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ABSTRACT: Hepatitis E virus (HEV) is implicated in many outbreaks of viral hepatitis in the Indian subcontinent. The conventional diagnosis of such outbreaks rests on the detection of anti-HEV IgM antibodies. However, IgM antibodies develop after 4-5 days of infection. An early-diagnostic marker is imperative for timely diagnosis of the outbreak and also initiation of control measures. This study aimed to determine the use of hepatitis E virus antigen detection as an early diagnostic marker in an outbreak in comparison to anti-HEV IgM and RT-PCR analyses. Forty samples were collected during a suspected outbreak of viral hepatitis due to HEV. A total of 36 samples were positive for one or more HEV markers. The positivity for anti-HEV IgM, HEV antigen, and RT-PCR was 91.6%, 69.4%, and 47.2% respectively. RT-PCR and HEV antigen detection gave the highest positive results (100%) in the first 3 days of illness. Positive HEV PCR declined to 54% by Days 4-7, whereas HEV antigen and IgM detection were 88% and 100%, respectively. Sequencing of representative HEV samples indicated that the strains responsible for this outbreak belonged to genotype I, subtype 1a. HEV antigen was found to be an early diagnostic marker of acute infection. HEV antigen was detected in three additional cases in the early phase (1-3 days), and they had no detectable anti-HEV IgM antibodies. These three samples were also positive for HEV RNA. After Day 7, anti-HEV IgM was the main diagnostic indicator of infection. J. Med. Virol. © 2013 Wiley Periodicals, Inc.
Journal of Medical Virology 02/2013; · 2.82 Impact Factor
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Journal of laboratory physicians 07/2011; 3(2):135-6.
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ABSTRACT: Japanese encephalitis (JE) is an important arboviral infection of public health concern. There is a significant variation in mortality (10-30%) in JE viral infection. Epidemics of JE have become regular features in the northern states of India. The recent resurgence of the A226V mutation leading to a widespread Chikungunya epidemic motivated the investigators to search for any such mutational occurrence with Japanese encephalitis virus (JEV) isolated from this region. This study looked for mutation of clinical strains at amino-acid positions 176, 177, 227, 244, 264 and 279. A novel mutation S227T was detected corresponding to the loop region of domain II, E gene of JEV in comparison to Indian and other isolates from different parts of the world. Genotype III was found to be circulating in this geographical area. Further studies are required to ascertain its role in JE pathogenesis and vector competency.
Epidemiology and Infection 06/2011; 139(6):849-56. · 2.84 Impact Factor
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Journal of clinical microbiology 12/2010; 48(12):4688; author reply 4688-9. · 4.16 Impact Factor
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ABSTRACT: Respiratory syncytial virus (RSV) has been reported as a leading cause of upper and lower viral respiratory tract infection in high-risk adult populations. We prospectively studied 48 patients with hematological malignancies over a period of 2 years. Throat and nasal washings were subjected to immunofluorescence and cell culture for virus isolation. Of these 48 patients, 31 had acute leukemia, 6 had chronic leukemia, 10 had lymphoma and one had multiple myeloma. The median age of the patients was 20 years with a male to female ratio of 4:1. No RSV was detected in any of the samples. RSV was not found as a major cause of community acquired upper respiratory tract infections in adults with hematological malignancies in India.
The Southeast Asian journal of tropical medicine and public health 12/2006; 37(6):1132-3. · 0.60 Impact Factor
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ABSTRACT: Dengue viral infection is one of the most important public health problem in tropical countries.
An outbreak of dengue fever was investigated in a periurban slum area of Chandigarh, India, during September to December, 2002.
Blood samples from 218 patients and 30 apparently healthy contacts were tested for dengue-specific immunoglobulin M (IgM) and IgG antibodies including 80 acute samples collected within 5 days of illness were subjected for virus isolation in newborn mice. The average temperature, rainfall, and humidity of the epidemic year were compared with the number of dengue cases.
statistical significance was found out using c2-test.
A total of 76 cases were positive by either dengue IgM capture assay (n = 57) or virus isolation (n = 17) or both (n = 2). Fifteen of nineteen viral isolates subjected for typing by type-specific multiplex reverse transcription-polymerase chain reaction were found to be of dengue virus. High rainfall and humidity with the temperature range from 21 degrees C to 33 degrees C during the months of August and September might have favored the breeding of mosquitoes, thus leading to an increase in the number of dengue cases in October and November, 2002.
