Chandipura virus encephalitis outbreak among children in Nagpur division, Maharashtra, 2007.
OBJECTIVE
An outbreak of acute encephalitis syndrome (AES) among children from Nagpur division, Maharashtra was investigated to confirm the aetiology and to describe clinico-epidemiological features.


METHODS
AES cases among children<15 yr, from Nagpur division, hospitalized between June-September 2007, were investigated. Serum and cerebrospinal fluid (CSF) were tested for IgM antibodies against Chandipura virus (CHPV) and Japanese encephalitis virus (JEV) and for CHPV RNA by RT-PCR. Partial N gene sequences were used for phylogenetic analysis. Virus isolations were attempted in rhabdomyosarcoma (RD) cell line. Sandflies were collected, pooled and tested for CHPV RNA by RT-PCR.


RESULTS
A total of 78 AES cases were recorded in children<15 yr of age. Case fatality ratio was 43.6 per cent. Male to female ratio was 1:1.2. Chandipura (CHP) was confirmed in 39 cases. CHPV RNA was detected in both CSF and serum specimens of 2 cases and in serum of 22 cases. Phylogenetic analysis showed 99.98-100 per cent nucleotide identity in the sequences studied. Anti-CHPV IgM antibodies were detected in CSF of 2 cases and in serum of 8 cases. Seroconversion to anti-CHPV IgM antibodies was observed in 5 cases. Clinical manifestations of CHP cases (n=38) were fever (100%), convulsion (76.3%), altered sensorium (34.2%), headache (23.7%), vomiting (44.7%) and diarrhoea (23.7%). CHPV RNA was detected in one of two pools of sandflies from affected locality.


CONCLUSIONS
Chandipura virus was confirmed as the aetiological agent of this acute encephalitis outbreak with high case-fatality among children.
Gurav
Yogesh K
YK
National Institute of Virology (ICMR), Pune, India.
Tandale
Babasaheb V
BV
Jadi
Ramesh S
RS
Gunjikar
Rashmi S
RS
Tikute
Sanjaykumar S
SS
Jamgaonkar
Aniruddha V
AV
Khadse
Ravindra K
RK
Jalgaonkar
Suresh V
SV
Arankalle
Vidya A
VA
Mishra
Akhilesh C
AC
D000818:Animals; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D001483:Base Sequence; D045744:Cell Line, Tumor; D002648:Child; D016000:Cluster Analysis; D017931:DNA Primers / Q000235:genetics; D004196:Disease Outbreaks; D018792:Encephalitis, Viral / Q000453:epidemiology* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007303:Insect Vectors / Q000821:virology*; D008297:Male; D008969:Molecular Sequence Data; D019590:Nucleocapsid Proteins / Q000235:genetics; D010802:Phylogeny; D011576:Psychodidae / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018353:Rhabdoviridae Infections / Q000453:epidemiology* / Q000473:pathology; D017422:Sequence Analysis, DNA; D018116:Vesiculovirus / Q000235:genetics*
D000914:Antibodies, Viral; D017931:DNA Primers; D019590:Nucleocapsid Proteins