Chandipura virus disease is caused by infection with a virus after being bitten by a sandfly. Sporadically this virus rears its ugly head and causes large outbreaks of fast emerging encephalitis or brain inflammation with extremely high mortality, especially in children.
While this disease is thought to mainly claim victims in the Indian subcontinent, this virus has been found to be wide-spread in tropical regions. The number of cases is unknown due to the fact that systematic surveillance of this disease is severely lacking.
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What causes Chandipura virus disease
Chandipura virus is usually transmitted by the bite of Phlebotomine sandflies and, to a lesser extent, other insects like mosquitoes and ticks. Sand-flies typically live in the cracks of mud and sand houses, which makes rural populations particularly susceptible to infection.
Chandipura virus disease is caused by the Chandipura vesiculovirus, a member of the Rhabdoviridae family of viruses that is associated with encephalitic illness (inflammation of the brain) in humans. The virus was named for the Chandipura village in Maharashtra, a state in central India, where it was first identified in 1965.
Where is Chandipura virus found
The virus was originally discovered in India, and since then has been associated with multiple cases of encephalitic illness in India.
The virus is ubiquitous in the Indian sub‐continent, Srilanka and West-Africa, indicating a wide distribution. However, no human cases of the virus have been recorded outside of India, likely due to a lack of systematic surveillance for this disease.
Risk factors include poverty, malnutrition, deforestation, lack of sanitation, suppressed immune system and urbanization.
What are the symptoms of Chandipura virus disease
The virus initially causes symptoms similar to that of the flu, such as high fever and headache. However, unlike the flu, acute encephalitis often follows with symptoms such as convulsions and vomiting and a rapid deterioration of the patient. Death occurs usually within a few to 48 hours of hospitalization.
Especially in children below the age of 15 the disease progresses fast.
Case fatality rates range from 56 to 75 per cent in cases with typical encephalitic symptoms.
How can Chandipura virus disease be prevented
Prevention is by avoiding bites of sand-flies. The disease can be partly prevented by using nets treated with insecticide while sleeping. To provide good protection against sand-flies, fine mesh sizes of 0.6 mm or less are required. Covering doors and windows with nets is also recommended. Programs of fumigation to reduce the number of sand-flies by using insecticides to locally reduce the risk.
Raising awareness in areas that are endemic to the disease is crucial to maintain preventative measures.
Currently there is no approved available vaccine against Chandipura virus.
How is Chandipura virus disease diagnosed
Chandipura virus disease shares many symptoms with other viral diseases but is marked by a rapidly progressing encephalitis with poor outcomes.
Polymerase chain reaction (PCR) tests, such as the ones made available by the WoIDMo are used to diagnose the disease. Due to the disease being relatively rare and occurring in outbreaks, access to diagnostics can be an issue.
Early diagnosis and fast treatment reduces the prevalence of the disease and prevents disabilities and death.
How is Chandipura virus disease treated
There is no specific treatment for Chandipura virus disease. Treatment typically relies on supportive care and managing the symptoms of the disease, such as administering mannitol to treat brain edema. No data is available on the effectiveness of antivirals.
In the case of outbreaks and in endemic areas of the virus, prevention is the best treatment.
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