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Tuesday, August 25, 2015

Suspected Hantavirus case in Mumbai - Aug 2015 - Promed update

Published Date: 2015-08-24 16:58:18
Subject: PRO/AH/EDR> Hantavirus update - Asia (03): India (MH) 
Archive Number: 20150824.3598785
HANTAVIRUS UPDATE - ASIA (03): INDIA (MAHARASHTRA)
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Date: Thu 20 Aug 2015
Source: Hindustan Times [edited]
http://www.hindustantimes.com/mumbai/contrary-to-bmc-s-claims-lab-reports-hantavirus-cases/article1-1382265.aspx


While the municipal health department has denied the incidence of [infections with a] hantavirus, a rare but deadly virus [clinically] similar to the leptospirosis pathogen, in Mumbai, a private diagnostic laboratory in the city that tested blood samples for the presence of the virus found 14 positive cases in the past 1.5 years.

On 4 Aug [2015], the Hindustan Times reported that the blood sample from a Kurla resident who was admitted to private hospital in Ghatkopar in July 2015 indicated that he had [a] hantavirus [infection] [see ProMED-mail archive no. 20150805.3560460]. The patient is now cured.

Following the report, the Brihanmumbai Municipal Corporation (BMC) collected blood samples from the patient and sent them for confirmatory tests to the National Institute of Virology (NIV) in Pune, but the reports were negative. Metropolis, a chain of pathology lab across the country, tested as many as 114 suspected samples of hantavirus, of which 14 were positive.

"Ours is a laboratory with pan-India presence, and it is not just Mumbai that we receive samples from but from all over the country. And we have positive cases of hantavirus [infection] from all over. In Mumbai alone, from 2014 to now we have had enough positive cases that show that the virus is very much present," said Dr Nilesh Shah, group president, scientific services and operations, west India, Metropolis.

The BMC said it is unaware of the new cases and it would have to investigate further and contact the lab for details. "We do not have any knowledge about the 14 cases. We will have to get in touch with the lab for further details," said Dr Mini Khetarpal, chief of epidemiology, BMC.

However, the civic body maintained that a hantavirus was not present in the city. "We cannot say for sure that there is hantavirus in light of the new cases that have been brought up. However, in our meeting with Bombay Veterinary College we were assured that no tests revealed the presence of virus in the city," he added. [But] "It would be unwise to say that are no hantavirus cases in the city. It is a matter of referring the cases for diagnosis for the said virus and reporting," said Dr Om Srivastava, infectious diseases expert at Jaslok Hospital. "In theory, it can be said that the antibodies will be present in the body. However, in this particular case it is unlikely that it will test positive, as there has been a significant delay in collecting the blood sample," he added. [This is incorrect. It is only the virus that disappears from the bpdy with time -- the antibodies remain and increase. - Mod.JW]

[Byline: Shobhan Singh]

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Communicated by:
ProMED-mail from HealthMap Alerts


[It is difficult to draw conclusions from the information provided in the report above regarding whether the patient reported on 4 Aug 2015 had a hantavirus infection or not. Initially, the diagnosis was made on clinical grounds (respiratory disease), but the results from the NIV, the national reference laboratory, were negative. It is equally difficult to conclude whether there are human hantavirus infections in Mumbai. The private laboratory reported that 14 blood samples tested positive, presumably for hantavirus antibodies. The type of test used is not specified nor is the particular hantavirus [tested for]. 

Cases of hantavirus infections in humans in India are reported occasionally. The most recent cases of reported suspected hantavirus infections in India were in January 2014 in Kerala and October 2011in Andhra Pradesh, where there were 3 cases of a suspected hantavirus infection in Nellore. The specific hantavirus involved in these cases was not stated either. In Asia, the 5 recognized hantaviruses with their main rodent reservoir species are: Hantaan virus (_Apodemus agrarius_), Amur virus (_A. peninsulae_), Thailand virus (_Bandicota indica_), Seoul virus (widely distributed worldwide in _Rattus norvegicus_), and Muju virus (_Myodes regulus_).

In a 4 Feb 2010 ProMED-mail post (archive no. 20100205.0385), it was reported that Dr J. Clement and colleagues from the National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Leuven, Belgium found evidence in India of the murine Seoul virus (SEOV) infection and also of the arvicoline Puumala virus (PUUV) infection, the latter in 2 fatal cases (from the Cochin and Chennai regions, respectively) with acute respiratory syndrome, symptoms similar to those in the more recently described Nellore cases in 2011 (see ProMED-mail archive no. 20111026.3187) as well as in the case described in 2011.

A HealthMap/ProMED-mail map of India can be accessed at http://healthmap.org/promed/p/142. - Mod.TY]

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