The present outbreak thus emphasizes the need for continuous sero epidemiological and entomological surveillance for the timely implementation of effective dengue control programme.
Indian Journal of Medical Sciences 01/2006; 59(12):518-26.
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ABSTRACT: Dengue fever (DF) is currently the most important mosquito-borne arboviral infection of humans. The dengue virus, with its four serotypes, has established endemicity in most tropical and subtropical regions, putting approximately 2.5 billion people at risk globally. [1,2] The outbreaks of dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) have occurred in several places in India [3] such as Delhi, [4] Ludhiana, [5] Tamil Nadu [6] and Maharashtra. [7] We investigated the outbreaks of DF/DHF that occurred during 1996 and 1999 in Chandigarh (north India). Acute-phase blood samples of 338 clinically suspected DF/DHF patients were tested for dengue-specific IgG antibodies using dengue blot assay (Genelabs Diagnostics, Singapore) and for IgM antibodies using µ-capture ELISA (Pan-Bio, Australia) during 1996 and 1999. Fifty samples were also tested for dengue antibodies by the haemagglutination inhibition (HI) test using the antigen extracted from the infected mouse brain (DENV-2 prototype) following the method described by Lenette et al. [8] Dengue virus antigen was detected in adult female Aedes aegypti mosquitoes by head squash preparation by indirect immunofluorescence test using prototype DENV-2 polyclonal hyperimmune serum raised in rabbit (in-house standardized) and anti-rabbit IgG-FITC conjugate (Sigma Aldrich, USA). Of the total of 338 patients, 50 patients were investigated during the outbreak in 1996 and 288 in 1999. The male to female ratio was 2.3:1. Children less than 10 years of age constituted 17.6% of the total number of patients, while 20.4%, 29.3% and 18.8% patients were in the age groups of 11-20, 21-30 and 31-40 years respectively. Dengue-specific IgM and IgG was found positive in 46.7% (158/338) and 73.6% (198/269) patients respectively. The year-wise dengue IgM and IgG positivity is shown in Table 1. The number of DF/DHF patients showing primary and secondary immune response is shown in Table 2. Dengue virus antigen was demonstrated in Aedes aegypti mosquito. The HI antibodies to dengue virus were found at >1:80 titre in all patients, whereas the titre of antibodies to Japanese encephalitis virus and West Nile virus was ≤10 in all patients. One of the largest outbreaks in north India occurred in Delhi and adjoining areas in 1996. [4] The outbreak lasted from September to November. DF/DHF reappeared within three years in a cyclical trend with a greater Short Note DF/DHF in Chandigarh, India Dengue Bulletin – Volume 30, 2006 279 propensity (288 vs. 50 patients), indicating an upsurge in the virus transmission in this region. These observations suggested that dengue had established the seasonal and cyclical pattern in this part of the country as had been observed in other South-East Asian Countries. [2] The 1999 epidemic was one of the largest DF/DHF outbreak reported in Chandigarh, which is comparatively a cleaner and more hygienic city. An increase in the population density and increased construction activities as part of urbanization over the years have led to inadequate water supply, leading to construction of overhead water storage tanks in most houses and also increase in water storage practices. These factors have contributed to the breeding of the prime vector Ae. aegypti throughout the year.
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The Indian Journal of Pediatrics 11/2005; 72(10):893-4. · 0.52 Impact Factor
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The Journal of communicable diseases 04/2005; 37(1):78-81.
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ABSTRACT: Parvovirus B19 mostly presents as a transient viral illness or as pure red cell aplasia. However, this virus can sometimes cause an illness that may pose diagnostic difficulties. We describe one such patient who had clinical features simulating a vasculitic disorder secondary to parvovirus B19 infection.
