National Institute of Communicable Diseases
Directorate General of Health Services
Ministry of Health and Family Welfare (GOI)
22, Sham Nath Marg, New Delhi-110 054

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ANNUAL REPORT 1997
 
CONTENTS
1.   Introduction
          Organisation Chart
          NICD Faculty/Administration/Staff
          Budget at a Glance (1997)
2.   Objectives and Functions of the Institute
3.   National Health Programmes
          National Surveillance Programme for Communicable Diseases (NSPCD)
          Guinea Worm Eradication Programme (GWEP)
          Yaws Eradication Programme (YEP)
4.   Scientific and Research Activities
       Headquarters
          Division of AIDS & HIV
          Division fo Biochemistry/Biotechnology
          Division of Epidemiology
          Division of Helminthology
          Division of Microbiology
          Division of Medical Entomology/Vector Control
          Division of Training & Malariology
          Division of Zoonosis
       Branches
          Alwar
          Bangalore
          Calicut
          Coonoor
          Jagdalpur
          Patna
          Rajamundry
          Varanasi
5.   Manpower Development/Training Courses, Workshops, Seminars
6.   Outbreak Investigations
7.   Participation in Conferences, Workshops, Seminars and Symposia
8.   WHO/Other International Fellowships
9.   Membership of Expert Committes/Advisory Panel/Honours
10. Important Visitors during the Year
11. Publications/Presentations
Annexures
          Central Library
          Central Animal Facility

Top

Microbiology Division

Microbiology Division of the Institute is a composite unit consisting of well organised sections of virology, bacteriology and mycology; each having specialised objectives mentioned below:

§         Referral diagnostic services for various infectious viz., viral hepatitis, polio, measles, coxsackie viruses, Rubella, Cytomegalo and herpes viruses (RCH of TORCH gastroenteritis, tuberculosis and fungal infections.

§         Laboratory based dianostic services and surveillance of the aforementioned diseases.

§         Laboratory support to National Health Programmes.

§         Imparting training, organising workshops for peripheral labhoratories for manpower development.

§         Supply of diagnostic kits and reagents.

§         Storage and supply of vaccines.

§         Supply of cell lines, viral/bacterial/fungal cultures to medical colleges, teaching and research institutions.

§         Compilation and dissemination of laboratory manuals/teaching materials.

§         Specialised research and development activities.

§         Help in establishment of a full-fledged Biotechnology unit at NICD, primarily for gene sequencing of wild and vaccine strains of polioviruses.

§         Technical support to National/International Health Agencies.

Routine Services / Activities

(Maintenance of stock cultures of various animals, pathogens and parasites)

        i.      Cholera/Enterobacteriaceae Laboratory

§         Laboratory based surveillance of diarrhoeal diseases.

§         Laboratory support to outbreak investigation of diarrhoea.

§         Referral services for identification and serotyping of Vibrio cholerae and other enteric pathogens.

§         Characterization of various types of E.coli

       ii.      ARI/Meningitis Laboratory

§         Isolation and characterisation of the bacterial etiological agents of acute Respiratory infection.

§         Serological studies of Dipohtheria, Pertussis, Tetanus and Meningitis.

§         Development and characterisation of indigenous rapid diagnostic tests.

§         Storage and supply of meningococcal kits/ vaccines etc.

§         Monitoring of the proved cases of faecal diphtheria in collaboration with I.D.Hospital.

§         Laboratory support to outbreak investigations.

§         Referral Diagnostic services for characterisation of pathogens causing meningitis.

     iii.      Polio/Enterovirus Laboratory

§         Regional reference Centre (WHO) for Polio diagnosis in South East Asia.

§         Potency testing of Oral Polio vaccine for cold chain monitoring.

§         RNA probe hybridisation and ELISA for intratypic differentiation of wild polio viruses.

§         Referral services for Coxsackie B virus associated cardiomyopathies, SSPE.

§         Diagnosis and serological studies of Measles.

