Molecular and serological evidence of chikungunya virus infection with high case fatality among pediatric population with acute encephalitis syndrome: first report from Eastern Uttar Pradesh, India.
Pooja BhardwajKamlesh SahVishal YadavShahzadi GulafshanPreeti DhangurUtkarsh SrivastavaGaurav Raj DwivediManoj MurhekarBhupendra SharmaRajeev SinghPublished in: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2024)
Acute encephalitis syndrome (AES) outbreaks in children of Eastern Uttar Pradesh (E-UP) region of India have been a longstanding public health issue, with a significant case fatality rate of 20-25%. Since past decade, a rise in chikungunya (CHIK) cases has been occurring, which is a reported etiology of AES. However, the burden of chikungunya virus (CHIKV) among pediatric AES (pAES) is unknown from E-UP. We included 238 hospitalized pAES cases. The presence of IgM antibodies for CHIKV, and Dengue virus (DENV) was tested, and RT-PCR was performed for CHIKV and DENV in serologically confirmed CHIKV and DENV pAES cases. Positive samples were sequenced using Sangers sequencing. Further, to check for co-infection, IgM antibodies for other AES etiologies including Japanese encephalitis virus (JEV), Leptospira and Orientia tsutsugamushi (OT) in serum were also investigated. IgM ELISA demonstrated 5.04% (12) positivity for CHIKV. Among CHIKV IgM positive, 3 (25%, 3/12) pAES patients died. CHIKV genome was detected in 3 pAES specimens. Among which, 2 CHIKV cases were also positive for OT DNA. Partially sequenced CHIKV were genotyped as ECSA. The overall finding indicates evidence of CHIKV infection with high case fatality among pAES patients from E-UP. This study advocates constant serological and molecular surveillance of CHIKV in AES endemic regions of India.
Keyphrases
- dengue virus
- zika virus
- public health
- end stage renal disease
- aedes aegypti
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- single molecule
- peritoneal dialysis
- risk factors
- intensive care unit
- patient reported outcomes
- high resolution
- case report
- acute respiratory distress syndrome
- mass spectrometry
- single cell
- dna methylation
- cell free
- nucleic acid