Rare Chandipura virus kills 8 children in India and sparks encephalitis outbreak concerns

Infection causes flu symptoms, vomiting and swelling of brain

At least eight Indian children have died in the past week from suspected infection by the relatively unknown Chandipura virus, sparking concerns about an encephalitis outbreak.

Seven children are fighting for their lives in hospital, Rushikesh Patel, health minister in the western Gujarat state, said.

Chandipura virus, or CHPV, is named after Chandipura village in coastal Maharashtra state where it was first identified during an investigation into a dengue and chikungunya outbreak in 1965.

An RNA virus of the Rhabdoviridae family, which includes the rabies virus, it primarily affects children and is associated with outbreaks of acute encephalitis in India.

“This disease occurs by the sting of a vector-infected sandfly and mainly affects children aged 9 months to 14 years," Mr Patel was quoted as saying by India Today.

“It is seen more in rural areas. Fever, vomiting, loose motion and headache are the main symptoms.”

The virus “has garnered significant attention in recent years due to its potential to cause severe and often fatal illnesses in humans, particularly children", Dr Neha Rastogi Panda, an infectious diseases specialist at the Fortis Memorial Research Institute in Gurugram, told IANS.

The virus lives in the salivary glands of the sandfly and the Aedes aegypti mosquito. It can move into the central nervous system after infecting a child, causing encephalitis or inflammation of the active brain tissue.

It initially presents symptoms like fever, body ache and headache but progresses to seizures, altered sensorium and encephalitis within 24 to 72 hours.

Although the disease is not contagious, it requires early diagnosis and supportive care due to the rapid onset of severe symptoms, lack of specific antiviral treatments or vaccines, making it a severe challenge for doctors and public health officials.

“Only symptomatic treatment is possible in the absence of any antiviral and proper care of the patient in an intensive care unit,” Dr Sayan Chakraborty, infectious diseases consultant at Manipal Hospital, Kolkata, told Telegraph India.

The Chandipura virus caused a major encephalitis outbreak in India in the early 2000s, killing 322 children.

The virus is endemic to Gujarat, Maharashtra and Andhra Pradesh, which appear to have higher sandfly and mosquito populations.

“A lot of houses also use cow dung paint or maybe make cow dung cakes, which in turn attracts sandflies,” Dr Rajesh Jeswani, a paediatrician in Gujarat, told The Indian Express.

“Additionally, outbreaks are more pronounced because sandflies multiply more during the monsoon season.”

Doctors have voiced concerns about the changing nature of the vector and symptoms.

“Sandflies usually do not fly at a height more than three feet from the ground but this time, during surveillance, sandflies have been found on terraces and higher heights,” Dr Sandipkumar Trivedi, a former executive board member of the Indian Association of Pediatrics, told the newspaper. “Additionally, of the six suspected deaths so far, two presented with brain haemorrhages, which is a new presentation.”

Insecticide sprays could help eliminate the vector, public health experts said and called for measures to prevent the spread of the virus by controlling sandfly populations and mosquito bites.

"Strategies include the use of insect repellents, bed nets and insecticides as well as raising awareness about the risks and symptoms of the disease," Dr Panda said.