§         Maintenance of different cell lines for virus studies.

§         Diagnostic services for enteroviruses.

    iv.      Hepatitis Laboratory

§         Services, research and training activities pertaining to viral hepatitis.

§         Co-ordination of National Viral Hepatitis Surveillance Programme.

§         Regional Centre for Viral Hepatitis Surveillance.

§         Multicentric study to ascertain aetiology of jaundice in community.

      v.      Teratogenic Virus Laboratory

§         Acts as Centre for diagnostic support for rubella, CMV and Herpes simplex virus infections in cases of pregnant women in and around Delhi.

§         Diagnosis of viral aetiology of congenial malformations in newborn babies.

    vi.      Tuberculosis Laboratory

§         Maintaining the cultures of mycobacteria isolated from various clinical samples from suspected cases of tuberculosis.

§         Serodiagnosis of tuberculosis.

§         Antimycobacterial drug sensitivity testing.

   vii.      Medical Mycology Laboratory

§         Processing of clinical samples by direct microscopy, culture, serology, identification of fungal pathogens, preservation of cultures, providing diagnostic services on mycosis on request from Hospital/Institutions.

 viii.      Environmental Microbiology Laboratory

§         Bacteriological analysis of water samples.

§         Evaluation of field kits for water testing.

§         RNA probe hybridisation and ELISA for intratypic differentiation of wild polio viruses.

§         Referral services for Coxsackie B virus associated cardiomyopathies, SSPE.

§         Diagnosis and serological studies of Measles.

§         Maintenance of different cell lines for virus studies.

Maintenance of live material/cell cultures

Cell Lines:

                                      i.      Hep2 Cincinnati cell line

                                     ii.      HELA

                                   iii.      Vero

                                  iv.      RD (Rhabdomyosarcoma)

                                    v.      L20B

Live Materials:

                                      i.      More than 100 isolates of various fungal cultures of medical importance

                                     ii.      Virus maintained are:

                                   iii.      Polio type 1, 2, 3 (Sabin and Wild)

                                  iv.      Coxsackie B1-B6

                                    v.      Some non-polio Enteroviruses

Bacterial cultures:

                                      i.      Some non-polio Enteroviruses

                                     ii.      Vibrio cholerae

                                   iii.      C.diphtheriae

                                  iv.      Mycobacterial cultures

                                    v.      Other enteropathogens

Supply of live material

§         On request 5 different fungal cultures viz. Aspergillus flavus, Sporothrix schenckii,

§         Madurella grisea, Trichophyton mentagrophytes and Cladrosposirum spp. were supplied to Shimla Medical College. Similarly 4 different fungal cultures viz.

§         Cryptococcus neoformans, Sporothrix schenckii, Dermatophyte and Aspergillus flavus were supplied to Deptt. of Microbiology, B.J. medical College, Civil Hospital, Ahmedabad (Gujarat).

§         Cell cultures HEP2, RD cell line vero cell line are frequently supplied to all polio national laboratories and OPV testing laboratories from time to time.

§         Supply of Vibrio cholerae and other enteric pathogens isolates for workshops, training and teaching purpose to the different part of country as demanded.

§         V.cholera. 01,V.cholerae 0139,Salmonella sp. Shigella sp. and NCTC E.coli.

§         Clinical specimens for quality control purpose.

§         Loeffler’s serum slopes to I.D. Hospital, Delhi.

§         Cary Blair Transport Medium to I.D. Hospital, Delhi and other Institutes.

§         Teaching slides for viral, bacterial and fungal pathogens.

§         Virological

§         MEM, Hanks BSS, Enteroviruses typing antisera.

§         Fungal

§         Serological reagents produced by the section for diagnosis of Aspergillosis.

Storage of reagents/materials

§         Meningitis vaccine: 71050 doses supplied to 25 states and Uts for HAJ pilgrims.

§         FCS and Microtitre plates to Polio Vaccine Testing Labs in the country.

