BACKGROUND Scrub typhus is a mite borne zoonotic bacterial disease caused by Orientia tsutsugamushi. It is transmitted by bite of chiggers of trombiculid mite. Clinical features generally include fever, headache, and myalgia, with or without eschar/rash. People with severe illness may develop organ failure and bleeding which can be fatal if left untreated. This study was done to detect outbreak of cases of scrub typhus in Eastern India. These mites generally live in paddy fields of forested area and people visiting those areas are generally affected. Now a days these mites migrate to urban area resulting in increased incidence of scrub typhus infection in urban area. This study was conducted in collaboration with another institute. The purpose of this study was to find out the incidence of scrub typhus in our area and the relationship between occurrence of scrub typhus and seasonal, age and sex variation. METHODS This study was carried out in our tertiary care hospital with 441 samples for a period of one year (01.01.2019 to 31.12.19). All the blood samples collected from febrile patients were subjected to Weil Felix test. If the titre is > 1 : 160; this was further confirmed by specific IgM testing. Both Weil-Felix tests and IgM scrub typhus positive tests were noted. RESULTS Out of 441 samples, 98 (22.2 %, n = 441) samples were positive for both WeilFelix and scrub typhus IgM by enzyme linked immunosorbent assay (ELISA) testing. Most of the cases were seen in males. Seasonal distribution showed higher cases in the months of September and October. CONCLUSIONS In our study, the highest numbers of scrub typhus cases were found in rural areas, during the harvesting period of July–September specially in monsoon or post monsoon period when there is abundance of mite larva. This infection is also reported high in cases among children in the age group of 1 - 14 years. Patients who tested positive for scrub typhus improved radically with doxycycline. KEYWORDS Orientia Tsutsugamushi, Scrub Typhus, IgM ELISA

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Background: Chikungunya virus (CHIKV) and dengue viruses (DENV) are both present individually in West Bengal and infection caused by both simultaneously has been recorded since 1965. Objectives: In 2011, a study was carried out to detect co-infection due to both the viruses from 671 blood samples collected from febrile patients attending OPDs and in-patient departments of different tertiary care hospitals of Kolkata and different district hospitals of West Bengal from March 2011-November 2011. The samples were tested for immunoglobulin M (IgM) antibody against both CHIKV and DENV by the enzymelinked immunosorbent assay (ELISA). Result: 493 patients (73.47%) had IgM antibody against CHIKV and 105 (15.65%) patients had IgM antibody against DENV, whereas 41 patients (6.11%) had IgM antibodies against both CHIKV and DENV. Fever, joint pain, rashes, headache, body-ache were the common complaints. Severe arthralgia and joint swelling was complained mainly by the CHIKV-positive cases. Headache, retro-orbital pain and altered sensorium were mainly associated with DENV positive cases. No mortality was observed. Conclusion: Detection of IgM antibodies by ELISA against both appears to play an important role in differentiating between the two and initiating proper treatment.

BACKGROUND Delhi is hyperendemic for dengue virus (DENV) where all the four DENV have been previously reported. A constant vigilance of circulating dengue virus serotypes is important in surveillance, since the introduction of a new variant to areas affected by pre-existing serotypes constitutes a risk factor for DHF and Dengue Shock Syndrome. OBJECTIVES This retrospective study was carried out with an objective to determine the circulating serotype and genotype of Dengue virus in acute phase blood samples of patients who reported to a tertiary liver care hospital in New Delhi during the last two years (2017 to 2018). METHODS The data of clinician-initiated testing for dengue NS1 antigen was searched in the institutional hospital information system. The serum sample of dengue NS1 antigen positive cases confirmed by ELISA (PANBIO, Gyeonggi-do, ROK) and a fever duration of less than 5 days were retrieved from the laboratory archive. The dengue virus serotyping on these sample were carried out by reverse transcriptase PCR. Sequencing and phylogenetic analysis was done for the capsid-pre membrane (CPrM) region to determine the genotype. RESULTS A total of 440 acute-phase samples were received. Twenty one(4.77%) were positive for dengue NS1 antigen with a mean age of 35.1 years and male to female ratio of 1.1:1. Eight cases (38.09%) were positive by Dengue RT-PCR and all belonged to DENV-3 serotypes. Phylogenetic tree analysis revealed DENV-3 clustered to genotype III with 100% homology with 2008 Indian subcontinent strain. CONCLUSION This study revealed that the present circulating dengue virus serotype in Delhi is DENV 3 genotype III. It is similar to previously isolated 2008 Indian subcontinent strain suggesting neither any change in serotype nor any further evolution of DENV 3. That explains the present relatively stable dengue endemicity in Delhi NCR.

Background: Japanese encephalitis virus (JEV) is a flavivirus related to dengue, yellow fever and West Nile viruses, and is spread by mosquitoes. JEV is the main cause of viral encephalitis in many countries of Asia with an estimated 68000 clinical cases every year. Although symptomatic Japanese encephalitis (JE) is rare, the case-fatality rate among those with encephalitis can be as high as 30%. Permanent neurologic or psychiatric sequelae can occur in 30-50% of those with encephalitis. This study was conducted to find the incidence of JEV IgM in patients presenting with acute encephalitis syndrome (AES) in Raiganj govt. medical college and hospital, Uttar Dinajpur, West Bengal, India.Methods: Blood and CSF samples were collected from patients presenting with AES. IgM antibody capture ELISA was performed on the CSF and serum samples by JE virus MAC ELISA kit.Results: The overall prevalence of JEV IgM was 13.8%. Among the positive cases male comprised of 71.4% and female 28.5%. The most common age group affected was above 16 years of age. JEV prevalence was present throughout the year with high number of cases between the monsoon and post monsoon seasons.Conclusions: This study demonstrates the endemicity of JEV in Uttar Dinajpur district of West Bengal, India. As most of the JE cases are asymptomatic strengthening the existing surveillance system is required to find out the actual scenario of JEV in West Bengal. Control of vectors, early diagnosis and treatment, vaccinations are the key to decrease the morbidity and mortality caused by JEV.