1171. Japanese Encephalitis Outbreak among Children in Mayurbhanj, Odisha-India, 2015
Session: Poster Abstract Session: Clinical Infectious Diseases: CNS Infection
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ID Week_Poster.JPG (1.8 MB)
  • Background: Japanese Encephalitis (JE) is one of the leading causes of viral encephalitis in Asia. Annually 50,000 cases are reported in India with 30% deaths and 75% disability, but burden may be underestimated because many suspected outbreaks are not confirmed. During September-November, 2015 a viral encephalitis epidemic among children was reported from Mayurbhanj district, Odisha, India. We investigated to identify the etiology and understand epidemiological characteristics of the outbreak.

    Methods: A case was defined as illness among children <15 years, presenting with fever, vomiting, altered sensorium and convulsions in Mayurbhanj during September-November 2015. We reviewed medical records to find cases. We collected serum and cerebrospinal fluid (CSF) samples from case-patients to test for JE IgM ELISA at the Regional Medical Research Centre (RMRC) laboratory. Environmental and entomological surveys were conducted and 80 mosquitos were processed in 8 batches for reverse transcriptase polymerase chain reaction (RTPCR) at RMRC.

    Results: We identified 20 cases (67% female; median age 3 years [range: 1.5-4.6 years]) including 2 deaths. Among 20 serum and 4 CSF samples, 12 (60%) serum samples and all CSF specimens were JE IgM positive. Entomological survey showed the prevalence of Culex vishnui (larvae and adult), a known vector for JE. Rice field with stagnant water were found close to the affected households. Two batches of mosquito samples containing Culex vishnui and Culex gelidus species were positive for JE based on RTPCR.

    Conclusion: Our investigation confirmed the JE outbreak based on clinical specimens and substantiated by presence of JE virus in the vector mosquitoes. An integrated vector control approach with continuous monitoring and high JE vaccine coverage for eligible children is recommended to prevent epidemics.

    Priyakanta Nayak Sr., MPH, EIS1, Arghya Pradhan, MBBS, EIS2, Rajendra Mallick, MBBS3, S Sethi, MBBS, MD3, Bikash Patnaik, MBBS3, Madan M Pradhan, MBBS3, Aakash Shrivastava, MBBS, MD4, S Venkatesh, MBBS, MD4 and Kailash C Dash, MBBS, MD5, (1)Epidemiology, National Centre for Disease Control, New Delhi, India, (2)Idsp, Directorate of Public Health, Odisha, Bhubaneswar, India, (3)Directorate of Public Health, Odisha, Bhubaneswar, India, (4)National Centre for Disease Control, New Delhi, India, (5)Public Health, Directorate of Public Health, Odisha, Bhubaneswar, India

    Disclosures:

    P. Nayak Sr., None

    A. Pradhan, None

    R. Mallick, None

    S. Sethi, None

    B. Patnaik, None

    M. M. Pradhan, None

    A. Shrivastava, None

    S. Venkatesh, None

    K. C. Dash, None

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