An Outbreak of Chandipura Virus Encephalitis in the Eastern Districts of Gujarat State, India

Abstract

An outbreak of encephalitis with a case fatality rate of 78.3% was investigated among children in Gujarat State, India. Twenty-six cases were reported. Three patients had IgM antibodies to Chandipura virus. Virus was isolated from one patient with rhabdomyosarcoma in porcine stable cell lines and in suckling mice. Chandipura virus RNA was present in 9 of 20 acute-phase serum samples, and virus sequences from the present outbreak were closely related to prototype strain (1965) and Andhra Pradesh, India (2003) isolates. Serologic and molecular assays documented the absence of Japanese encephalitis virus, West Nile virus, dengue virus, and paramyxoviruses in clinical samples. The etiologic agent was Chandipura virus, which has become an important encephalitis-causing virus in India.

Changing epidemiology of hepatitis A virus in Indian children

“…India has experienced HAV outbreaks in children, 24 children and young adults, 25 and adults. 26 The World Health Organization (WHO) recommends large-scale hepatitis A vaccination in countries with improving SEC that have moved from high to intermediate hepatitis A endemicity.…”

The host-range tdCE phenotype of Chandipura virus is determined by mutations in the polymerase gene

“…CV was first isolated in 1965 from two adults presenting with febrile illness in Nagpur district, Maharashtra state, India (Bhatt & Rodrigues, 1967), and was later isolated from a patient suffering from encephalopathy syndrome in 1980 (Rodrigues et al, 1983). CV epidemics occurred in Andhra Pradesh and Maharashtra in 2003, Gujarat state in 2004and Maharashtra in 2005(Chadha et al, 2005Gurav et al, 2010;Tandale et al, 2008). The epidemic case fatality rates were high: 41 % in Maharashtra, 55.6 % (183 out of 329 cases) in Andhra Pradesh in 2003, 78.3 % (18 out of 23 cases) in Gujarat in 2004 and 44 % (34 out of 78 cases) in Maharashtra in 2007 (Chadha et al, 2005;Gurav et al, 2010), giving a mean of 54.8 %.…”

Is Chandipura virus an emerging human pathogen?

“…Epidemic coma was reported as epidemic brain attack of childhood (EBAC) (supported by clinical features, normal CSF in all cases, neuroimaging, and response to treatment) [3][4][5] or Chandipura encephalitis (supported by virus isolation, identification by electron microscopy, immunofluorescence, and PCR). [6][7][8][9] CHPV is ubiquitous in the Indian subcontinent (at least since 1955), 1 Srilanka, 10 and Africa (Nigeria, Senegal). 11 12 Human cases have only been reported from India.…”