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Health & Medicine
Mahesh

17/07/24 11:42 AM IST

Chandipura virus infection in Gujarat

In News
  • The Gujarat government recently said that six children have died of suspected Chandipura virus (CHPV) infection in the state since July 10.
About CHPV
  • CHPV is a virus of the Rhabdoviridae family, which also includes other members such as the lyssavirus that causes rabies.
  • Several species of sandflies like Phlebotomine sandflies and Phlebotomus papatasi, and some mosquito species such as Aedes aegypti (which is also the vector for dengue) are considered vectors of CHPV.
  • The virus resides in the salivary gland of these insects, and can be transmitted to humans or other vertebrates like domestic animals through bites.
  • The infection caused by the virus can then reach the central nervous system which can lead to encephalitis — inflammation of the active tissues of the brain.
Symptoms
  • The CHPV infection presents initially with flu-like symptoms such as acute onset of fever, body ache, and headache.
  • It may then progress to altered sensorium or seizures and encephalitis.
  • Retrospective studies from India have also reported other symptoms such as respiratory distress, bleeding tendencies, or anaemia.
  • The infection often progresses rapidly after encephalitis, which may then lead to mortality within 24-48 hours of hospitalisation, according to studies.
  • Susceptibility has largely remained limited to children below 15 years
  • The infection can only be symptomatically managed as currently there is no specific antiretroviral therapy or vaccine available for treatment.
  • As a result, it becomes crucial to manage brain inflammation to prevent mortality.
  • Disease progression can be as rapid as a patient reporting high fever in the morning, and their kidneys or liver being affected by the evening.
  • This makes it harder to manage the symptoms, according to several paediatricians.
Worst affected regions in India
  • The CHPV infection was first isolated in 1965 while investigating a dengue/chikungunya outbreak in Maharashtra.
  • However, one of the most significant outbreaks of the disease in India was seen in 2003-04 in states such as Maharashtra, northern Gujarat and Andhra Pradesh, with the three states reporting more than 300 deaths of children.
  • Gujarat, during the 2004 outbreak, saw a case fatality rate (CFR) of around 78% while CFR in Andhra Pradesh, during the 2003 outbreak, was pegged at around 55%.
  • The infection has largely remained endemic to the central part of India, where the population of CHPV infection-spreading sandflies and mosquitoes is higher.
  • The outbreaks are often reported in rural, tribal and peripheral areas, and the same may have a correlation with the prevalence of sandflies in these areas.
  • There is also a seasonal aspect to the infection where outbreaks are reported more when the sandflies’ population increases.
  • Sandflies usually do not fly at a height more than 3 feet from the ground but this time during surveillance, sandflies have been found on terraces and higher heights.
  • Additionally, of the six suspected deaths so far, two presented with brain haemorrhages.

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