, “Outbreaks of Unexplained Neurologic Illness – Muzaffapur, India, 2013-14”. We are planning on investigating the concern you raised,” she said in an email. MMWR has not sent any further information on the matter since then. Srivastava, meanwhile, did not reply to the emailed queries.

Several questions are raised by this incident, especially since the parallel research published by CDC was also done with help of Indian government bodies.

Dr John also rues the fact that this episode pits Indian scientists against each other. He says that ultimately it proves that Indians can do their research and reach the truth without external help. However, he adds that distortion of truth does leave a bitter taste in the mouth and is just not done in science.

An ethical scientist would not claim credit for someone else’s work, says the veteran virologist.


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