http://bmj.com/cgi/content/full/322/7288/693/a
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News
Indian scientists warn of "mutant measles" virus
Ganapati Mudur
Indian scientists have warned that India may be witnessing the emergence of
a highly lethal measles-like virus, causing encephalitis in adults
and children.
Scientists investigating an outbreak of encephalitis among adults in the
town of Siliguri, in West Bengal, told the health ministry this week
that the disease was caused by a mutant measles virus that affects
the brain, lungs, or kidneys.
"For now, we're calling this a variant of measles," Dr Nirmal
Kumar Ganguly, director general of the Indian Council of Medical Research,
told the BMJ.
This is India's third outbreak since 1998 of a highly fatal illness
involving the brain or the kidneys and attributed to the measles
virus. The unexplained outbreak in February this year killed at
least 28 people, including two doctors and five nurses in a
clinic. The infection spread through droplets in air expelled by
patients during the terminal phase of the illness, which is marked
by pneumonia.
Epidemiologists say that adequate protection and barrier nursing helped to
quell the outbreak. Investigations had ruled out vector borne
infections common in India, such as cerebral malaria or Japanese
encephalitis. Tissue samples studied at the National Institute of
Virology in Pune showed antibody signatures of measles in
17 samples collected. Measles virus antigen was detected in brain
tissues of two patients. The diagnosis has also been confirmed through
other tests for the virus.
"A measles-like virus that is highly fatal to adults and spreads
through droplets in the air is very worrying," said Dr T Jacob
John, a leading Indian virologist, formerly with the Christian Medical
College in Vellore. "This doesn't look like a one-time event.
India may even have had early warnings."
Two years ago a team from the National Institute of Virology had isolated
the measles virus from five adults in Bombay with acute renal
failure and neurological symptoms. Four of the patients died, but
none had a rash. The institute had also isolated the measles virus
in two highly fatal outbreaks of encephalitis among children aged
under 12 years in three states
Haryana, Gujarat, and Andhra
Pradeshduring 1998.
"In those previous outbreaks, immunisation seems to have failed to
protect against this virus," said Dr Ganguly.
The National Institute of Virology had said last year that the absence of a
rash and unusual symptoms may mean that measles was re-emerging in
India despite widespread vaccination coverage. Virologists say that
genetic studies of the virus are necessary.
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Rapid Response responses to
this article:
Read all Rapid Response
responses
Emerging mutant measles virus: not an unexpected
event
ARYA, Subhash C, Research Physician
, Centre for Logistical Research and Innovation
bmj.com, 25 Mar 2001 [Response]
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