The Journal of communicable diseases

Online ISSN: 0019-5138
Publications
Article
An outbreak of V. cholerae 01 occurred in remote villages of Rohru tehsil, district Shimla, Himachal Pradesh, during June-July 1994. Seven villages were affected. Overall attack rate was 16.4 per cent in surveyed villages. Attack rate in children < 5 was significantly high. Suspected source was spring water contaminated from open air defaecation. V. cholerae was resistant to co-trimoxazole and streptomycin.
 
Mean duration of disease by PB/MB type in New/Prevalent Leprosy, Agra Dist 2004-06 23 163 8 896 N = Prevalent New 80 70 60 50 40 30 20 10
Visible (Grade >2) Disability rate among PB and MB leprosy in Agra, 2004-06 
Article
This study based on rapid survey methodology examining 17.86 lakhs population revealed that leprosy prevalence in Agra District is 6.1/10,000 during 2004-06, with 97.2% of the cases detected for the first time. Although leprosy is still endemic but all the leprosy indicators have shown positive change since last survey in 2001-03. The results seem promising to achieve elimination target (<1/10,000) since prevalence/10,000 population declined from 16.4 in 2001-03 to 6.1 in 2004-06, MB rate from 22.3 to 17.1, Mean duration of disease at detection (months) from 32.3 to 22.9, per cent new cases increased from 88.2% to 97.2% and visible disability (Grade > or = 2) rate declined from 4.8% to 2.36% over this period. The data on patients with incomplete history of treatment (prevalent) but having active disease indicate that only about 3% (31/1090) had approached the health center for treatment. Of these 31 patients, 29% defaulted from treatment and still have active disease and 75.2% (23/31) had MB disease indicating a pattern of late reporting to health system. This study suggests that repeat surveys are useful to detect cases for treatment and seems the key to achieve leprosy elimination or even eradication at district level in all endemic districts.
 
Article
One of the epidemiological descriptor of a fatal infectious disease is the time it takes from infection to death or the survival period. The present study has focused on trend in survival and death of Iranian nonhemophiliac HIV patients from 1988 to 2002 and has estimated the nonparametric distribution of the survival function of HIV patients with respect to different variables of interest, like mode of transmission, gender and age at the time of diagnosis.
 
Article
Bacillus thuringiensis H-14 is a well recognized bioinsecticide against mosquitoes. This study investigates the inactivation effect of sunlight on the larvicidal activities of four Nigerian isolates of B. thuringiensis H-14, code-named OBG1, OBG8, GSC3 and GNA13 as compared with a standard mosquito larvicide, B. thuringiensis var. israelensis (BTI). A 0.125 mg/1 suspension of spore-delta-endotoxin powder of each isolate was exposed to direct sunlight for 7 h on a concrete roof (ca. 13 m high). After exposure, the toxicity of each bacterial suspension to Aedes aegypti larvae was determined by bioassay. Three of the isolates, OBG8, OBG1 and GSC3 exhibited higher larvicidal activities than B.T.I. against A. aegypti larvae after exposure to sunlight. The resistance of Nigerian isolates to inactivation effects of sunlight advocates their potential in biocontrol of mosquitoes.
 
Article
An unusual morphological type of Trypanosoma (Herpetosoma) lewisi (Kent, 1880) which was detected in Rattus norvegicus in India is reported in the present study. This type is different from known types of T. lewisi in that the kinetoplast is at a greater distance from the posterior end (P-K) than the usual type. The total length, including the free flagellum, is 35.3-39.3 microns and P-K is 11.9-15.0 as against total length of 21 to 36.5 microns in the normal form.
 
Article
Japanese encephalitis virus (JEV) antigen has been detected by antigen capture enzyme linked immunosorbentassay (ELISA) in dry specimens of the mosquito Culex tritaeniorhynchus Giles, 1901, collected from Karnal district of Haryana state in northern India. These mosquitoes were stored in dry condition for 20 months, at room temperature, before processing. The procedure of detecting JEV infection in long time stored, dry vector mosquitoes, has important application in the surveillance of Japanese encephalitis.
 
Article
The International Health Regulations (IHR 1969), replaced by IHR 2005 had been adopted by the World Health Assembly on 23 May 2005 and came into force on 15 June 2007. IHR 2005 are a legally binding agreement among World Health Organisation (WHO) member states and other states that have agreed to be bound by them. New revision was necessitated by concerns about increasing global health threats and the need to respond with more effective surveillance and control practices. The limitations of IHR 1969, which led to their revision, related to their narrow scope, their dependence on official country notifications, and their lack of a formal internationally coordinated mechanism to contain international disease spread. The IHR 2005, which is firmly based on practical experiences, has broaden the scope of IHR 1969 to cover existing, new and re-emerging diseases, including emergencies caused by non-infectious disease agents.
 
