Chandipura Virus: An Emerging Neurological Threat Transmitted by Sandflies in India

Chandipura virus (CHPV), a neurotropic, negative-sense RNA virus belonging to the genus Vesiculovirus (family Rhabdoviridae), has emerged as a significant cause of acute encephalitis syndrome (AES) in India, predominantly affecting children. Since the major outbreaks in 2003-2004 and the recent resurgence in 2024, CHPV has re-emerged as a high-fatality, climate-sensitive arboviral threat transmitted primarily by phlebotomine sandflies. The absence of specific antivirals or licensed vaccines underscores the need for comprehensive understanding and preparedness.

This narrative review synthesizes available literature on CHPV epidemiology, outbreak history, molecular virology, transmission ecology, neuropathogenesis, host immune responses, diagnostic modalities, therapeutic candidates, and preventive strategies. Data from published outbreak reports, genomic analyses, experimental studies, and public health updates were critically examined to provide an integrated One Health perspective.

CHPV outbreaks have been characterized by rapid disease progression, high case-fatality rates (often 30%-70%), and marked pediatric predominance. Molecular studies reveal a conserved vesiculovirus genomic organization (3'-N-P-M-G-L-5'), with emerging phylogenomic evidence indicating geographic clustering but limited global genomic representation. Neurotropism is mediated by rapid viral replication in the central nervous system, triggering microglial activation, oxidative stress, cytokine dysregulation, complement interactions, and Fas-mediated neuronal apoptosis. Diagnosis relies primarily on RT-PCR during the early viremic phase and IgM ELISA in later stages, though rapid field-deployable diagnostics remain unavailable. Experimental antiviral strategies, including ribavirin, favipiravir, lycorine, RNA interference, and immunomodulatory approaches, demonstrate preclinical promise but lack human clinical validation. Vector control and environmental management remain the cornerstone of prevention.

Chandipura virus represents a re-emerging neuroinvasive arbovirus with significant public health implications in India. Strengthening AES surveillance, integrating genomic monitoring, developing rapid diagnostics, advancing antiviral and vaccine research, and implementing climate-informed vector control strategies are critical priorities. A coordinated One Health framework is essential to mitigate future outbreaks and reduce pediatric mortality.