Rheumatology International 04/2005; 25(2):125-9. · 1.88 Impact Factor
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ABSTRACT: A study was carried out to find out a) the seroprevalence of herpes simplex viral infections (HSV) in and around Chandigarh city, North India and the probable age of acquisition of infection; b) the usefulness of salivary antibody detection in seroprevalence studies; c) role of HSV immunofluorescence antibodies in the sero-diagnosis of herpes simplex encephalitis (HSE) patients. Single blood samples from 306 and paired blood and saliva samples from 48 apparently healthy individuals as well as paired blood and C.S.F. samples from 50 clinically suspected patients of HSE were included in the study proper. The subjects belonged to <6 months to > 30 years age group. Serum, saliva and C.S.F. samples were subjected to in house standardized indirect immunofluorescence test for the detection of HSV antibody. The overall seropositivity was 59.3%, which increased from 37.5% in children less than 10-years of age to 88.9% in individuals above 30 years of age (p<0.001). The maximum titer in less than 10 years children and above 10 years subjects were found to be 40 and 160 respectively. The difference in percentage positivity of HSV antibody in these groups was statistically significant (p<0.001). No difference in the seroprevalence rate was observed between different socio-economic groups and sex. Saliva in comparison to serum showed a sensitivity of 44% and specificity of 100% for the detection of HSV antibodies. Among the suspected HSE patients 4 (8%) could be serologically confirmed. This study indicated the endemicity of HSV infection in this locality. Indirect immunofluorescence test could detect intrathecal HSV antibodies in 8% of suspected HSE patients proving it to be a very useful rapid serodiagnostic tool. However, saliva testing showed limited sensitivity in HSV sero surveys.
Indian Journal of Pathology and Microbiology 10/2004; 47(4):582-5. · 0.68 Impact Factor
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Journal of Clinical Microbiology 06/2004; 42(5):2357; author reply 2357-8. · 4.15 Impact Factor
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ABSTRACT: The present study has been carried out to analyse the trend of heterophile antibody positive infectious mononucleosis cases.
A total of 1741 cases of clinically suspected infectious mononucleosis from various age groups were investigated during the period January, 1986 to December, 2000 and were analysed for infectious mononucleosis (IM) specific heterophile antibody by Paul-Bunnel-Davidsohn (PBD) test. Forty seven heterophile antibody negative samples were also tested simultaneously for the presence of the IgG antibody to viral capsid antigen (VCA) and Epstein Barr nuclear antigen (EBNA) to detect the exposure to Epstein Barr Virus (EBV) infection.
The overall percentage of EBV specific heterophile (Paul-Bunnel) antibody positivity was found to be 11.1% (194/1741). The average Paul-Bunnel antibody positivity between 1986 to 1990 was 20.5% which declined drastically to 5.7% during 1991-2000. Males comprised of 55.2% of the serologically proven IM cases. Of the 47 heterophile antibody negative cases, 38 (80.9%) and 33 (70.2%) were found to be positive for anti-VCA IgG and anti-EBNA IgG antibodies respectively. Paul Bunnel antibody positivity was found to be higher in >14 year age group patients than those below 14 years.
These findings suggest that the EBV infection still continues to be endemic in this part of the country, however, a declining trend in IM cases was observed during the last decade.
The Indian Journal of Pediatrics 02/2004; 71(1):15-8. · 0.52 Impact Factor
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ABSTRACT: Blood transfusion is indispensable in the management of many haematological diseases and has become the mainstay in major surgical procedures. Transfusion-transmitted infections have been a major threat to life since the dawn of transfusion therapy. The authors have highlighted the different viral, parasitic and bacterial infections associated with transfusion and have focussed on the precautionary measures that can be implemented for prevention of the infections along with a brief review of the literature.
Journal of the Indian Medical Association 02/2003; 101(1):18, 20-3.
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ABSTRACT: Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three VZV IgM positive cases, two were positive in acute blood samples and one in vitreous fluid. Thus VZU can be incriminated as the causative agent of ARNS cases in North India.
Indian Journal of Pathology and Microbiology 08/2002; 45(3):269-71. · 0.68 Impact Factor
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ABSTRACT: An outbreak of measles was investigated in the periurban areas of Chandigarh Union Territory, during the months of December 1998 to February 1999. Mainly the children below 15 years of age were affected. The children of migrant labourers belonging to the neighbouring states of Uttar Pradesh and Bihar constituted the majority of population in the area under study. They belonged to lower socio economic status with low immunization coverage.
A total of 2968 houses were surveyed for epidemiological investigations in the areas of colony No. 5, Ramdarbar, Palsora and Pandit colony of Kajheri, covering a population of 14,601 and 7.3% (216/2968) of families were affected in the outbreak.