Article
Cholera has been present in India since antiquity. Six pandemics originated in Indian subcontinent. The present seventh pandemic caused by El Tor Vibrio cholerae started from Indonesia (Sulawesi) in 1961 and entered India in 1964. By the end of 1965 it has replaced the age old classical V. cholerae. Many of the States which never had cholera or were free from it for a long time got infected and became endemic foci of El Tor infection. This article reviews the epidemiological features of important outbreaks reported after 1975 in India.
 
Article
A total of 314 cases of Plasmodium falciparum malaria studied during 1980-88 in nine times monitoring revealed three RIII foci i.e. two in Jalpaiguri and one in Purulia districts. The studies showed a parasite clearance of 40 per cent and 32 per cent of P. falciparum cases within seventh day in Purulia and Jalpaiguri districts respectively, with a dosage of 25 mg per kg body weight, spread over three days in divided doses. Increase in transmission potential and prolonged drug pressure with single drug have been noted in association with development of resistance. Malaria parasite clearance time (MPCT) value of sensitive and resistant cases reach parallelism and malaria parasite recrudescence time (MPRT) value starts declining, giving an indication of stabilisation of genetic change in the parasite.
 
Article
Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne zoonotic disease caused by a protozoan parasite, Leishmania donovani. Nepal, together with India, Bangladesh, Brazil and Sudan constitutes the five countries of the world where more than 90% of VL occurs. In Nepal, the disease affects eastern Terai region which lies adjacent to the Bihar state of India. Although leishmaniasis is regarded as a significant health problem in Nepal by the Ministry of Health, there is no active case detection programme in the country. Information on the morbidity and mortality is thus very limited. The objectives of this study were to determine the up-to-date morbidity and mortality trend for VL in Nepal. Data collected from eight zonal hospitals in the Terai region suggests that the first confirmed case of VL was recorded in 1980. By 2003, the disease has spread to 14 districts of central and eastern regions of Nepal, and nearly six million people residing in these districts were at the risk of acquiring the disease. A total of 25890 cases with 599 deaths were reported during the year 1980-2006 (up to July). The case fatality rate (CFR) varied from 0.23% to 13.2%. District-wise analysis showed that, during 2003, highest incidence (per 100,000) was in Mahottari district (184), followed by Sarlahi (100) and Sunsari (96). The highest CFR was in Dhanusha (2.9%) followed by Bara (2.4%) and Saptari (2.0%). Majority (70.9%) of persons affected by VL were aged 15 years and above, followed by 10-14 years (13.9%), 5-9 years (11.9%) and 1-4 years (3.3%). The incidence of VL in Nepal seems to be increasing at a faster rate indicating that the existing control programs have been ineffective. To achieve success in control programs, the existing ones should be amended as there is evolution of resistance in the parasite as well as the vector. Public health education, to make the people aware about preventive aspects of the disease is important. The possibility of the existence of animal reservoirs should also be considered and checked out for better control measures.
 
Article
A general presentation is made of data derived from systematic trend studies on the Anopheles fauna in 12 study villages of Orissa State, India. Adult and larval species prevalences, seasonal densities of prominent anophelines and predilections of various species to feed on human blood are discussed and demonstrated.
 
Article
An in-depth study of Japanese Encephalitis (JE) situation in Gorakhpur district of Uttar Pradesh from 1982-1988 showed increasing trend in the incidence of JE. Total number of annual cases and case fatality rate (CFR) rose from 118 and 23.7 per cent in 1982 to 772 and 32.2 per cent in 1988 respectively. A definite increase was noticed in the number of cases per block following lull years in 1984 and 1987. Among the total affected 1201 villages, 1083 were affected only once. All age groups were affected and the disease showed marked seasonality during August to November. JE, which came in epidemic form in earlier years has established in the area in endemic form.
 
Article
Review of medical journals is not common in India. A quantitative review of the articles published in the Journal of Communicable Diseases from 1982 through 1991 was undertaken in the present study to give feedback to all concerned and stimulate them for initiating constructive criticism of medical journals published in India. Articles were categorised as per the classes of four predetermined parameters and variations in the proportions of number of articles under different classes of each parameter are briefly discussed.
 