§         Hepatitis kits to different surveillance centres in the country.

§         Bacterial, viral and fungal typing antisera for typing and identification purposes.

Diagnostic support services

The division provides diagnostic support services in various diseases:

Viral Hepatitis

Name of diseases/test

No. of samples received

Found positive

Hepatitis A

363

 

175

 

Anti HAV IgM

 

 

 

 

Hepatitis B

1350

 

243

 

HbsAg

 

 

 

 

Anti HBc IgM

501

 

100

 

Anti Hbc

371

 

157

 

Anti Hbs

52

 

29

 

HBeAg

46

 

18

 

Anti Hbe

49

 

29

 

Hepatitis C

 

 

 

 

Anti HCV

103

 

18

 

Anti HCV IgM

36

 

0

 

Hepatitis E

 

 

 

 

Anti HEV

200

 

84

 

Hepatitis D

 

 

 

 

Anti Delta

28

 

1

 

Rubella IgG

513

 

471

 

IgM

297

 

15

 

CMV IgM

360

 

33

 

HSV-IgM

411

 

171

 

Virus isolation from AFP Cases

                    Polio 1                                        124 Wild (cases 520)

                    Polio 2                                        6 (3 Sabin)

                    Polio 3                                        21 (5 Wild, 1 Sabin)

                    Non-Polio enterovirus                     6 (3 Sabin)

                    Mixture of Polio                              28

Tuberculosis

Name of the test

No. of samples tested

No. found positive

Tubercular Serology

Acid Fast Staining

Mycobacteria culture

Antimycobacterial drug sensitivity testing

Tuberculin test

 

1654

220

220

65

63

499

109

109

-

30

Enteropathogens

 

Name of test

No. of samples received

Positive and results

 

 

 

 

1. (a)

V.cholera

      Culture, biochemiscal

      Serology and biotyping 

      and biotyping

260

rouine samples

from ID Hospital, Delhi

and other parts of country

V.cholerae 01 – 939

V.cholerae 0139 – 22

NAG vibrios – 55

 

 

(b)

V.cholerae & other

128

V.cholerae 01 – 93

NAG vibrios – 14

(Note: 22 isolates were to be found negative for vibrios and all the identified

V.cholerae 01 were V.cholerae

01 EIT or Ogawa serotype)

 

(c)

V.cholerae

         antibiotics tests

 

V.cholerae isolates were handed over to Antibiotic Drug Resistance Monitoring Lab. for sensitivity

 

----

2(a)

Other entero pathogens Culture Biochemicals Serology

2604

Esch coli pure culture – 146

Salmonella species        25

Shigella species             19

Species isolated

Salmonella factor (2)    – 1

Salmonella factor (4,5) – 6

Salmonella factor (7) –   5

Salmonella factor (8) –   2

Salmonella factor (9) –   2

Salmonella factor (10) – 6

Salmonella factor (19) – 3

 

(b)

Other

2604

190 isolates of E.coli pure culture, Salmonella/ Shigella were transferred to Antibiotic Drug Resisstance Monitoring tests for antibiotic sensitivity.

 

3.

Rotavirus Latex Agg test in Infantile diarrhoea

160

16 cases were positive for Rota virus by latex Agg test method from Infantile diarrhoea cases.

 

4.

Infantie Diarrhoea Microscopic examination culture Identification antibiotic sensitivity

168

Esch.coli pure culture – 15

Salmonealla species – 13

Shigella species – Nil

(These stool specimens were received from Delhi Council for Child Welfare (DCCW), 168 stool samples wre processed.

5.

Carrer Study Culture, biochemical scroyping

101

Esch.coli pure culture – 8

Salmonella species – 3

Shigella species – 1

(101 stool samples were received from Delhi Council for Child Welfare, Delhi, Staff-members to find out a carrer of enteropatho genes i.e. Salmonella and Shigella.

