Dengue Scourge in Delhi – What the Stakeholders Think, a Search for Perspective

Background and Objective: Amongst all the states and union territories in India, New Delhi shares the highest burden of the disease. Dengue infection is influenced by several socioeconomic factors, which involve roles, and responsibilities of various stakeholders of the society. In this study, we attempt to explore the awareness, knowledge and perception about dengue amongst relevant stakeholders.Methodology: A sample of 30 stakeholders having different roles in management of dengue was taken all over from Delhi. In-depth, face-to-face, qualitative interviews were taken using an interview tool customized as per roles and responsibilities of the stakeholders.Result: The study identified four key themes in management of dengue in Delhi. These themes were studied in depth and various challenges in dengue management were explored

Molecular Study of Glycoprotein (G) Gene Region of Rabies Virus from Spotted Deer, Delhi, India

Rabies is a viral zoonotic disease of public health importance in India. The disease is usually transmitted by a rabid animal bite, scratches and licks on broken skin and mucous membrane. Rabies is reported from all continents except Antarctica although prevalence is more in Asia and Africa. India is endemic for rabies virus (RABV) throughout the country except for islands of Lakshadweep, Andaman & Nicobar. In the present study, brain samples of clinically suspected animals obtained during the RABV outbreak at National Zoological Park, New Delhi, India, in 2016 were initially tested for rabies antigen by DFAT. All the 32 DFAT positive brain samples were then processed for RNA isolation. The extracted RNA was amplified for glycoprotein (G) gene of 590 bp by RT-PCR followed by nucleotide sequencing. Nucleotide alignment revealed only substitutions without any insertion or deletion. Amino acid alignment revealed replacement at four positions namely L244I, T264A, M310I and N375K. The amino acid change at position where Leucine is replaced by Isoleucine has not been observed in available RABV references of the G gene region either from India or other countries. This mutation was observed in all the samples included in the present study. A phylogenetic tree showed that all the study sequences belonged to Arctic like 1a lineage, in RABV genotype 1. In conclusion, RABV in the study region is acquiring genetic variation; which may have effect on the pathogenicity. This indicates that continued molecular surveillance of the circulating rabies virus strains should be carried out

Urban Malaria Scheme - Past, Present & Future

Urban Malaria, as a specific problem in India, was first recognized in 1969, after an in- depth review of the situation of malaria in India was done by Madhok Committee. However, main malaria vector in urban areas of India is An. stephensi, which was first recognized in early part of the 20th century. Many of the local bodies carrying out anti- larval operations earlier failed to continue the same due to paucity of funds. During that time, malaria in urban areas was not considered as a major problem because the epidemics recorded earlier in Bombay, Delhi, Lucknow etc. could immediately be contained. Based on recommendations of Madhok Committee to control malaria in urban areas, the Urban Malaria Scheme (UMS) was launched in the country in 1971–7 2. A large scale migration of population, creation of slum clusters, construction activities and water storage practices have contributed in the establishment of malaria foci. Urban malaria control is therefore based on source reduction, larviciding, minor engineering interventions, legislative measures, building bye laws and limited spraying of indoor residual spray in peri- urban and jhuggies. Initially 131 towns with a population of > 40,000 and reporting > 2 API were included in the UMS. Later in 1978, due to merger of National Filaria control programme, 206 towns were also brought under vector control support and the preventive measures against malaria vector breeding in clean water as well as filaria vector breeding in polluted water were integrated. Though there has been a well structured separate programme for prevention and control of malaria in urban areas since 1971, the priority attached to it and its implementation has been an issue primarily because it is the responsibility of the local body. Moreover, in recent past, upsurge in cases of Dengue and Chikungunya in urban areas has diverted attention on both disease surveillance and vector control. Coincidently, the vectors of malaria and dengue/ Chikungunya in urban areas breed in clean water and control strategies are same but surveillance with limited resources has affected in assessing the actual magnitude of problem. This has resulted in upsurge in cases and deaths due to malaria in Mumbai during 2010. Historical background and future vision of Urban Malaria Scheme has been discussed in present article

Evaluation of Direct Rapid Immunohistochemistry Test (DRIT) for Postmortem Diagnosis of Rabies

Direct fluorescent antibody test (DFAT) is considered as the gold standard for diagnosis of rabies in infected mammals as it has high sensitivity and specificity. However, high cost and technical demand limits its utilization, particularly in developing countries including India. Therefore, in this study we evaluated recently developed direct rapid immunohistochemistry test (DRIT) for diagnosis of rabies in comparison with the DFAT. A total of 109 brain samples received during the period of 6 years from different regions of India were tested following standard protocol. The results showed 100% correlation between the two tests.

RSV-specific airway resident memory CD8+ T cells and differential disease severity after experimental human infection

In animal models, resident memory CD8+ T (Trm) cells assist in respiratory virus elimination but their importance in man has not been determined. Here, using experimental human respiratory syncytial virus (RSV) infection, we investigate systemic and local virus-specific CD8+ T cell responses in adult volunteers. Having defined the immunodominance hierarchy, we analyze phenotype and function longitudinally in blood and by serial bronchoscopy. Despite rapid clinical recovery, we note surprisingly extensive lower airway inflammation with persistent viral antigen and cellular infiltrates. Pulmonary virus-specific CD8+ T cells display a CD69+CD103+ Trm phenotype and accumulate to strikingly high frequencies into convalescence without continued proliferation. These are more highly differentiated but express fewer cytotoxicity markers than in blood, but their abundance prior to infection correlates with protection from more severe disease