Gujarat counts 28 child deaths in a Chandipura outbreak with a 67 percent fatality rate

Gujarat said on Thursday that 28 children have died in the current Chandipura virus outbreak, six more than the 22 deaths last confirmed on 3 August. Forty-two children have laboratory-confirmed Chandipura vesiculovirus infection. Twenty-eight deaths among 42 confirmed cases is a case-fatality ratio of 66.7 percent.

The first case this year was recorded on 30 June. The state has counted 324 suspected cases across Gujarat and in border districts of Rajasthan. Not every suspected case is Chandipura. Acute encephalitis syndrome has several causes in the monsoon months, and many children who present with fever and altered consciousness test negative for the virus.

The confirmed death total now equals the number of children who had both AES and laboratory-confirmed CHPV in Gujarat’s 2024 outbreak. That parallel is the number health officials are watching. It does not mean the two seasons are the same size. The 2024 season also included a larger pool of AES deaths that never received a CHPV label.

A virus that moves with sand flies

Chandipura vesiculovirus sits in the Rhabdoviridae family. It was first isolated in 1965 from the blood of two patients in Chandipura village, Maharashtra. Outbreaks cluster in western, central and southern India in the monsoon, when sand flies and some ticks are active. Children under 15 are the group that dies. Adults are infected less often and die less often.

There is no licensed vaccine and no specific antiviral in routine use. Treatment is supportive: airway, fluids, control of seizures, and intensive care when it is available. The speed of the illness is the clinical problem. A child can move from fever to coma in a day. District hospitals that see the first cases often lack a paediatric intensive-care bed.

Gujarat has run spraying and awareness drives in the 61 locations that reported cases last year. Officials said those sites have not produced new cases this season. The new map is therefore a different set of villages and towns, including pockets of Saurashtra and Kutch. A Kutch team surveyed one affected area specifically to look for the insect carriers.

What the 324 and the 42 both hide

Suspected-case counts mix true CHPV, other encephalitis viruses, bacterial meningitis and non-infectious encephalopathy. Confirmed-case counts depend on whether a sample reached a laboratory that can run the test before the child dies or is discharged. A fatality ratio of two in three among confirmed cases is therefore both a statement about the virus and a statement about who gets tested. The sickest children are more likely to be sampled. Milder infections, if they exist in large numbers, would lower the ratio and are not in the current denominator.

The Indian Council of Medical Research and the National Centre for Disease Control have been on the national call list since July. State guidelines went out to paediatricians through the Indian Medical Association. The operational gap is still at the first clinic: recognising AES early enough to move the child, and collecting a sample that can actually be read.

Twenty-eight confirmed deaths is already a full outbreak by Gujarat’s own recent standard. The remaining open questions are the same ones researchers could not close in 2024: which sand-fly species is carrying the virus in each district this year, why some villages light up and neighbouring ones do not, and whether any of the children who die with AES and a negative CHPV test are dying of a close relative of the same virus that the current assay misses.