Chandipura Virus: Media confirms "outbreak" based on 1 confirmed case
2003: Chandipura outbreak in Andhra Pradesh that wasn’t?
The Outbreak
As of July 19th, 2024, several media houses have confirmed the existence of a viral outbreak attributed to the Chandipura virus, a virus which according to “experts” is transmitted through sandflies. [1, 2, 3] Importantly, Chandipura virus is considered to be one of the “causes” of viral encephalitis or AES (Acute Encephalitis Syndrome). [9]
However, the simple question to be asked here is - what is the basis for attributing the outbreak to the virus? A closer look at media reports, and you realize that almost all cases and deaths reported are “suspected”. According to one article from July 19th, the Gujarat Health Minister has acknowledged that out of the 7 samples tested by NIV so far, only 1 has come back positive. [4] Amazing that this fact is used to conclude we have an outbreak caused by the “Chandipura virus”.
So if 1 is positive, it implies 6 are negative. Right? Shouldn’t the logical question, at a minimum, then be that what should these 6 negative cases be attributed to? Perhaps, based on our observation of the behavior of media over the last 4 years, it’s no surprise that such questions are not being asked.
Let’s dig deeper, and see if we can come up with some answers, or at least come up with the right questions.
Is the Gujarat Chandipura outbreak triggered by last month’s mass polio vaccinations, or mass vaccinations in general?
In June 2024, mass polio campaign was inaugurated aimed at immunizing over 8 million kids aged 5 or below. Less than a month later, we hear about an infectious outbreak impacting children, attributed to the "Chandipura" virus. Is this more than just a coincidence? [6] It has been argued in a detailed writeup by me before that vaccines can cause encephalitis. [5] It is all the more important to look at this angle, because, prior to intensified vaccination campaigns for polio nationally (in 2003) and for JE (or Japanese Encepahlitis) in Andhra Pradesh (in 2001), no reports of outbreaks from Chandipura virus had been reported for nearly 3 decades. [11]
In India’s context, it is important to understand the history of mass polio vaccinations, the history of Japanese Encephalitis vaccinations, the outbreaks of acute encephalitis syndrome (AES), the ever increasing number of vaccinations in the childhood immunization schedule, and the relationship between these 4 events. The below graphs are reproduced from previous articles written by this author [7, 8]
1. Mass polio vaccinations: When mass polio vaccinations were launched and further intensified, India experienced rising cases of Acute Flaccid Paralysis, or, AFP (polio renamed) and also experienced one of its worst outbreaks of Japanese Encephalitis (or what was later known as Acute Encephalitis Syndrome or AES) in 2005. It is important to note that at least some cases of AES or Acute Encephalitis Syndrome were pre-1997 classified as polio and later considered a subset of AFP.
2. AES before 2007 was known as Japanese Encephalitis. As AFP cases rose, so did JE (Japanese Encephalitis) cases, and in 2005, India launched JE vaccinations in select regions, which were subsequently expanded to cover over 180 districts by 2011. JE was redefined in 2007, per WHO's recommendation, to Acute Encephalitis syndrome or AES (just like polio was reclassified as AFP), giving rise to the illusion of efficacy of the JE vaccines.
3. With JE redefined as AES, only about 15-20% of AES cases post-2007 were attributed to JE. The others were attributed to various other "viruses" such as dengue, chikungunya, nipah, chandipura etc. [10] The launch of JE vaccines had no negative impact on the overall incidence of AES.
4. Around the time when India became "polio free", and was certified so by WHO, India started gradually increasing the number of vaccines in the immunization schedule (while the number of pulse polio campaigns was reducing arguably to reflect the success of the polio campaign). As a number of new vaccines/vaccine doses were introduced in the immunization schedule, the AES cases continued to rise.
The above 4 facts bring forth the below hypotheses
1. There is a positive association between polio immunization campaigns and AES.
2. There is a positive association between mass vaccinations in general and AES.
3. The same disease (JE) has been rebranded as AES and attributed to various "viruses" including Chandipura.
4. More broadly speaking, AES, at least in part, was nothing but polio pre-1997, prior to change in definition of polio. About 3% of AFP cases are sub classified as encephalitis/meningoencephalitis per one study.
