Serological evidence of rickettsial infections in Delhi.

BACKGROUND & OBJECTIVES: Rickettsial infections remain under-diagnosed due to lack of diagnostic facilities in developing world. Here we present our experience at National Centre for Disease Control, Delhi, about a serosurvey done in Delhi for rickettsial disease with easy to perform low cost, low expertise Weil Felix test. METHODS: On the basis of cut-off titre obtained in healthy population, Weil Felix test results were interpreted along with clinical data. Entomological investigation was also carried out in select areas of Delhi. Rodents were trapped from houses and gardens and vector mites were collected. RESULTS: When serum samples were collected during initial 5 yr period from patients with fever of unknown origin, seropositivity was 8.2 per cent whereas when rickettsial infection was kept as one of the differential diagnosis by clinicians seropositivity increased to 33.3 per cent. Rickettsial infections detected were scrub typhus (48.2%) followed by spotted fever group (27.5%) and typhus group (6.8%) during 2005-2009. In preliminary entomological survey vector mite Leptotombidium deliense was found on rodents. INTERPRETATION & CONCLUSIONS: Our findings showed that results of Weil Felix test should not be disregarded, rather clinically compatible cases should be treated to save lives.

Humoral response to rabies vaccines in pet dogs.

Humoral immune response was studied in dogs vaccinated with different tissue culture vaccines commonly used for immunization of dogs in India. The results revealed that after single dose of vaccination only 56% dogs developed protective titer (> or = 1:8). The response of the three vaccines used in the study was not similar, highlighting the need to maintain post marketing surveillance.

Prompt laboratory diagnosis in timely containment of a plague outbreak in India.

A focal outbreak of pneumonic plague occurred in a hamlet of village Hatkoti, district Shimla, Himachal Pradesh in the first fortnight of February, 2002. A total of 16 cases with 4 deaths were reported. Diagnosis of plague was confirmed by the laboratory in 10 (63%) cases. Y. pestis was isolated from clinical samples of 3 cases and confirmed by bacteriophage lysis. Molecular tests confirmed the presence of Y. pestis specific pla and F1 genes in 4 cases; DNA fingerprinting had identity with the known sequence of plague bacilli. Paired samples from 5 cases showed more than 4 fold rise and 1 case showed more than 4 fold fall in antibodies against F1 antigen of Y. pestis. The present communication emphasises that timely and systematic laboratory investigations give confirmatory diagnosis in shortest possible time which forms the backbone of the outbreak control in a timely fashion and prevents confusion and controversy.

Quick control of bubonic plague outbreak in Uttar Kashi, India.

A localized outbreak of bubonic plague occurred in village Dangud (population 332), district Uttar Kashi, Uttaranchal, India in the second week of October 2004. 8 cases were considered outbreak associated based on their clinical and epidemiological characteristics; 3 (27.3%) of them died within 48 hours of developing illness. All the 3 fatal cases and five surviving cases had enlargement of inguinal lymph nodes. None of them had pneumonia. The age of the cases ranged from 23-70 years and both sexes were affected. No such illness was reported from adjoining villages. The outbreak was fully contained within two weeks of its onset by supervised comprehensive chemoprophylaxis using tetracycline. A total of approximately 1250 persons were given chemoprophylaxis in three villages. There was no clear history of rat fall in the village. No flea was found on rodents or animals. 16 animal serum samples were found to be negative for antibodies against F-1 antigen of Y. pestis. However, Y. pestis was isolated from two rodents (Rattus rattus and Mus musculus) trapped in the village. One case and three animal sera showed borderline sero-positivity against rickettsial infection. The diagnosis of plague was confirmed by detection of four fold rise of antibody titre against F-1 antigen of Yersinia pestis in paired sera of three cases (one of the WHO approved criteria of diagnosis of confirmed plague). This outbreak and the occurrence of earlier outbreaks of plague in Surat (Gujarat) and Beed (Maharashtra) in 1994 and in district Shimla (Himachal Pradesh) in 2002 confirm that plague infection continue to exist in sylvatic foci in many parts of India which is transmitted to humans occasionally. Thus, there is a strong need for the States to monitor the plague activity in known sylvatic foci regularly and have a system of surveillance to facilitate prompt diagnosis and treatment of cases to control the disease. This investigation highlights that with high index of suspicion the disease can be diagnosed early and mounting of supervised comprehensive response can prevent the disease to proceed to pneumonic stage where man to man transmission gets established and outbreak assumes larger dimensions.

An outbreak of human anthrax in Mysore (India).

