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CURRENT
ISSUE AUGUST 11, 2003
HEALTH: MYSTERY FEVER
Birth of a Killer
The rare Chandipura virus is identified as the
cause of the brain fever deaths in south India
By Anil Padmanabhan in New York
A deadly
new virus could be on the rampage in south India. Since June, a mysterious
"brain fever" claimed the lives of 163 children in Andhra Pradesh
and spread to nearby Maharashtra. The killer was swift and lethal-most
children died within 24 hours. Nobody could explain why. Now scientists
at the National Institute of Virology (NIV), Pune, believe they have zeroed
in on the culprit-a rare, mosquito-borne virus not generally known to
kill. The treatment for the fever, however, continues unchanged.
MISERY: Parents mourning the death
of their child at a hospital in Hyderabad
There were suspects galore for the epidemic-the common one being Japanese
encephalitis (JE), a familiar mosquito-borne viral disease that claimed
more than 600 lives in 1986. A laboratory in Hyderabad found only three
JE cases. But a team of experts from Delhi that visited the affected areas
concluded the disease was most likely JE. Their premise was based on clinical
evidence. The confusion only deepened the mystery. Samples were then sent
to NIV. The true identity of the killer added a further twist to the tale.
The culprit, revealed NIV in a confidential report to the Union Health
Ministry, is the Chandipura virus. It belongs to the same family as the
rabies virus and is rarely found in human beings.
The revelation raises more questions than it answers. For the Chandipura
virus is nowhere near the top of the list of killer viruses. "It
is normally not pathogenic," says Dhrubajyoti Chattopadhyay, an expert
on the Chandipura virus. First isolated from two dengue victims in Chandipura,
Madhya Pradesh, the virus was identified in 1967. Since then it made an
appearance in Delhi in 1980 and in Africa in 1988. But it had not been
reported to be fatal in India.
FATAL
CHANGE
The Chandipura virus could be behind the deaths in
Andhra Pradesh and Maharashtra, says the National Institute of Virology.
The virus, however, is not known to affect the nervous system.
So how it causes brain fever remains a mystery.
It is possible that, like the SARS virus, it mutated into a lethal
form.
How the virus spread rapidly can be easily explained. The virus is carried
by the Aedes mosquito and is found in a range of hosts, from cattle to
birds. Symptoms of Chandipura infection include high temperature, vomiting
and diarrhoea, all of which were reported in most of the affected children.
But the Chandipura virus generally does not affect the brain. Yet the
children died as their brain was affected. Tests done on mice at NIV confirmed
that this variant does indeed affect the brain-the infected mice died
within 24 hours.
Could a virus change so much? Is this a new mutant? Like the common-cold
variety of viruses that mutated to cause SARS, the genetic material of
the Chandipura virus consists of RNA, not DNA. The single-strand RNA is
more susceptible to changes than the double-strand DNA. "It is possible
that as with the SARS virus, the Chandipura virus could mutate to become
a more lethal variety," says Chattopadhyay. It is a problem NIV is
working hard to answer. Its Director A.C. Mishra, who was reluctant to
talk about the report to the Health Ministry, says, "Our knowledge
of the Chandipura virus is based on a few episodes. Nobody knows much
about it and its disease patterns." Union Health Ministry officials
are also cautious. "The Chandipura virus has been reported, but you
cannot rule out JE. Some symptoms tally with those of JE," says B.M.
Das, director (emergency services), Ministry of Health and Family Welfare.
As officials debate, the clock ticks for the victims. Two months after
the epidemic began, there is still no consensus on the cause. Hyderabad,
cybercity and biotech hub, does not even have the Biosafety Level-3 laboratory
facilities required to detect a lethal virus. "We badly need to improve
facilities across India," says a public health official. It is the
only way to quell problems before they turn into disasters. It is a common-sense
solution-but it hits the authorities only after the disaster strikes.