Pathologic study of pandemic influenza A (H1N1) 2009 cases from India.

The pandemic influenza A (H1N1) 2009 originated in Mexico and rapidly spread to the United States and many other countries. India reported the first pandemic influenza case in May 2009. Autopsy studies describing the pathology of pandemic influenza infection in humans have appeared in the literature and most of these were from Western countries. We present the clinicopathologic features in 46 fatal cases with confirmed pandemic influenza A (H1N1) 2009 virus infection during August 2009 to October 2010. Postmortem needle biopsy tissues were examined for histopathological changes and distribution of virus antigen by immunohistochemistry. The results are comparable with previous autopsy studies. Diffuse alveolar damage was the consistent finding in the lung tissues. However, underlying medical conditions were not noted in the cases from present study. Consistent presence of viral antigen was noted in the bronchiolar epithelium without any reference to the duration of illness. This study also emphasizes the use of the postmortem needle biopsy technique whenever an autopsy is not possible.

Seroepidemiology of pandemic influenza A (H1N1) 2009 virus infections in Pune, India.

BACKGROUND: In India, Pune was one of the badly affected cities during the influenza A (H1N1) 2009 pandemic. We undertook serosurveys among the risk groups and general population to determine the extent of pandemic influenza A (H1N1) 2009 virus infections. METHODS: Pre-pandemic sera from the archives, collected during January 2005 to March 2009, were assayed for the determination of baseline seropositivity. Serosurveys were undertaken among the risk groups such as hospital staff, general practitioners, school children and staff and general population between 15th August and 11th December 2009. In addition, the PCR-confirmed pandemic influenza A (H1N1) 2009 cases and their household contacts were also investigated. Haemagglutination-inhibition (HI) assays were performed using turkey red blood cells employing standard protocols. A titre of >or=1:40 was considered seropositive. RESULTS: Only 2 (0.9%) of the 222 pre-pandemic sera were positive. The test-retest reliability of HI assay in 101 sera was 98% for pandemic H1N1, 93.1% for seasonal H1N1 and 94% for seasonal H3N2. The sera from 48 (73.8%) of 65 PCR-confirmed pandemic H1N1 cases in 2009 were positive. Seropositivity among general practitioners increased from 4.9% in August to 9.4% in November and 15.1% in December. Among hospital staff, seropositivity increased from 2.8% in August to 12% in November. Seropositivity among the schools increased from 2% in August to 10.7% in September. The seropositivity among students (25%) was higher than the school staff in September. In a general population survey in October 2009, seropositivity was higher in children (9.1%) than adults (4.3%). The 15-19 years age group showed the highest seropositivity of 20.3%. Seropositivity of seasonal H3N2 (55.3%) and H1N1 (26.4%) was higher than pandemic H1N1 (5.7%) (n = 2328). In households of 74 PCR-confirmed pandemic H1N1 cases, 25.6% contacts were seropositive. Almost 90% pandemic H1N1 infections were asymptomatic or mild. Considering a titre cut off of 1:10, seropositivity was 1.5-3 times as compared to 1:40. CONCLUSIONS: Pandemic influenza A (H1N1) 2009 virus infection was widespread in all sections of community. However, infection was significantly higher in school children and general practitioners. Hospital staff had the lowest infections suggesting the efficacy of infection-control measures.

Neuro-invasion of Chandipura virus mediates pathogenesis in experimentally infected mice.

Neuro-tropism is a major feature in many viral infections. Chandipura virus produces neurological symptoms in naturally infected young children and experimentally infected suckling mice. This study was undertaken to find out the neuro-invasive behaviour of Chandipura virus in suckling mice. The suckling mice were infected with the virus via footpad injection. Different tissues were collected at 24-h intervals up to 96-h post infection and processed for virus quantification and histological study. Further confirming the virus predilection to nerves tissues, the adult mice were inoculated with the virus via different routes. The suckling mice experimental results revealed a progressive replication of virus in spinal cord and brain. The progressive-virus replication was not observed in the other tissues like kidney, spleen, liver etc. Histo-pathological lesions noticed in the spinal cord and brain tissues suggested the extensive damages in these tissues. In adult mice experiment, the virus replication observed only in the brain of the mice infected via intra-cerebral route. From this study, we conclude that nervous tissues are predilection sites for Chandipura virus replication in suckling and adult mice. In suckling mice, virus might transmit through nervous tissues for dissemination. In contrast, the adult mice the nervous terminal might not pick up the virus through footpad infection. The pathogenesis in mice might be due to the virus replication mediated damage in the central nervous system.