Ronan Kelly
Retired 2020
Taken from Quarterly Newsletter from the National Centre for Disease Control (NCDC) Volume 4, Issue 3, July-Sept, 2015
http://nicd.nic.in/writereaddata/linkimages/Newsltr0915277865388.pdf
Dengue outbreak in Bauhara Village of Kanpur district, Uttar Pradesh,
August 2015.
On 13th August 2015 an outbreak of dengue fever characterized by high grade fever, severe
headache, pain in abdomen, nausea, vomiting and generalized weakness was reported from
Bauhara village of Ghatampur block in Kanpur district. This village has a population of
approximately 5000 with 600 households. Initially it was reported as mysterious fever by
the media.
Team from NCDC consisting four members investigated the outbreak. The overall situation
in Bauhara village revealed that from 13th August 2015 there was increase in fever cases
from affected village. Subsequently district health authorities visited the affected village
and deputed Medical officer incharge and his team from CHC, Bheetargaon for screening of
fever cases. Symptomatic treatment was given. Those who required additional care were
referred to the Ursula Horsman Memorial (UHM) Hospital, Ganesh Shankar Vidyarthi
Memorial Medical College (GSVMC) and Trauma Care hospital, Kanpur.
A total 225 patients with complaint of fever were reported from 14th August
to 20th August. Most affected age group was 16-35 years (35%) followed by
36- 50 years (24.9%). Male and female were equally affected. In addition to high
grade fever patients also had symptoms like severe headache, nausea, vomiting
and pain in abdomen.
Team from NCDC visited the houses in the affected village and conducted entomological
investigation which revealed that Aedes aegypti larvae was predominantly present and the
main breeding sources were the domestic and peri domestic containers, metal containers,
earthen pots and discarded containers.
The house index (HI) was 50%, container index (CI) 32.22% and breteau index (BI) 83.33%
which was higher than the threshold values.
Out of 47 serum samples sent from patients admitted in LLR hospital, UHM hospital &
Trauma Care hospital Kanpur to microbiology laboratory, GSVMC and hospital, Kanpur,
38 serum samples were positive for the IgM Dengue antibody (Mac ELISA) by 24th August
2015. 225 blood slides collected from affected village and examined at CHC Bheetargaon
were negative for Malaria parasite.
Microbiological survey and testing at NCDC: NCDC team also collected total 12 serum
samples & slides for MP from suspected cases in Bauhara village and those who were
admitted in Ursala Horsman Memorial Hospital, Kanpur from 19.8.2015 to 21.8.2015.
Except one case, all were residents of Bauhara village. 3 patients were females. Ages
ranged from 15 to 73 years. The samples were collected in serum separation tubes using
aseptic precautions. Blood was allowed to clot, samples were packed appropriately and
transported to Delhi maintaining cold chain and were submitted to Zoonosis Division,
NCDC for testing.
The samples were divided into two groups -
Group 1 - Cases of fever less than 5 days duration
Group 2 - Cases of fever more than 5 days duration.
NS1 antigen detection tests for dengue and PCR for dengue virus was done on the Group 1
samples and IgM ELISA was done on the Group 2 samples
All 7 samples of group 1 were positive for dengue virus by PCR technique (100% positivity)
while 5 were positive for NS1 antigen test. All samples positive by NS1Ag were positive by
PCR. One of the samples of group 2 was positive for IgM antibodies. All samples were
negative for PS for MP. All three samples collected directly from Bauhara village were
positive for dengue virus by PCR technique. Out of 11 cases, 8 were found to be positive for
dengue by NS1Ag/PCR/IgM ELISA giving a positivity rate of 72.7%. Further molecular
studies carried out at NCDC revealed the serotype of the virus in all cases to be DEN-3
serotype.
Larvae and pupae of Aedes were collected and kept for
emergence. Emerged adults were identified and pooled in
3 tubes, which were forwarded to VAD laboratory, CME &VM for
virus detection (report is awaited).
Based on the clinical, entomological and microbiological findings it
has been concluded that mysterious fever outbreak was due to the dengue virus.
Based on the investigation findings the team recommended for intensification of efforts to
reduce actual or potential larval habitats in and around houses and IEC regarding the use
of personal protective measures against mosquito bite.
Some Health messages given to the community for Dengue prevention:
Wear protective clothing (full sleeves shirts & full pants during day time).
Cover water containers in the house to prevent fresh egg laying.
Have infants sleep under bed nets during the day.
Use commercially available repellents during the day time.
Use tight-fitting screens/wire mesh on doors and windows.
Water in bird baths and plant pots or drip trays should be changed at least twice each
week.
Pet?s water bowls need to be emptied daily.
