The World Health Organization (WHO) has highlighted that the recent outbreak of the Chandipura virus in India is the largest in 20 years. The Chandipura virus (CHPV) was first identified in the Chandipura district in Maharashtra, India. It is an emerging arbovirus from the Rhabdoviridae family. It is known to cause sporadic neurological symptoms that can be fatal. It also causes encephalitis and high mortality rates. This virus affects mainly children and young adults. This virus outbreak affected a larger geographical area and caused many deaths compared to previous outbreaks. So WHO reported that India’s Chandipura outbreak is the largest in the past 20 years.
History & background
The Chandipura virus was first isolated in 1965 from the blood of two fever-stricken patients in Chandipura district, Maharashtra. The virus was identified by Dr. R. D. Work and his colleagues at the National Institute of Virology in Pune. After identification, doctors and researchers said the Chandipura virus is the leading cause of Acute Encephalitis Syndrome (AES). This virus primarily attacks children and young adults and is a transmitted disease. It is transmitted mainly by sandflies, especially Phlebotomus papatasi.
Sometimes, especially during monsoon season, mosquitoes transmit this fatal virus because rainy seasons provide perfect conditions and weather for vector proliferation. The Chandipura outbreak in 2024 is not the first time in India before 2024. In 2003 and 2009, this outbreak happened in Gujarat. However, the 2024 outbreak was fatally surpassing the other two Chandipura outbreaks.
Distribution of Chandipura virus
Image Credit – NCBI
Virology and Epidemiology of Chandipura Virus
The Chandipura virus is from the Rhabdoviridae family, including rabies. It is primarily transmitted through the bite of infected sandflies, but mosquitoes and ticks also carry this acute encephalitis-causing virus. It is a negative-sense, single-stranded RNA virus and part of the Vesiculovirus genus. The host cell translates it into proteins. The genetic material of this virus is RNA, which is encapsulated by a nucleoprotein, and the virus also has some structural proteins for its replication and survival. The genome is approximately 11 kilobases in length. It encodes five proteins: N (nucleoprotein), P (phosphoprotein), M (matrix protein), G (glycoprotein), and L (large protein). These proteins are essential for the replication of the Chandipura virus.
It causes inflammation or swelling of the brain tissue. The symptoms of Chandipura virus infection are rapid fever, followed by vomiting, convulsions, diarrhea, inability to speak, imbalanced body, low vision, headaches, photophobia, muscle weakness, coma etc. In 2003, a sizable fatal outbreak of acute encephalitis associated with the Chandipura outbreak happened in Andhra Pradesh, India. This virus mainly affects children and young adults who are under 15. Most of the infected people died within 48 to 72 hours after hospital admission.
Genome structure of Chandipura virus
Image Credit – NCBI
Public Health Response
The Indian government takes various steps to control the vectors. They collaborate with state authorities and try to control the situation and with several international bodies, WHO for technical support, guidance and resource sharing. Although there is no specific treatment for this deadly virus yet the government has been advised to take some precautions, also Gujarat Health Minister has said to not panic as the situation is under control. The Indian Government and Health authorities have taken a number of stages in order to control the situation and to manage the Chandipura outbreak.
The government has enhanced diagnostic facilities and protocols to ensure accurate and timely detection of the Virus including the use of advanced laboratory techniques like PCR (Polymerase Chain Reaction). As this Virus Transmitted by insects, specifically mosquitoes, several initiatives have been undertaken to control the mosquito population like insecticide spraying, eliminating mosquito breeding sites, and using larvicides.
Moreover, the government has also initiated public awareness campaigns so that the public are able to inform the public about the virus, its transmission, and preventive measures. This includes disseminating information through media, community health programs, and public health announcements. Several indigenous health initiatives have been undertaken including targeted health interventions and local health campaigns by the government on the areas where the outbreaks of the Chandipura Virus is more. Also they have been initiated to strengthen healthcare infrastructure so they can handle the outbreaks including providing training to the healthcare workers and ensuring the availability of medical supplies and enhancing the treatment protocols.
The government has been confronted with a number of challenges in order to manage the Chandipura outbreak. Identifying the virus in the early stage is becoming challenging due to its rare occurrence and non-specific nature of the symptoms of the virus. It has become challenging to identify the virus in the early stage and also to provide advanced diagnostic tools and facilities might be limited, especially in rural or underserved areas.
Impact of this outbreak
The Chandipura Virus has significantly impacted the health of the individual and it causes encephalitis, leading to high morbidity and mortality rates. Survivors of this virus may experience long-term neurological complications. This outbreak has led to shortage to the local healthcare facilities and trained personnel and medication. For the treatment of this virus the cost is a burden for the individual as well as the healthcare providers. The outbreak of this virus suggestively affected the economy particularly if they affect key industries or lead to restrictions on movement and trade. The Chandipura outbreak has disrupted normal social activities and community life and leads to social isolation.
