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Lole KS, Thorat NC, Bhukya PL, Ramdasi AY, Hundekar SL, Patil AR, Shelkande SD, Sapkal GN. Circulation of a single hepatitis A virus genotype IIIA with two distinct clusters in different states of India. Indian J Med Microbiol 2023; 43:96-100. [PMID: 36481121 DOI: 10.1016/j.ijmmb.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/03/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Abstract
With the changing hepatitis A epidemiology in India, focal viral outbreaks are being reported from different parts of the country. This study presents Hepatitis A Virus (HAV) strain characterization (period 2009-2020) from 18 states of India. For that, blood and stool samples (n = 280) were screened for HAV RNA and sequences for 5'non-coding and VP3 regions were generated from positive samples (n = 68). Presence of a single IIIA genotype in all samples indicated IIIA being the only HAV genotype currently circulating in India. Interestingly, it was evident that these strains form two distinct groups suggesting independent evolution of these two clusters.
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Affiliation(s)
- Kavita S Lole
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India.
| | - Neeta C Thorat
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Prudhvi Lal Bhukya
- Resource Centre and Virus Diagnostic Laboratory (RCVDL), ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Ashwini Y Ramdasi
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Supriya L Hundekar
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Anuradha R Patil
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Sunil D Shelkande
- Hepatitis Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Gajanan N Sapkal
- Resource Centre and Virus Diagnostic Laboratory (RCVDL), ICMR-National Institute of Virology, Pune, Maharashtra, India
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Liu C, Zhang J, Zhang Z, Li Y, Kang Z. Correlation Analysis of TSB Level and Globus Pallidus-Related Metabolite Indexes of Proton Magnetic Resonance Spectroscopy in the Newborn with Neonatal Jaundice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:9785584. [PMID: 35832519 PMCID: PMC9273364 DOI: 10.1155/2022/9785584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/15/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
Objective To investigate the correlation between serum total serum bilirubin (TSB) levels and globus pallidus-related metabolic indexes of proton magnetic resonance spectroscopy (1H-MRS) in the newborn with neonatal jaundice. Methods 50 children with neonatal jaundice admitted to our hospital from January 2019 to January 2021 were recruited and assigned to a mild condition group (TSB < 221 μmol/L, n = 16), a moderate condition group (221 μmol/L ≤ TSB < 3 42 μmol/L, n = 18), and a severe condition group (342 μmol/L ≤ TSB < 428 μmol/L, n = 16) based on peak TSB. The differences in globus pallidus-related metabolic indexes of 1H-MRS between the groups were compared and their correlation with TSB levels was analyzed. Results The three groups had comparable N-acetylaspartic acid (NAA)/creatine (Cr), choline (Cho)/Cr, lactic acid (Lac)/Cr, and ml/Cr levels (P > 0.05), while there were statistical differences in glutamine (Glx)/Cr levels (P < 0.05). The severe condition group showed the highest levels of neuron-specific enolase (NSE), creatine kinase-MB (CK-MB), and troponin (cTnl), followed by the moderate group, and then the mild group (P < 0.05). The TSB level is positively correlated with the 1H-MRS metabolic index Glx/Cr. Conclusions The serum TSB level is correlated with the 1H-MRS metabolic index Glx/Cr in the newborn with neonatal jaundice, and the levels of TSB and Glx/Cr provide a reference for the diagnosis of bilirubin encephalopathy.