The association between vaccines and outbreak of encephalitis cannot be ruled out and it is odd that “experts” don’t look at this angle. In an earlier article on encephalitis, this author has highlighted the association between the two and referenced several studies. [5]
2003: Chandipura outbreak in Andhra Pradesh that wasn’t?
The Chandipura virus outbreak in Andhra Pradesh in 2003 was earlier speculated to be Japanese Encephalitis by National Institute of Communicable Diseases (NICD) [15], but subsequently attributed to Chandipura by National Institute of Virology (NIV). Coincidentally, Andhra Pradesh is where the Japanese Encephalitis vaccine had been trialed from 2001 to 2004. While Andhra Pradesh reported a drop of 90% in JE cases in 2003 per a presentation by PATH, one of the sponsors of the program [12, 13, 14], oddly enough, Andhra also reported an outbreak of the Chandipura virus. Based on the facts mentioned in the preceding section, the question needs to be asked if the reduction in JE cases coinciding with increase in "non JE" AES cases was simply a coincidence, or a case of reclassification of JE to non-JE AES, specifically Chandipura?
Based on 2 published studies regarding this outbreak, there are serious doubts if the so called “Chandipura” virus was the driver of this outbreak. This is based on 2 facts.
Per one study, only about half of the small number of samples tested were positive for the virus. This leaves the other half unexplained. Moreover, the authors have not looked at the possible link between outbreaks of encephalitis and the mass vaccinations.
Importantly, another study, which exclusively looked at strokes during the epidemic, and where about half of the cases showed evidence of Chandipura virus, raised doubts about Chandipura being the cause.
“The recent epidemic, reported as Chandipura encephalitis, was neither encephalitis nor the role of Chandipura virus (CHPV) confirmed. …. It was, in fact, an “epidemic of brain attacks” masquerading as an encephalitis epidemic, which played havoc in 10 districts of Andhra Pradesh”
“Though infection is the cause, etiologic role of Chandipura virus is doubtful” [16]
“Of the 55 cases of encephalitis investigated, evidence of recent infection with Chandipura virus could be established conclusively in 28 cases (51%) based on either the presence of virus or viral RNA, IgM antibodies, or both” [17]
Conclusion
Is it possible that the Chandipura virus outbreak is associated with the mass polio immunization campaigns in June, or in general with the ever increasing number of vaccines in the immunization schedule, or both? Is the media frenzy aimed at hyping up another vaccine for Chandipura virus? [18] A deep understanding of how diseases are redefined to create the illusion of vaccine efficacy, and the same disease is represented by a different name, especially post immunization campaigns, is required by the key stakeholder, i.e. the public, to question this. We should not forget the negative role played by media during Covid-19, from spreading panic to cheering mindless, harmful public health measures.
References
[1] Sahay, Jigyasa. “Chandipura Virus in Gujarat: What Is This Viral Infection That Has Claimed 4 Lives? All You Need to Know.” Www.india.com, 16 July 2024, www.india.com/health/chandipura-virus-outbreak-in-gujarat-what-is-the-deadly-virus-that-has-claimed-6-lives-all-you-need-to-know-symptoms-precautions-7088903/.
[2] Express Web Desk. “What Is the Chandipura Virus (CHPV): Know the Symptoms, Treatment, Prevention, and More.” The Indian Express, 19 July 2024, indianexpress.com/article/what-is/what-is-the-chandipura-virus-chpv-symptoms-treatment-prevention-9461299/.
[3] Clarance, Daphne. “Chandipura Virus Outbreak in Gujarat: All about the Deadly Infection.” India Today, 17 July 2024, www.indiatoday.in/health/story/chandipura-virus-outbreak-gujarat-symptoms-causes-prevention-treatment-the-deadly-infection-2567916-2024-07-17.
[4] Shastri, Parth. “Docs Dispel “Chandi” Misconceptions.” The Times of India, 19 July 2024, timesofindia.indiatimes.com/city/ahmedabad/chandipura-virus-outbreak-in-gujarat/articleshow/111847607.cms.
