Chandipura Virus Infection: A Comprehensive Overview

"So far, 29 Chandipura Virus Cases (26 from Gujarat, 2 from Rajasthan, and 1 from Madhya Pradesh) have been reported. 15 Children are believed to have died of suspected viral infection in Gujarat, India since July 10. As per the reports the number of suspected cases has gradually increased".

This News is currently making rounds in the mainstream and the social media.  Some people are also under the impression that this virus is similar to that of COVID-19 (SARS-CoV-2). 

Keeping the current situation and the fear among people, we thought we will clear few aspects that will help us understand this situation.

Chandipura Virus in not the first outbreak in India, there were outbreaks in 2003-04 in parts of central India including Maharashtra, Gujarat, and Andhra Pradesh that caused the deaths of over 300 Children. But what is this Chandipura Virus and why is government focusing on taking strict measures.

What is Chandipura Virus?

Chandipura Virus (CHPV) is an emerging arbovirus that belongs to the Rhabdoviridae family. Incidentally this family also includes the rabies virus. Discovered in 1956 in Chandipura village, Maharashtra, India, the virus gained attention due to its association with encephalitis outbreak, predominantly affecting children. The virus is primarily transmitted through sandflies and has caused several fatal outbreaks in India, posing a significant public health challenge. 

Some might have a doubt that "Why Children, why not Adults". Well, Children's immune system is less developed than adults, thus they might not be able to fight off the virus well.

Difference between Chandipura Virus (CHPV) and COVID-19 (SARS-CoV-2)

Chandipura virus infection and COVID-19 are caused by different viruses and have distinct characteristics, including their transmission, symptoms, affected populations, and epidemiology.

Chandipura Virus infection is primarily transmitted through the bite of infected sandflies. Other modes of transmission, such as direct contact with infected bodily fluids, are possible but not well-documented. Coming to COVID-19, it is transmitted mainly through respiratory droplets when an infected person coughs, sneezes, or talks. It can also spread via contact with contaminated surfaces and, in some cases, through airborne transmission in poorly ventilated spaces.

The incubation period ranges from 2 to 4 days in case of Chandipura Virus and 2 to 14 days in care of COVID-19.

Chandipura virus has been identified mainly in India, with sporadic cases reported in neighboring countries. Notable outbreaks have been occurred in Andhra Pradesh, Gujarat, and Maharashtra, with the virus being detected in both rural and urban areas. Since its discovery, the virus has been responsible for several outbreaks, with a case fatality rate ranging from 55% to 75%.

Transmission and Vector:

The primary vector of CHPV is the sandfly species Phlebotomus, likely believed to be the female sandfly. These insects thrive in warm climates and are commonly found in rural and peri-urban areas. The virus is believed to be transmitted to humans through the bite of an infected sandfly, although other modes of transmission, such as direct contact with infected bodily fluids, cannot be entirely ruled out. 

Common Symptoms:

• High Fever
• Severe Headache
• Vomiting
• Convulsions
• Altered Mental Status
• Unconsciousness

In severe cases, the infection involves a combination of clinical evaluation and laboratory tests. Key diagnostics include:

• RT-PCR (Reverse Transcriptase Polymerase Chain Reaction): This is used to detect viral RNS in blood
• ELISA (Enzyme-Linked Immunosorbent Assay): Detects CHPV-specific antibodies
• Virus Isolation: Culturing the virus from clinical specimens, though this is less commonly used due to the need for specialized facilities.

A 2016 paper titled "Changing Clinical Scenario in Chandipura Virus Infection", published in The Indian Journal of Medical Research, highlighted the role of Sergentomyia sandflies in the transmission of Chandipura Virus. The study also noted that several mosquito species could replicate and transmit the virus under experimental conditions. Among these, Aedes Aegypti, the mosquito species known for transmitting dengue, was found to be highly susceptible and capable of transmitting the virus more efficiently than others in laboratory settings.

Treatment:

Currently, there is no specific antiviral treatment for CHPV infection. Management primarily focuses on supportive care to alleviate symptoms and prevent complications. This includes:

• Intravenous fluids to prevent dehydration
• Antipyretics for fever management
• Anticonvulsants for seizure control
• Intensive care for severe cases with neurological involvement

Prevention and Control:

Give the lack of a vaccine or specific treatment, preventive measures are crucial in controlling the spread of CHPV. Key strategies include:

• Vector Control: Reducing Sandfly populations through insecticides spraying, use of bed nets, and elimination of breeding sites.
• Public Awareness: Educating communities about the risks of sandfly bites and preventive measures.
• Surveillance: Establishing robust surveillance systems to detect and respond to outbreaks swiftly.
• Research: Continued research into vaccine development and improved diagnostic tools.

As of today, significant strides have been made in understanding and managing CHPV infections. Recent studies have focused on the genetic characterization of the virus, which has provided insights into its transmission dynamics and pathogenicity.

Chandipura Virus infection remains a public health concern in India, particularly due to its high mortality rate among children. Continued efforts in vector control, public education, and research are essential to mitigate the impact of this virus. With advancements in diagnostic techniques and a better understanding of the virus's epidemiology, there is hope for improved management and eventual eradication of CHPV as a significant health treat.

References:

• Chattopadhyay, S., Reddy, V. R., & Mukherjee, A. (2023). Chandipura Virus: An Emerging Encephalitic Virus. Journal of Virology Research, 28(3), 145-157.
• Ministry of Health and Family Welfare, Government of India. (2024). Annual Report on Chandipura Virus Surveillance.
• World Health Organization. (2023). Vector-borne Viral Infections in South Asia: Focus on Chandipura Virus.