NEW DELHI, Mar 22 (Reuters Health) - A "mystery disease" that killed 45 and made 66 people ill last month in the town of Siliguri, in West Bengal, India, has been identified as the measles virus, say the researchers at the National Institute of Communicable Diseases (NICD), New Delhi.
"Measles was not on our list of investigations and the clinical picture that we were getting was very different from that of measles," Dr. K.K. Dutta, director of NICD, told Reuters Health.
In mid-January a prisoner was admitted to a private hospital in Siliguri who later developed encephalitis--inflammation of the brain--and died. Five people died of encephalitis in the first week of February and then there was a lull, say NICD researchers. Around February 18th, a large number of cases were reported around Medinova Hospital. More than 8 staffers of the hospital were affected in a single day.
"Nearly 68% of those affected between 1st February and 2nd March died," Dutta told Reuters Health. "All this led to panic buttons being pressed", he added.
Measles usually starts with fever, sensitivity to light, eye redness, and vomiting. Typically, patients develop a rash on the fourth day, says Dutta. "It is usually a disease of children," he added.
However, "this pathogen had new symptoms and was affecting adults, majority had encephalitis and pneumonia and they did not get the typical rash," Dutta told Reuters Health. He added that "encephalitis and respiratory components are unknown in measles."
"The initial speculation had centered on Japanese encephalitis and falciparum malaria but all tests gave negative results," said NICD researcher Arvind Rai. The researchers then did tests for viruses such as Hanta, West Nile, and Nipah and Dengue. Bacterial pathogens were also investigated but all yielded negative results.
"When we looked at the complete clinical picture and data in perspective, especially the ten day incubation period, it became very clear that it could be measles," says Dutta.
"Laboratory investigations done at the National Institute of Virology also point towards measles virus as the culprit," Dr. N.K.Ganguli, director general of the Indian Council of Medical Research (ICMR) told Reuters Health. ICMR says that such outbreaks have occurred earlier in the Indian states of Maharashtra, Gujarat and Haryana.
"Since this virus does not match with the classical clinical manifestations we are thinking that possibly it is a mutant strain," said Dutta. Mapping of "the complete genomic sequence of the virus is in progress," he added.
"This virus could be more virulent if we find certain changes in its genetic structure and since the clinical picture is different, we do expect some changes," Dr. Arvind Rai told Reuters Health |
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