Medical mycology

Name of disease/test

No. of samples received

No. found positive

Pulmonary/systemic mycosis

49

22

Fungal meningitis

27

4

Mycetoma

9

4

Dermatomycosis

2

1

Sporotrichosis

1

1

Public health and other biological services

Bacteriological analysis of drinking water provided to the following beneficiaries:

        i.      Airport Health Authority – in connection with VVIP flights going abroad; on request

       ii.      Govt. hospitals and other institutions; on request

     iii.      General public: by reference.

Identification services

§         Identification of V.cholerae and other enteropathogens (Salmonella, Shigella and Yersinia)

§         Identification of different mycobacterial isolates sent from other laboratories by carrying out different biochemical tests.

§         Identification of Polio isolates obtained from different polio laboratories in the country.

§         Identification of fungal isolates obtained from different hospitals in Delhi.

Serological tests

§         ELISA test for Tuberculosis.

§         Immunodiffusion and Latex agglutination test for fungal infections.

§         Neutralization test for Coxsackie B virus, Measles and Polio virus antibodies.

§         Haemagglutination Inhibition test for Measles.

§         ELISA test for various markers of Viral hepatitis A, B, C, D and E.

§         ELISA test for antibodies against different teratogenic viruses.

§         Latex agglutination test for meningitis (Antigen detection in CSF).

Research Projects

1.     Laboratory diagnosis and surveillance of Cholera in Delhi

In the year 1997, 2532 rectal swabs were tested from the cases of gastroenteritis from I.D. Hospital, Delhi and 72 from area in and around Delhi for the isolation of V.cholerae. Of these specimens, 937 (37%) were positive for V.cholerae 01 Ogawa serotype, 22 were V.cholerae 0139 (0.87%) and 54 were NGA vibrios (2.13%) from I.D. Hospital, Delhi. Of the 72 cases from in and aground Delhi, 2 cases were positive for V.cholerae 01 and one was NAG vibrios. The incidence of V.cholerae 0139 was higher as 22 cases were identified in compare with previous year. On serotyping, all the V.cholerae 01 isolates were found to be Ogawa serotype as previous years. Strains of V.cholerae were received from different places for identification, serotyping and biotyping are given below:

Sr. No.

Name of Place

No. of Strains

VC-01

VC-0139

Vibrios NAG

Others

1.

S.P.Med. College

Bokaner (Raj.)

98

72

-

9

-

2.

J.L.N.Med. College Ajmer, (Raj.)

7

2

-

-

-

3.

J.L.N.Med. College Aligarh (U.P.)

23

19

-

5

One case was +ve for VC-01 and NAG vibrios

2.     Studies on gastroenteritis at Delhi council for Child Welfare, Delhi (DCCW)

168 stool specimens were tested for enteropathogen collected from cases of gastroenteritis from Council for Child Welfare, Delhi. Of these specimens, 15 specimens yielded Each coli pure culture, 13 Salmonella sps. None of cases were positive for Shigella. Of these 13  Salmonella, eight were Salmonella factor (8) and five were Sal. Factor (4,5). IOI stood specimens were also tested from the staff members of Delhi Council for Child Welfare (DCCW), Delhi to assess the carrier of enteropathogens i.e. Salmonella and Shigella among the staff. Of these specimens, 3 yielded Salmonella, one Shigella, 8 Esch.coli  pure culture were also detected 160 stool samples were tested for Rota-virus by Latex Agglutination test method in infacts from Delhi Council for Child Welfare, Delhi. Of these specimens, 16 cases yielded Rota-virus positivity.