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Affiliation(s)
- Chaoyan Liu
- Department of Imaging, Hengshui People's Hospital, Hengshui, Hebei Province, China
| | - Jieyu Zhang
- Department of Imaging, Hengshui People's Hospital, Hengshui, Hebei Province, China
| | - Zhao Zhang
- Department of Imaging, Hengshui People's Hospital, Hengshui, Hebei Province, China
| | - Yang Li
- Department of Newborn, Hengshui People's Hospital, Hengshui, Hebei Province, China
| | - Zhilei Kang
- Department of Imaging, Hengshui People's Hospital, Hengshui, Hebei Province, China
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Srinivasan M, Sindhu KN, Giri S, Kumar N, Mohan VR, Grassly NC, Kang G. Salmonella Typhi Shedding and Household Transmission by Children With Blood Culture-Confirmed Typhoid Fever in Vellore, South India. J Infect Dis 2021; 224:S593-S600. [PMID: 35238362 PMCID: PMC8892528 DOI: 10.1093/infdis/jiab409] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Children suffer the highest burden of the typhoid fever, with a considerable proportion shedding Salmonella Typhi in stool, potentially resulting in transmission of S Typhi. METHODS We enrolled 70 children with blood culture-confirmed typhoid fever (index cases), from 63 households, during community-based fever surveillance in India. The index cases and their household contacts were followed up with stool samples at multiple time points over 3 weeks and 1 week, respectively. S Typhi was detected using quantitative real-time polymerase chain reaction. RESULTS Fifteen of 70 (21.4%) children with culture-confirmed typhoid fever shed S Typhi in stool after onset of fever. Ten of 15 children shed S Typhi for a median of 11.5 (range, 3-61) days from the day of completion of antibiotics. Of 172 household contacts from 56 of the 63 index case households, 12 (7%) contacts in 11 (19.6%) households had S Typhi in stool. Five of the 12 contacts who were shedding S Typhi were asymptomatic, whereas 7 reported recent fever. CONCLUSIONS One in 5 children with typhoid fever shed S Typhi, with shedding persisting even after antibiotics. One in 5 households had at least 1 contact of the child shedding S Typhi, highlighting potential concurrent typhoid infections in households in settings with poor water and sanitation.
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Affiliation(s)
- Manikandan Srinivasan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore,India
| | | | - Sidhartha Giri
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore,India
- Indian Council of Medical Research – Regional Medical Research Centre, Bhubaneswar, Odisha,India
| | - Nirmal Kumar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore,India
| | | | - Nicholas C Grassly
- Department of Infectious Disease Epidemiology, Imperial College, London,United Kingdom
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore,India
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Srinivasan M, Sindhu KN, Nag A, Karthikeyan AS, Ramasamy RK, Murugesan M, Kumar D, Ganesan SK, Rose W, Kang G, John J. Hospitalization Rates and Direct Medical Costs for Fever in a Pediatric Cohort in South India. J Infect Dis 2021; 224:S548-S557. [PMID: 35238368 PMCID: PMC8892546 DOI: 10.1093/infdis/jiab329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Primary data on causes and costs of hospitalization are necessary for costing and cost-effectiveness analysis. Data on incidence and causes of hospitalization and consequent expenses among Indian children are limited. Methods A cohort of 6000 children aged 0.5–15 years residing in urban Vellore was followed for 3 years, under the Vellore Typhoid Study, 2016–2017, and later under the Surveillance for Enteric Fever project, 2017–2019. Data on hospitalization events and associated antibiotic use, and direct medical costs for fever-related hospitalization of study children were obtained from caregivers through weekly follow-up by study field workers. Results The incidence of hospitalization was 33 per 1000 child-years of observation. Children aged 0.5–5 years had the highest incidence of hospitalization. The top 5 infectious causes for hospitalization were acute undifferentiated fevers, respiratory tract infections, acute gastroenteritis, enteric fever, and dengue. The overall median cost of hospitalization for fever was 4243 (interquartile range, 2502–7215) Indian rupees (INR). An episode of dengue had a median cost of 5627 INR, followed by acute undifferentiated fevers and enteric fever with median costs of 3860 and 3507 INR, respectively. Conclusions Hospitalization for fever is common in young children and impacts household finances in low-income Indian households.