Anthrax is a zoonotic disease caused by Bacillus anthracis. Intestinal anthrax though a rare entity mostly ends with fatal outcome. Very few cases of intestinal anthrax are reported. Present outbreak of intestinal anthrax is unique in itself that four cases succumbed to the illness within a span of 48-72 hours in a small hamlet of Mysore district of Karnataka, after consuming diseased deer meat. Confirmation of the diagnosis was carried out at NICD, Delhi by bacteriological culture isolation, biochemical tests, animal pathogenicity and polymerase chain reaction (PCR). This outbreak clearly indicates surveillance of anthrax in animals in endemic areas is an essential part in the control of the disease with intersectoral coordination between the departments of health, animal husbandary, agriculture and forest.

A new model for blood flow through an artery with axisymmetric stenosis.

Presented herein are the studies on the flow behavior of a blood type suspension through a circular tube with an axisymmetric stenosis. The suspension of the cells in plasma is represented by a layered fluid model, with a marginal cell-free layer of the suspending medium near the wall, a central core region and an annular layer of a biviscous fluid layer. It is understood that the proposed model may contribute to the inbuilt mechanism for drag reduction and prevention of the further development of the stenosis. The concept of lubricating pipe lining for transporting various industrial fluids is well represented through three-layered core-annular flows. The governing equations are solved numerically by using finite element method. The velocity fields, including separation and reattachment points, and the distribution of pressure and wall shear stresses have been brought out and discussed. The results of the analysis show that the presence of the marginal cell-free layer reduces the wall shear stresses and the length of the flow reversal zone. The non-Newtonian character of the suspension is helpful in reducing the abnormal effects of the stenosis. The model thus establishes the inbuilt character of blood for decreasing the stresses and this, in turn, reduces the load on the heart in propelling the blood.

A mathematical model for blood flow through an arterial bifurcation.

By introducing the finite element technique, a study of blood flow through an arterial bifurcation is presented in this paper. The blood is represented by a modified model of thixotropic power-law fluids, for which the parametric values for blood, both in normal and pathological states, have already been established. The results for the velocity profiles, pressure and wall shear stress distributions are elucidated and discussed for normal old and diseased states. The separation and reattachment points are also located for different values of the Reynolds number and the flow behaviour index (n) of the model representing the blood. The analysis identifies low shear stress zones behind the stenosis along the outer wall and high shear stresses downstream of the apex. The increasing percentage of the stenosis and the increasing values of the Reynolds number facilitate the high shear stress zones, whereas the thixotropy of the blood depicts an inbuilt mechanism of reducing high shear stresses as well as flow reversal regions.

A model for blood flow through a stenotic tube.

This article deals with the introduction of the modified Casson's fluid model as the true representation for the blood for the steady laminar flow through a small diameter artery with axi-symmetric identical double stenoses in series. The governing equations are solved by using the finite element method. The results for the velocity profiles, the pressure and the wall shear stress distributions in addition to the location and length of the flow reversal zones have been brought out and discussed in reference to the severity of the disease. It has been observed that the non-Newtonian nature of the blood helps in reducing the magnitude of the peak wall shear stress at the throat and the length of the reversed flow regions in the post stenotic dilatation.

Pathogenesis of buffalo-pox virus in buffalo calves.

Pathogenesis of buffalo-pox virus (BP4 strain) in buffalo calves following intradermal inoculation revealed bimodal thermal reaction. The prominent symptoms were lacrimation, mucoprulent nasal discharge and diarrhoea. The typical pook lesions produced in the skin were passed through reseolar, papular, vesicular, pustular and desquamative stages of infection followed with a second rash, between day 6-8 on the lips, tongue, neck, perinium region and around the nostrils and eyes. After the eclipse phase of 10 hours, the concentration of the virus started increasing logarithmically. Thereafter, the virus was subsequently detected in the regional lymphnode, blood stream and central organs viz., lung, liver & spleen on 2nd, 4th and 5th day, respectively. In blood stream the virus was found to be associated with white blood cells. Secondary viremia was again on day 6 post-inoculation. Gross and microscopic changes were observed in these organs. The presence of virus along with pathologic changes were also detected in stomach and intestine. The disease ran a course of 13 to 15 days.

A sero-epidemiological study of brucellosis among workers of veterinary hospitals and slaughter house of Union Territory of Delhi.

In the sero-epidemiological study in Union Territory of Delhi. sera from 148 veterinary workers and fifty healthy individuals were examined. Of the serum samples collected from veterinary workers 41 (27.7%) showed a titre of 80.I.U./ml for brucella agglutinins. Among positive individuals 9 (22%) exhibited clinical features. The highest sero-positivity was recorded in veterinary compounders (51.4%) followed by veterinary assistant surgeons (40%). Agewise positivity was found to be maximum (37.3%) in the age group 31 to 40 years and minimum (11.6%) in the age group 21 to 30 years. The incidence was found to be higher in rural than urban districts. In healthy control group none was found to be positive.