3.     Studies on enteropathogens other than V.cholerae

The project was to look for other important enteropathogenis i.e. Salmonella, Shigella, Esch.coli pure cultures, Yersinia etc. in the cases of gastroenteritis. Of the 2604 rectal swabs process, 146 yielded Esch.coli pure culture, 25 Salmonella species, 19 Shigella species. For species identification of Salmonella, the isolates were sent to C.R.I., Kasauli (H.P.). Out of 19 Shigella species, Shigella flexneri was predominant (8), followed by Shigella boydii (6). Shigella dysenteriae (3) and Shigella sonnei (2). E.coli serogrouping – out of 121 E.coli isolates sent to CRI, Kasauli for serogrouping. 9 were founded to being to Enterotoxigenic (ETEC), 5 to Enteropathogenic (EPEC), 2 to Enteroinvasive (EIEC) and 1 to Enterohaemorrhagic category of diarrhoegenic E.coli. All the pathogenic isolates were sent to antibiotic/drug resistance monitoring laboratory for antibiograms.

4.     Monitoring of faecal diphtheria in and around Delhi

185 throat swabs from suspected diphtheria cases were received from I.D. Hospital, Delhi, of these 19 were positive for C.diphtheriae. All the isolates were sensitive to Penicillin, Erythormycin, and other commonly used antibiotics.

5.     National monitoring of cold chain system: potency testing of field samples of OPV

This is an on-going activity with the aim to monitor cold chain system in the country. This project is in collaboration with Ministry of Health & F.W. and supports polio eradication activity. States which send the OPV field samples are –U.P., Delhi, Rajasthan, Bihar and Madhya Pradesh.

Potency testing of field samples of OPV, 1997

State/UT

Total samples received

Tested

Satisfactory

Delhi

495

 

495

 

410

 

U.P.

852

 

852

 

532

 

M.P.

1989

 

1989

 

1649

 

Rajasthan

301

 

299

 

254

 

Orissa

4

 

4

 

3

 

Punjab

3

 

3

 

2

 

                 Total

3642

 

3640

 

2850

 

During 1997, a total of 3640 samples of OPV samples from different states were tested. All the samples were subjected to total virus concentration by microtitration technique using Hep2 cell line. The results are shown in Table above. A total of 73.20% samples were found to be having a satisfactory titres indicating that cold chain condition is good but needs more strengthening at the peripheral level.

6.     Laboratory based surveillance of Acute Flaccid Paralysis in Delhi and surrounding areas

This is an on-going project under the polio eradication activity of the country. During 1997, a total of 520 cases of AFP were reported to polio laboratory and 819 stool samples were collected from these cases. Two stool samples with 14 days of onset of paralysis were collected only in 394 cases. As compared to previous year, collection of samples has improved though still we still need to strengthen it. All the samples after collection and pre-treatment were subjected to polio virus isolation in RD and Hep2 cell line.

Acute Flaccid Paralysis cases – 1997

No. AFP cases

Laboratory Results for AFP Cases

 

P1

P2

P3

MIX

Polio/

NPEW

NPEW only

-ve for Polio & NPEW

1009

252

24

64

50

0

118

501

Intratypic differentiation of polio isolates from AFP cases

No. AFP cases

Polio-I

Polio-II

Polio-III

Mix

 

W

V

W

V

W

V

 

390

246

8

6

44

65

10

14 P1wild

The virus isolates were subjected to polio and enterovirus typing. Results are shown in the table. Fifty two samples showed the presence of non-polio enterovirus. All the polio isolates  were subjected to intratypic differentiation by ELISA and probe technique. All were found to be wild type except two polio type 2 isolates.

7.     Epidemiology  of Subacute Sclerosing Pan Encephalitis (SSPE)  in Delhi and surroundings

Of the important late sequalae of measles virus infection is SSPE. From all the major hospitals of Delhi, a total of 963 clinically suspected cases of SSPE were reported to the laboratory. These cases have evidence of SSPE by Cat Scan and EEG findings. Serum and CSF samples were collected from each case to confirm the diagnosis.

Both samples were subjected to presence of antibody titre by HAI test using monkey erythrocyutes. Forty cases were confirmed to be having SSPE, as high antibody titres were present in serum and CSF.

These positive cases were in the age group of 4 years to 18 years and predominantly in male population. So far no case have been reported following measles vaccination. The polio isolates from national laboratory at Bombay,Madras, Ahmedabad and Kasauli were referred to regional laboratory at NICD for intratypic differentiation. No polio type 2 wild virus was seen in 1997.