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Affiliation(s)
- Manikandan Srinivasan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Atrayee Nag
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Arun S Karthikeyan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Ranjith Kumar Ramasamy
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Malathi Murugesan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Dilesh Kumar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Santhosh Kumar Ganesan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Winsley Rose
- Department of Child Health, Christian Medical College, Vellore, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jacob John
- Department of Community Health, Christian Medical College, Vellore, India
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Susarla SK, Palkar S, Sv PS, Diwan A, Barsode S, Satish M, Rajashakar BC, Sandhya G, Lingala R, Sahoo DP. Safety and immunogenicity of inactivated hepatitis-A vaccine developed by Human Biologicals Institute in two age groups of healthy subjects: A phase I open label study. Vaccine 2021; 39:2088-2093. [PMID: 33741190 DOI: 10.1016/j.vaccine.2021.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 08/13/2020] [Accepted: 03/03/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hepatitis-A is an acute viral infection of the liver. Hepatitis-A virus has worldwide spread and is endemic in India. Though the disease is self-limiting in most cases, outbreaks are reported frequently from both developing and developed countries of the world. Severity and fatality occur more among infected symptomatic adults. The infection can be prevented with proper and timely immunization. This phase I, single arm, open label, multicenter trial was designed to assess the safety and immunogenicity of the inactivated hepatitis-A vaccine developed by Human Biologicals Institute when administered in a single dose in two age groups of healthy subjects. METHODS This study was carried out in 55 subjects in two healthy age groups at two centers in India. Group A included subjects of 19-49 years and group B subjects of 12-18 years of age. Enrolled subjects received a single dose of inactivated hepatitis A vaccine. Blood samples were collected at baseline and 4-6 weeks after vaccination. Safety was assessed by collection and analysis of data on solicited and unsolicited adverse events and immunogenicity was assessed by estimating the seroconversion rate, seroprotection rate and the geometric mean titres of antibodies. RESULTS Among the 55 subjects enrolled, 15 reported adverse events. No serious adverse event was reported. Pain at the injection site was the lone local adverse event. Systemic adverse events reported in Group A were: fatigue, headache, diarrhoea, fever, anorexia, nausea and upper respiratory tract infection, whereas there was no systemic event reported in Group B. There was 100% seroconversion and seroprotection and significant rise in antibody titre levels were observed in both the groups post vaccination. CONCLUSIONS This study found HBI inactivated hepatitis-A vaccine to be safe and highly immunogenic when administered as a single dose in adolescent and adult subjects.
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Affiliation(s)
| | - Sonali Palkar
- Department of Paediatrics, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Pardha Saradhi Sv
- Consultant Physician and Nephrologist, Apollo DRDO Hospital, Hyderabad, Telangana, India
| | - Arundhati Diwan
- Department of Medicine, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Supriya Barsode
- Department of Medicine, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - M Satish
- Indian Immunologicals Limited, Hyderabad, Telangana, India
| | - B C Rajashakar
- Indian Immunologicals Limited, Hyderabad, Telangana, India
| | - G Sandhya
- Indian Immunologicals Limited, Hyderabad, Telangana, India
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Shenoy B, Andani A, Kolhapure S, Agrawal A, Mazumdar J. Endemicity change of hepatitis A infection necessitates vaccination in food handlers: An Indian perspective. Hum Vaccin Immunother 2021; 18:1868820. [PMID: 33595412 PMCID: PMC8920195 DOI: 10.1080/21645515.2020.1868820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
In the last two decades, outbreaks due to the foodborne hepatitis A virus (HAV) have been frequently reported in India, with adolescents and adults primarily affected. In India, most food handlers are adolescents and young adults who might be exposed to unsatisfactory environmental conditions and poor water quality. This increases the risk of HAV infection and consequently compounds the risk of HAV transmission from food handlers to susceptible populations. Given the shift in hepatitis A endemicity from high to intermediate levels in India, implementing the vaccination of food handlers has become important as it can also contribute to the elimination of hepatitis A in India. This narrative review makes a case for hepatitis A immunization of food handlers in India considering the growing food industry, evolving food culture, and the substantial burden caused by hepatitis A outbreaks.
What is the context?
Hepatitis A disease is a common form of viral hepatitis and is transmitted through contaminated food and water or through close contact with an infected person. The virus with stands high temperature and can survive on surfaces for long periods of time. In India, the burden of hepatitis A has shifted from children to adolescents and adults who are more culnerable to infection. They present a high risk of complications, often requiring hopitalization. The prevention of the disease has often bee neglected, inadequate safety measures for the preparation of food (via food handlers) is a known risk factor for the transmission of hepatitis A.
What is new?
Our review highlights the relationship between food handling and hepatitis A infection among adolescents and adults in Inida. The lack of knowledge of food safety regulations and hygiene measures among food handlers and the organizations that guide them may contribute to the spread of hepatitis A.
What is the impact?
Sanitation efforts, awareness and educational programs for food are needed to help reduce the transmission of hepatitis A virus and disease, yet these measures alone may not be sufficient. Vaccination among high-risk populations such as food handlers can prevent hepatitis A infection and its complications as well as transmission.
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Affiliation(s)
- Bhaskar Shenoy
- Department of Paediatrics, Division of Pediatric Infectious Diseases, Manipal Hospital, Bangalore, India
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