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7 : Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India

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Abstract:

Until recently, Japanese encephalitis (JE) was recognized as the only encephalitis having outbreak potential in India. The clinical features described for the viral encephalitis outbreak in Raipur and Jabalpur in 1980 exactly match the typical case definition of Chandipura (CHP) encephalitis. Undoubtedly, the virus has now attained the status of an important emerging pathogen of public health significance. In this chapter, the author briefly describes the outbreaks that have led to the identification of this disease and also provides a brief description of the classical, as well as modern, virological techniques used. Other important studies that have been undertaken on the virus and disease are also summarized. An outbreak of acute encephalitis of unknown origin with a high case fatality rate (CFR) was reported in children from 11 districts of Andhra Pradesh, India, during 2003. The general clinical features of CHP encephalitis include high-grade fever of short duration, vomiting, altered sensorium, generalized convulsions, and decerebrate posture, leading to grade IV coma, acute encephalitis/encephalopathy, and death within a few to 48 hours of hospitalization. Based on the G-gene sequence of an Indian CHP virus isolate (GenBank accession number J04350), the diagnostic PCR was standardized. Genomic DNA was extracted from frozen peripheral blood mononuclear cells. For HLA A, B, and C typing, a PCR-single-strand polymorphism molecular method was followed. To overcome chance deviation in the frequency of the HLA allele, the P value was corrected by the use of the Bonferroni inequality method.

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
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Figures

Image of Figure 1.
Figure 1.

Negatively stained electron micrograph of CHP virus.

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
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Image of Figure 2.
Figure 2.

Phylogenetic tree for all Indian isolates. Percent bootstrap support is indicated by each node. AP, Andhra Pradesh; MAH, Maharashtra.

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
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Image of Figure 3.
Figure 3.

Phylogenetic analyses of the complete G gene (a), P gene (b), and N gene (c) of CHP virus isolates. Percent bootstrap support is indicated by the value at each node. For G- and P-gene-based analyses, Piry virus (accession number D26175) was used as an outgroup. For the N gene, an unrooted tree was constructed, as the sequence for Piry virus was not available.

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
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Image of Figure 4.
Figure 4.

Alignment of the deduced amino acid sequences of the G proteins of different isolates of CHP virus. The solid bars represent the signal sequence (amino acids 1 to 18), transmembrane region sequence (amino acids 482 to 502), and intracytoplasmic region sequence (amino acids 503 to 530). Dashes indicate no data, and dots indicate the same amino acid as above.

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
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References

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Tables

Generic image for table
Table 1.

Relationship of anti-CHP virus antibodies to number of DPO of sample collection in Andhra Pradesh, 2003

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
Generic image for table
Table 2.

Encephalitis cases showing CHP virus IgM antibodies in different districts of Maharashtra, 2003

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
Generic image for table
Table 3.

Neutralization test results for human sera collected between 1955 and 1966 from different parts of India

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7
Generic image for table
Table 4.

N Abs for CHP virus in different animals collected in 2003 and 2004

Citation: Chandra Mishra A. 2007. Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India, p 121-137. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch7

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