(Contributed by Drs Amol Annasaheb Patil- EIS Officer, Ganesh Lokhande- IDSP,
Simrita Singh, Dr, L.J.Kanhekar, Veena Mittal- NCDC)
http://nicd.nic.in/writereaddata/linkimages/Newsltr0915277865388.pdf
Dengue outbreak in Bauhara Village of Kanpur district, Uttar Pradesh,
August 2015.
On 13th August 2015 an outbreak of dengue fever characterized by high grade fever, severe
headache, pain in abdomen, nausea, vomiting and generalized weakness was reported from
Bauhara village of Ghatampur block in Kanpur district. This village has a population of
approximately 5000 with 600 households. Initially it was reported as mysterious fever by
the media.
Team from NCDC consisting four members investigated the outbreak. The overall situation
in Bauhara village revealed that from 13th August 2015 there was increase in fever cases
from affected village. Subsequently district health authorities visited the affected village
and deputed Medical officer incharge and his team from CHC, Bheetargaon for screening of
fever cases. Symptomatic treatment was given. Those who required additional care were
referred to the Ursula Horsman Memorial (UHM) Hospital, Ganesh Shankar Vidyarthi
Memorial Medical College (GSVMC) and Trauma Care hospital, Kanpur.
A total 225 patients with complaint of fever were reported from 14th August
to 20th August. Most affected age group was 16-35 years (35%) followed by
36- 50 years (24.9%). Male and female were equally affected. In addition to high
grade fever patients also had symptoms like severe headache, nausea, vomiting
and pain in abdomen.
Team from NCDC visited the houses in the affected village and conducted entomological
investigation which revealed that Aedes aegypti larvae was predominantly present and the
main breeding sources were the domestic and peri domestic containers, metal containers,
earthen pots and discarded containers.
The house index (HI) was 50%, container index (CI) 32.22% and breteau index (BI) 83.33%
which was higher than the threshold values.
Out of 47 serum samples sent from patients admitted in LLR hospital, UHM hospital &
Trauma Care hospital Kanpur to microbiology laboratory, GSVMC and hospital, Kanpur,
38 serum samples were positive for the IgM Dengue antibody (Mac ELISA) by 24th August
2015. 225 blood slides collected from affected village and examined at CHC Bheetargaon
were negative for Malaria parasite.
Microbiological survey and testing at NCDC: NCDC team also collected total 12 serum
samples & slides for MP from suspected cases in Bauhara village and those who were
admitted in Ursala Horsman Memorial Hospital, Kanpur from 19.8.2015 to 21.8.2015.
Except one case, all were residents of Bauhara village. 3 patients were females. Ages
ranged from 15 to 73 years. The samples were collected in serum separation tubes using
aseptic precautions. Blood was allowed to clot, samples were packed appropriately and
transported to Delhi maintaining cold chain and were submitted to Zoonosis Division,
NCDC for testing.
The samples were divided into two groups -
Group 1 - Cases of fever less than 5 days duration
Group 2 - Cases of fever more than 5 days duration.
NS1 antigen detection tests for dengue and PCR for dengue virus was done on the Group 1
samples and IgM ELISA was done on the Group 2 samples
All 7 samples of group 1 were positive for dengue virus by PCR technique (100% positivity)
while 5 were positive for NS1 antigen test. All samples positive by NS1Ag were positive by
PCR. One of the samples of group 2 was positive for IgM antibodies. All samples were
negative for PS for MP. All three samples collected directly from Bauhara village were
positive for dengue virus by PCR technique. Out of 11 cases, 8 were found to be positive for
dengue by NS1Ag/PCR/IgM ELISA giving a positivity rate of 72.7%. Further molecular
studies carried out at NCDC revealed the serotype of the virus in all cases to be DEN-3
serotype.
Larvae and pupae of Aedes were collected and kept for
emergence. Emerged adults were identified and pooled in
3 tubes, which were forwarded to VAD laboratory, CME &VM for
virus detection (report is awaited).
Based on the clinical, entomological and microbiological findings it
has been concluded that mysterious fever outbreak was due to the dengue virus.
Based on the investigation findings the team recommended for intensification of efforts to
reduce actual or potential larval habitats in and around houses and IEC regarding the use
of personal protective measures against mosquito bite.
Some Health messages given to the community for Dengue prevention:
Wear protective clothing (full sleeves shirts & full pants during day time).
Cover water containers in the house to prevent fresh egg laying.
Have infants sleep under bed nets during the day.
Use commercially available repellents during the day time.
Use tight-fitting screens/wire mesh on doors and windows.
Water in bird baths and plant pots or drip trays should be changed at least twice each
week.
Pet?s water bowls need to be emptied daily.
(Contributed by Drs Amol Annasaheb Patil- EIS Officer, Ganesh Lokhande- IDSP,
Simrita Singh, Dr, L.J.Kanhekar, Veena Mittal- NCDC)
