Title: Chandipura Virus Resurfaces: The Indian State Gujarat’s urgent wake-up callDarshani Ransariya 1, Dhruvit Makvana1, Nirav Nimavat 1, Shruti Singh21. Department of Community Medicine, Gujarat Adani Institute of Medical Science, Bhuj, Gujarat, India.2. Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India.The recent outbreak of Acute Encephalitis Syndrome (AES) cases since early June 2024 have been reported from Gujarat in children under 15 years of age. As on 31st July 2024, 148 AES cases (140 from 24 districts of Gujarat, 4 from Madhya Pradesh, 3 from Rajasthan & 1 from Maharashtra) have been reported, out of which 59 cases have died. Chandipura virus (CHPV) has been confirmed in 51 cases, serves as a stark reminder of the persistent threat posed by vector-borne diseases in India.1 This resurgence demands immediate attention from health authorities and policymakers alike. Chandipura virus, first identified in 1965 in Maharashtra, has periodically emerged as a significant public health concern, particularly in western and central India, with its alarming fatality rate of nearly 50%-75%, underscores the virus’s potency and the urgent need for robust preventive measures.2,3Comparing this outbreak to previous occurrences, we see a troubling pattern. In 2003, Gujarat faced a severe outbreak with over 300 cases and a mortality rate exceeding 50%. The virus struck again in 2004 in Andhra Pradesh, causing 16 deaths from 329 suspected cases. These historical data points, juxtaposed with the current situation, indicate that while the scale of outbreaks may have reduced, the virus’s lethality remains a grave concern.4,5 The recurring nature of these outbreaks raises critical questions about our long-term strategies for disease control and public health infrastructure. Why, despite our experiences with previous outbreaks, are we still struggling to contain the spread effectively? The answer likely lies in a combination of factors: insufficient vector control measures, inadequate surveillance systems, and perhaps a lack of sustained public awareness campaigns during inter-epidemic periods.Furthermore, the present outbreak is taking place as the healthcare system is still getting over the COVID-19 pandemic’s effects. This combination of difficulties calls for a reassessment of our strategy for controlling vector-borne illnesses.Moving forward, a multi-pronged strategy is imperative:1. Enhanced surveillance: Putting in place reliable early warning systems to find viral activity before it spreads to epidemic levels.2. Vector control: Stepping up measures to combat the sand fly population, which serves as the main vector for the Chandipura virus.3. Research and development: Funding research to learn more about the possible mutations and patterns of viral propagation.4. Public awareness: Launching extensive public education programmes about early detection of symptoms and preventative measures.5. Healthcare preparedness: Ensuring that clinics and hospitals in endemic areas have the necessary tools to quickly identify and treat Chandipura virus infections.The current outbreak in Gujarat is not just a local crisis but a national wake-up call. It highlights the need for a more proactive and sustained approach to managing vector-borne diseases. As climate change potentially expands the habitable zones for disease vectors, the threat of such outbreaks may only increase. From July 19, 2024, a decreasing trend in the number of newly reported cases of AES per day has been seen. Gujarat has implemented a number of public health initiatives, including IEC, insecticidal spray for vector control, medical staff awareness, and prompt case referrals to approved hospitals. To support the Gujarat State Government in implementing public health measures and carrying out a thorough epidemiological investigation into the outbreak, a National Joint Outbreak Response Team (NJORT) has been sent in. NCDC and NCVBDC are releasing a combined recommendation to help neighbouring States with their AES case reporting.1In conclusion, it is critical to see this as a chance to improve our general readiness against vector-borne diseases, even as we struggle with the pressing issue of managing the outbreak in Gujarat. The sad loss of life serves as a stark warning about the price of complacency. It’s time for coordinated efforts to make sure that outbreaks are avoided in the future or, at the very least, are handled more skilfully.References:1. PIB. Update on Chandipura Outbreak in Gujarat [Internet]. 2024 [cited 2024 Aug 1]. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=20399352. Bhatt PN, Rodrigues FM. Chandipura: a new Arbovirus isolated in India from patients with febrile illness. Indian J Med Res. 1967 Dec;55(12):1295–305.3. Dhanda V, Rodrigues FM, Ghosh SN. Isolation of Chandipura virus from sandflies in Aurangabad. Indian J Med Res. 1970 Feb;58(2):179–80.4. Chadha MS, Arankalle VA, Jadi RS, Joshi M V, Thakare JP, Mahadev PVM, et al. An outbreak of Chandipura virus encephalitis in the eastern districts of Gujarat state, India. Am J Trop Med Hyg. 2005 Sep;73(3):566–70.5. Rao BL, Basu A, Wairagkar NS, Gore MM, Arankalle VA, Thakare JP, et al. A large outbreak of acute encephalitis with high fatality rate in children in Andhra Pradesh, India, in 2003, associated with Chandipura virus. Lancet. 364(9437):869–74.