Two hundred and eighty three cases of measles were reported with an attack rate of 4.5% and male to female ratio of (M:F) 5.3%:3.6%. Among the measles cases, 48.8% had received measles vaccination. The outbreak was investigated by detecting measles specific IgG/IgM antibodies either in acute or convalescent serum samples or both. Due to inadequate surveillance system and containment measures, the outbreak was in full swing during the winter months. Measles related complications were reported in 31.1% cases (i.e. diarrhoea in 15.2% and Pneumonia is 7.1%).
Following smallpox and guinea worm eradication, WHO's next thrust, is on eradication of poliomyelitis and measles. Hence, strengthening of disease surveillance as well as vaccination policies are mandatory to achieve disease control in these areas.
The Indian Journal of Pediatrics 02/2002; 69(1):33-7. · 0.52 Impact Factor
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ABSTRACT: Twenty one cerebrospinal fluid (CSF)/brain tissue (16 CSF and 5 brain tissue) from patients clinically suspected of herpes simplex encephalitis (HSE) were collected during one year period and was subjected for the detection of HSV type I and type II antigen by direct Immunofluorescence (DIF). Paired serum and CSF samples obtained from 12 patients were tested for herpes simplex virus antibodies by indirect immunofluorescence test. Of the 21 cases, two were positive for HSV-1 antigen in CSF and one in brain tissue by DIF. Virus specific IgG antibody in paired CSF and serum samples was positive in one case only. In none, virus could be grown in verocell line. In 2 Patients antemortem diagnosis was possible and parenteral acyclovir could be administered in one case that recovered following treatment. Thus, besides antibody detection, direct immunofluorescence is an useful and rapid method for the early diagnosis of HSE.
Indian Journal of Pathology and Microbiology 08/1999; 42(3):333-7. · 0.68 Impact Factor
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ABSTRACT: A study on sero prevalence of Japanese Encephalitis (JE) and West Nile (WN) viruses in pigs was carried out in and around Chandigarh. A total of 158 blood samples collected (June, 1995-March, 1996) from batches of pigs were screened for antibodies against JE and WN viral antigens by haemagglutination inhibition and complement fixation tests. In Chandigarh out of 13 pigs, 5 had JE and one WN HAI antibodies. Similarly, the sera of 14 and 1 pigs in Punjab and 29 and 3 pigs in Haryana were positive for JE and WN HAI antibodies respectively. In total JE specific HAI antibodies were found in 30.3% and CF antibodies in 12.5% of pigs whereas WN specific HAI antibodies were obtained in 3.2% and only one pig had CF antibodies. The results show that JE and WN viral infections are prevalent in pig population in and around Chandigarh.
The Journal of communicable diseases 07/1999; 31(2):113-6.
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The Journal of the Association of Physicians of India 05/1997; 45(4):327.
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ABSTRACT: An increased incidence of intestinal helminthic infections has been observed in patients with viral encephalitis in endemic areas. Both Japanese B encephalitis (JE) and neurocysticercosis (NCC) share some common socio-demographic and ecologic factors, and pigs act as the intermediate carrier for both. Our purpose was to show the coexistence of JE and NCC in brain on MR images and highlight the possible role of NCC as an amplifier of JE.
MR images from 10 cases of coexistent JE and NCC were studied retrospectively. T1-weighted axial and sagittal, proton T2-weighted axial and coronal, and T2-weighted fluid-attenuated inversion recovery axial and coronal sections of the brain were evaluated. NCC was diagnosed on the basis of neuroimaging. Diagnostic serologic testing for JE was conducted using paired blood and CSF samples.
The JE changes were bilateral and asymmetrical and were more severe on the side harboring the solitary cyst or the side bearing the greater number of cysts or lodging the degenerating cyst. In each of nine of 10 cases, at least one degenerating cyst was found on the side of predominant JE pathologic abnormality.
The study suggests that the co-occurrence of JE and NCC is not just a chance coincidence. NCC apparently predisposes a person to JE infection and is a positive modulator of the encephalitic process. The study shows a spectrum of MR imaging findings of coexistent JE and NCC.
American Journal of Neuroradiology 22(6):1131-6. · 2.93 Impact Factor