[5] Srivastava, Vratesh. “Encephalitis in India: A Man Made Epidemic?” Vratesh’s Newsletter, 31 Mar. 2024, vratesh.substack.com/p/encephalitis-in-india-a-man-made.
[6] India. “Gujarat CM Launches Anti-Polio Campaign to Vaccinate 837,200 Children.” @Bsindia, Business Standard, 23 June 2024, www.business-standard.com/india-news/gujarat-cm-launches-anti-polio-campaign-to-vaccinate-837-200-children-124062300220_1.html.
[7] Srivastava, Vratesh. “Encephalitis in India: A Man Made Epidemic?” Vratesh’s Newsletter, 31 Mar. 2024, vratesh.substack.com/p/encephalitis-in-india-a-man-made.
[8] Srivastava, Vratesh. “The Other Side of India’s Polio Eradication Story.” Vratesh’s Newsletter, 18 Nov. 2023, vratesh.substack.com/p/the-other-side-of-indias-polio-eradication.
[9] Gajanan Sapkal, et al. “Chandipura Viral Encephalitis: A Brief Review.” The Open Virology Journal, vol. 12, no. 1, 31 Aug. 2018, pp. 44–51, https://doi.org/10.2174/1874357901812010044.
[10] Misra, UshaK, and Jayantee Kalita. “Changing Spectrum of Acute Encephalitis Syndrome in India and a Syndromic Approach.” Annals of Indian Academy of Neurology, vol. 25, no. 3, 2022, p. 354, https://doi.org/10.4103/aian.aian_1117_21.
[11] Chandna, Himani. “How Chandipura Virus Made a Comeback and Continues to Recur among Children in Gujarat.” News18, 19 July 2024, www.news18.com/explainers/how-chandipura-virus-made-a-comeback-and-continues-to-recur-among-children-in-gujarat-8971182.html.
[12] Durgan, Susan. “Bill Gates Visits New Delhi Clinic to Encourage Final Push to Eradicate Polio.” Bill & Melinda Gates Foundation, www.gatesfoundation.org/ideas/media-center/press-releases/2000/09/support-for-vaccinepreventable-diseases.
[13] PATH. Andhra Pradesh: Building a Model Immunization System Indian State Protects Millions and Demonstrates What New Vaccines and Technologies Can Achieve. 2004.
https://media.path.org/documents/CVP_AP.pdf?_gl=1*16kcddt*_gcl_au*MTQ2NDQ4NzEyMi4xNzIxMzk4MTg2*_ga*ODQyNTkzMDUwLjE3MjEzOTgxODY.*_ga_YBSE7ZKDQM*MTcyMTQwOTA5OC4yLjAuMTcyMTQwOTA5OC42MC4wLjA.
[14] PATH. “Case Study: India’s Leadership in the Fight against Japanese Encephalitis.” Www.path.org, www.path.org/who-we-are/programs/center-for-vaccine-innovation-and-access/case-study-indias-leadership-in-the-fight-against-japanese-encephalitis/.
[15] Varshney, Vibha. “Deceptive Bug behind Andhra Disease.” Down to Earth, 31 Aug. 2003, www.downtoearth.org.in/environment/deceptive-bug-behind-andhra-disease-13375.
[16] Kumar, P., et al. “Role of Chandipura Virus in an “Epidemic Brain Attack” in Andhra Pradesh, India.” Journal of Pediatric Neurology, vol. 02, no. 03, 29 July 2015, pp. 131–143, tspace.library.utoronto.ca/retrieve/4003/pn04027.pdf, https://doi.org/10.1055/s-0035-1557208.
[17] Rao, BL, et al. “A Large Outbreak of Acute Encephalitis with High Fatality Rate in Children in Andhra Pradesh, India, in 2003, Associated with Chandipura Virus.” The Lancet, vol. 364, no. 9437, Sept. 2004, pp. 869–874, https://doi.org/10.1016/s0140-6736(04)16982-1.
[18] Chandna, Himani. “How Chandipura Virus Made a Comeback and Continues to Recur among Children in Gujarat.” News18, 19 July 2024, www.news18.com/explainers/how-chandipura-virus-made-a-comeback-and-continues-to-recur-among-children-in-gujarat-8971182.html.