CHPV is a serious public health concern specifically in endemic regions understanding its causes, symptoms and treatment is crucial to combating this deadly disease. Chandipura outbreak infection is primarily caused by the bites of the infected sand flies. These tiny insects when the infected sandfly bites a human it injects the virus into the bloodstream initiating the infection process the virus then travels to different parts of the body including the brain where it can cause severe neurological symptoms.
Understanding the role of sandfly in CHPV transmission is crucial for implementing effective control measure awareness and education are key these measure include vector control strategies such as insecticide spraying and personal protection against the sandfly bites like including bed nets and repellants the symptoms of the Chandipura outbreak infection often appear suddenly. The early symptoms can easily be mistaken for other common illnesses, one of the most common initial symptoms is a high fever; this fever can be accompanied by chills and shivering; other early symptoms include headache, muscle pain and general weakness.
Due to fear of this deadly virus also significant disruption has been found in the education and impacted students’ learning and education. The outbreak of this deadly virus has imposed fear and anxiety among the population and it has suggestively impacted the mental health and wellness of the individual. This outbreak has changed the behavior in response to this outbreak and people have been starting to avoid public spaces. The Chandipura outbreak can have wide-ranging impacts that affect individual health, economic stability, social dynamics, and public health systems. Effective management and response strategies are crucial to mitigating these impacts and protecting public health.
In July 2024, the outbreak occurred, particularly affecting children in Sabarkantha district, Gujarat. At the end of July, 245 confirmed cases of Acute Encephalitis Syndrome were reported, with 82 deaths. The fatality rate is 33%. Of these, 64 cases are confirmed instances of Chandipura virus infection.
Diagnosis & Treatment
Diagnosing the Chandipura outbreak can be challenging this is because the symptoms often mimic those of other viral incilius cases making it difficult to distinguish without specific tests however early diagnosis is critical for enhancing the chance of survival and preventing severe complication doctors use a combination of methods to diagnose Chandipura outbreak infection ensuring a comprehensive approach. The first step usually involves physical examination and a detailed review of the patient’s medical history.
This helps in understanding the patient symptoms and potential exposure to sand flies which are known carriers of the virus laboratory tests play a vital role in confirming the diagnosis providing concrete evidence of the infection. One of the most common and reliable tests is the polymerase chain reaction or PCR test. This test detects the presence of viral RNA in the patient’s blood or cerebrospinal fluid offering a precise diagnosis. Other tests such as the serological tests detect antibodies produced by the body in response to the virus indicating an immune response.
However, they may not be as reliable in the early stages of the infection as the body may not have produced enough antibodies yet. Combining these diagnostic methods helps healthcare professionals make an accurate diagnosis and plan appropriate treatment early and accurate diagnosis and plan the appropriate treatment is essential for effective treatment and better patient outcomes highlighting the importance of these diagnostic tools. Once Chandipura enters the bloodstream it begins to replicate rapidly spreading throughout the body at an alarming rate.
It targets the central nervous system, specifically the brain and spinal cord, which are crucial for controlling bodily functions; this leads to inflammation of the brain, a condition known as sephit which can cause severe headache, fever and confusion. The virus’s ability to cross the blood brain barrier makes it particularly dangerous as it can evade the body’s natural defenses. This barrier acts as a shield around the brain but CHPV can bypass it causing severe damage and making the treatment more challenging.
FAQ
How can we protect against the Chandipura virus?
To control the Chandipura virus we can prevent mosquito populations like insecticide spraying, eliminating mosquito breeding sites, and using larvicides and bed nets.
What are the antidotes for Chandipura virus?
Although there is no specific treatment for this deadly virus yet the government has been advised to take some precautions.
When was the first case of Chandipura found in India?
The Chandipura virus was first isolated in 1965 from the blood of two fever-stricken patients in Chandipura district, Maharashtra.
What is the Chandipura virus outbreak 2003?
In 2003, a sizable fatal outbreak of acute encephalitis associated with the Chandipura outbreak happened in Andhra Pradesh, India.
What is the Chandipura outbreak?
Chandipura outbreak infection is primarily caused by the bites of the infected sand flies, mosquitoes. These tiny insects when the infected sandfly bites a human it injects the virus into the bloodstream initiating the infection process the virus then travels to different parts of the body including the brain where it can cause severe neurological symptoms.
Which flies cause the Chandipura outbreak?
The Chandipura outbreak is mainly transmitted by sandflies, especially Phlebotomus papatasi.
Who identified the Chandipura Virus?
The virus was identified by Dr. R. D. Work and his colleagues at the National Institute of Virology in Pune.