Article
Recurrent epidemics of encephalitis in Nagaland, a North-Eastern State of India, following its first appearance in 1985, were investigated both epidemiologically and virologically. Although, no viral agent could be isolated from any of the clinical samples and mosquitoes, detection of JE specific IgM antibodies in many of the CSF and acute blood samples, together with presence of HI and CF antibodies to JE antigen in a number of acute and convalescent sera established the etiologic role of JE virus in this region. A total number of 83 clinically diagnosed cases could only be investigated virologically between 1985-89, where evidence of JE could be established in 34 (40.9 per cent) and flavivirus (including JE in majority) in 17 (21.5 per cent) cases. A limited serological survey among the close contacts of the victims in 1985 revealed JE antibody in 26.6 per cent of them. Analysis of the epidemiological and serological findings of different years revealed that while the outbreaks of 1985, 1987 and 1988 were due to JE infection, the episodes of 1986 and 1989, on the other hand, had chiefly features of high and prolonged fever with limited number of CNS involvement of undetermined origin, where the possibility of malarial infection has been a suspect apart from JE etiology.
 
Article
Delhi experienced an outbreak of cholera during July-August 1988 which affected residents from all walks of life. A total of 1824 laboratory confirmed cholera cases were detected in two months period at I.D. Hospital, Delhi alone. The number of cholera cases in July-August 1988 was 5-10 times that of the same period during the previous years in the Capital. The outbreak was caused by Vibrio cholerae Ogawa biotype ElTor. Majority of the laboratory confirmed cases (about 74 per cent) were seen in children under the age of 15 years. Though the cases were spread all over Delhi, almost three-fourths of total cases were reported from two specific zones (Shahdara and Civil Lines). Most of the isolates were sensitive to all antibiotics tested. The proportion of isolates resistant to furazolidone during this outbreak was substantially higher than in previous years suggesting that the outbreak may have been caused by the introduction of a new strain rather than proliferation of endemic strain. The salient features of the outbreak are discussed.
 
Article
During 1988 a large scale outbreak of cholera occurred in Delhi giving rise to a total of 1708 bacteriologically proved El Tor cholera cases, the highest number recorded in a single year in Delhi, following its first detection in 1965. Civil lines and Shahdara zones were the worst affected areas recording 85.7 and 55.7 cases per 100,000 population respectively. The highest incidence rate was observed in the age group of 1-4 years (77 per 100,000). Males and females were equally affected. The data of moving average show the endemicity of cholera in Delhi with an increasing trend. The risk factors identified are lower socioeconomic status, poor personal hygiene, drinking water and food storage practices.
 
Article
A field evaluation of efficacy of BCG vaccine to prevent tubercular meningitis was undertaken in a case control study in Delhi during 1988-89. Each case of tubercular meningitis was matched by age and neighbourhood with 2 controls from the community. Thirty-seven cases of tubercular meningitis were matched with 74 controls and thus 37 triplets were analysed. ODDS RATIO between BCG vaccinated and non vaccinated individuals for acquisition of tubercular meningitis was 11.3. This gives 84 per cent efficacy of BCG vaccine in the prevention of TB meningitis under the field conditions prevailing in Delhi. Paired matched analysis of tubercular meningitis with the control group 1 and 2 separately revealed the ODDS RATIO to be 9.5 and 15 respectively. The corresponding BCG vaccine efficacy worked out were 90 and 93 per cent respectively. Authors suggest that this method of evaluating BCG vaccine efficacy is fairly reliable and cost effective. This methodology could be further simplified by using hospital patients as control and be introduced to evaluate BCG vaccine efficacy in different areas with reference to its role in preventing tubercular meningitis under the programme of immunisation.
 
Article
An outbreak of Japanese encephalitis (JE) was reported from Rourkela city for the first time in September-November 1989. 41 cases and 15 deaths occurred with a case fatality rate of 36.6 per cent. Most of the cases (66 per cent) were in the age group of 5-19 years. There was no case under 5 years. Female-male ratio of cases was 1:1.7. Serological examination of convalescent cases showed JE specific IgM indicating strong evidence of recent JE infection. Large number of pigs were seen in the affected areas.
 
Article
An outbreak of Dengue Haemorrhagic Fever (DHF) occurred in Calcutta between September and December, 1990. Children and young adults were the major victims. Haemorrhagic manifestations and shocks were the main features in most of the hospitalised cases. Five mouse pathogenic agents were isolated from 105 acute cases and all were identified as DEN-3. HI and CF test with 55 paired sera revealed evidence of dengue infection in 33 (60 per cent) and flavivirus group reaction including dengue in 17 (30.9 per cent). It was for the first time, that DEN-3 was considered to be the etiologic agent for DHF in Calcutta.
 
Top-cited authors
Kamal Krishna Datta
  • National Centre for Disease Control, India
Jaipaul Singh
  • University of Central Lancashire
Mysore Kalappa Sudarshan
  • Kempegowda Institute of Medical Sciences
Mahendra B J
  • Rajiv Gandhi University of Health Sciences, Karnataka
Jagadish Mahanta
  • Regional Medical Research Centre, Dibrugarh