Day 1 :
- Clinical virology
Chair
Jaspreet Jain
Session Introduction
Jaspreet Jain
International Centre for Genetic Engineering and Biotechnology, India
Title: Chikungunya outbreaks in India – A prospective study comparing neutralization, sequelae, and molecular epidemiology during two outbreaks in 2010 and 2016
Biography:
Jaspreet Jain has recently submitted her thesis for the award of PhD degree in Virology from International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India and currently she is working on her own project at ICGEB to develop prototype for early, accurate and affordable diagnosis of chikungunya infection for epidemic settings. She has published more than 15 papers in international peer reviewed journals and two patents aplications in process. She is also working with the Government of India, Depaartment of AYUSH to provide clinical evidences for alternative and complementary system of medicine in India.
Abstract:
Chikungunya fever (CHIKF) is a major public health concern in India. In 2005, the etiologic agent, chikungunya virus (CHIKV) was reintroduced into the Indian subcontinent after a gap of 32 years and thereafter, occurred as outbreaks in several parts of the country. We recruited 588 patients in the acute phase of CHIKF during outbreaks in 2010 and 2016 from a tertiary-care-hospital in New Delhi, India and collected their blood along with their clinical information. Their arthralgic status was documented after 12 weeks post onset of fever. We evaluated IgM/IgG CHIKV-binding antibodies and their neutralizing capacity for all sera. We sequenced whole genomes of 22 CHIKV strains, analyzed them for mutations and correlated these with patient sequelae status. We performed infections of murine models using representative strains from both the outbreaks to evaluate differences in their pathogenesis. Our detailed screening and analysis revealed that patients afflicted during the 2016 outbreak developed earlier IgM and neutralizing antibodies that were negatively correlated with CHIKF sequelae as compared to 2010 patients. Mutation analysis and in vivo pathogenesis studies of the viral isolates revealed differences in virulence based on their genetic makeup. Our study provides insights into CHIKF progression in the Indian subcontinent during outbreaks in an endemic setting with respect to host response as well as viral pathogenesis. Importantly, we provide information on the development of neutralizing antibodies and sequence variation in clinical isolates that correlate with human sequelae.
- Respiratory Viral Infections
Session Introduction
Nkengafac Villyen Motaze
National Institute for Communicable Diseases,South Africa
Title: Congenital rubella syndrome surveillance in South Africa using a sentinel site approach: a cross-sectional study
Biography:
Dr. Nkengafac Villyen Motaze (M. D, M.Sc, PhD fellow) is an epidemiologist with the Centre for Vaccines and Immunology, (CVI) at the National Institute for Communicable Diseases (NICD). Villyen completed his masters in Clinical Epidemiology at Stellenbosch University where he is now a PhD fellow in Epidemiology. He conducts systematic reviews of healthcare interventions and facilitates training on systematic reviews and Evidence-Based Practice. Villyen has published more than five papers in peer-reviewed journals and is also an associate editor with the Cochrane Effective Practice and Organization of Care (EPOC) review group.
Abstract:
Background
Congenital rubella syndrome (CRS) includes disorders associated with intrauterine rubella infection. Incidence of CRS is higher in countries with no rubella-containing vaccines (RCV) in their immunization schedules. In the World Health Organization African region, RCVs are being introduced as part of the 2012-2020 global measles and rubella strategic plan. This study aimed to describe the epidemiology of confirmed CRS in South Africa prior to introduction of RCVs in the immunization schedule.
Methods
This was a descriptive study with 28 sentinel sites reporting laboratory-confirmed CRS cases in all nine provinces of South Africa. In the retrospective phase (2010 to 2014), CRS cases were retrieved from medical records and in the prospective phase (2015 to 2017) clinicians at study sites reported CRS cases monthly.
Results
There were 42 confirmed CRS cases in the retrospective phase and 53 confirmed CRS cases in the prospective phase. Most frequently reported birth defects were congenital heart disease and cataracts. The median age of mothers of CRS cases was 21 years in the retrospective phase (range: 11 to 38 years) and 22 years in the prospective phase (range: 15 to 38 years).
Conclusion
Baseline data on laboratory-confirmed CRS obtained in this study will enable monitoring for planning and implementation of RCV in the South African EPI program. Mothers of infants with CRS were mostly young women 14 to 30 years old, indicating a potential immunity gap in this age group to be considered during introduction of RCV.
Keywords: Rubella, congenital rubella syndrome, surveillance, rubella containing vaccines, birth defects.