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The deaths due to an "unknown" disease in Kandhamal district of Odisha increased to 10 on Wednesday with two more persons breathing their last at the MKCG Hospital at Berhampur. Although the first death took place at Gudrigaon village of Kandhamal six days ago, the authorities had not been able to conduct the necessary examination to know the cause of the deaths so far. Even as the state government had sent a medical team, the death toll was likely to rise as more 10 persons were admitted to different hospital. All the deaths had taken place in Gudrigaon village so far though some people from a neighbouring village had been taken ill with similar symptoms. While some were of the view that deaths could be due to cerebral malaria, others were suspecting that the deaths were due to consumption of poisonous mushrooms. Meanwhile, a team of medical experts from the Regional Medical Research Centre in Bhubaneswar left for Kandhamal to inquire about the cause of the deaths as they were suspecting that the deaths could have taken place due to some viral infection.
It was not botulism or food-poisoning which killed the dozen villagers in Kandhamal’s Gudrigaon last month. A deadly virus called Chandipura which had swept across Andhra Pradesh and Maharashtra in the past with an alarming fatality rate is the killer. Between September 17-25, at least 11 deaths were reported at Gudrigaon, close to Daringibadi, even as Health administration found it hard to ascertain the reason attributing botulism (a bacterial infection caused by toxic food) to be the main cause. Eight of the victims were children below 10 years. A team from Regional Medical Research Centre (RMRC) which carried out field investigation collected blood and serum samples of family contacts and other acquaintances who had developed symptoms of motor weakness, vomiting and convulsion followed by spells of unconsciousness and neurological problems with the help of Health Department officials.
Since similar sporadic cases were reported from Malkangiri in early October, samples were collected from the affected persons there. The samples, sent to National Institute of Virology (NIV), Pune, were subjected to specific ELISA test. Of the total 30 samples, four tested positive for Chandipura virus encephalitis. Of the 21 collected from Gudrigaon, three were positive pointing out what claimed the lives in Kandhamal. The virus spreads fast but it was not known how it transmitted. "Clinically, it is after four days of the onset of symptoms that antibody is developed in patients. Since a number of serum samples were collected in the first three to four days, not all cases would come positive,’’ Dr SK Kar, Director of RMRC said. Chandipura virus, first reported from a village in Nagpur in 1965, owes its clinical name to the place. In 2003, when an outbreak of acute encephalitis took place in Andhra Pradesh, 329 children were affected out of which 183 died. Similarly, 115 casualties were reported from Vidarbha and Marathwada regions during the same period. In 20 per cent cases, the Chandipura virus was found present.
In most cases, children were victims with 80 per cent deaths occurring in 24 hours of hospitalisation. Kar said, complete information on source and the vector has not been found yet. The situation, however, could pose a challenge since the virus has been spotted in Malkangiri and Koraput.
Chandipura virus is a member of the Rhabdoviridae family that is associated with an encephalitic illness in humans. It was first identified in 1965 after isolation from the blood of two patients from Chandipura village in Maharashtra state, India (Bhatt et al.,1967) and has been associated with a number of otherwise unexplained outbreaks of encephalitic illness in central India. The most recent occurred in Andhra Pradesh and Maharashtra in June-August 2003 with 329 children affected and 183 deaths (Rao et al, 2004). Further sporadic cases and deaths in children were observed in Gujarat state in 2004 (Chadha et al, 2005).
Chandipura virus has been isolated from sandflies in India and West Africa (Fontenille et al., 1994) and is probably spread through its bite. The presence of the virus in Africa indicates a wide distribution although no human cases have been observed outside of India.
The significance of Chandipura virus as a human pathogen is unresolved due to doubts over its role in the 2003 and 2004 outbreaks.