Full text loading...
7 : Chandipura Encephalitis: a Newly Recognized Disease of Public Health Importance in India
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.