8.     Role of RUBELLA, CMV and HSV2 in congenital defects and abortions

A total of 557 samples were received from women and malformed babies belonging to different clinical groups, attending Gynae OPD a various hospitals of Delhi and surrounding areas. These samples were subjected to ELISA test for Rubella, CMV and HSV-2 to show the presence of IgM/IgG antibodies against the above infections. The detail result is shown in the table.

Prevalence of CMV, HSV and Rubella infection in BOH and congenitally malformed babies

Clinical Group

No. samples received

Rubella Rubella IgG

IgM

CMV

IgM

HSV

IgM

Congenitally

74

*73(47)

72(1)

72(5)

4(1)

malformed

 

 

 

 

 

Mothers of

28

28(28)

4(2)

5(2)

 

malformed babies

 

 

 

 

 

Pregnant women

231

225(214)

150(8)

175(20)

195(90)

(with or without BOH)

 

 

 

 

 

BOH cases

190

187(182)

75(6)

100(5)

188(72)

Suspected viral

34

-

-

9(1)

34(8)

fever cases

 

 

 

 

 

Total:

557

513(471)

297(15)

360(33)

411(171)

9.     Prevalence of various hepatitis markers in acute and chronic viral hepatitis in and around Delhi

Acute sporadic jaundice cases/chronic active hepatitis/cirrhosis/portalhypertension/ chronic renal failure/haemodialysis patients, etc. have been studied for hepatitis markers for hepatitis A, B, C, D and E in the serum samples. The detail results are shown in the table.

Prevalence of hepatitis markers in acute and chronic viral hepatitis in and around Delhi

Marker

No. of samples processed

No found positive

Hbs-Ag

1350

 

243

 

Anti-HAV IgM

363

 

175

 

Anti-HBc IgM

501

 

100

 

HbeAG

46

 

18

 

Anti-Hbe

49

 

29

 

Anti-HBS

52

 

29

 

Anti Hbc

371

 

157

 

Anti-Delta

28

 

01

 

Anti-HCV

103

 

18

 

Anti-HCV IgM

36

 

0

 

Anti-HEV

200

 

84

 

Earlier. HBsAg was found positive in 243 out of 1352 cases screened while acute activity out of those positive was seen in only 100 cases, while hepatitis C prevalence specially among high risk individuals was seen in 18/103 cases.

10. Evaluation of various diagnostic modalities in smear negative pulmonary tuberculosis, and role of estimation of anti A60 and anti 38 kd antibodies in the diagnosis of cutaneous tuberculosis

So far 15 serum and bronchial aspirates samples have been subjected to ELISA test; of these 9 serum samples and 7 bronchial aspirates are positive for anti A60 antibodies. So far twenty-five serum samples obtained from suspected cases of skin tuberculin. 50% were found positive for anti 38kd antibodies and 55% positive for Anti A60 antibodies.

11. To monitor the drug resistance pattern in clinical drug resistant/treatment failure and relapsed cases of pulmonary TB

So far 65 samples have been tested against INH, Streptomycin (SM), Ethambutol, Rifampicin, Thiacetazone and Pyrazinamide. Results of 45 isolates are available, and out of these, 42.55% are resistant to INH, 55.5%l to SM, 47.5% to Rifampicin and 16.6% to Ethambutol. No resistance was seen towards Thiacetazone and Pyrazinamide.

12. Water quality in various environments in and around Delhi

The water samples collected from different environments – rural, semi-urban and urban in and around Delhi were tested for bacteriological standards by the conventional multiple  tube method and the Ejkman’s test. The water samples tested consisted of running and stored tap water, running and stored hand pump water, well water, mineral water bottles. From an analysis of the test results obtained, the following interesting observations can be made:

Bacteriological Testing of drinking water samples

SI..

Category of water samples

No.

Bacteriological Quality

No

 

Tested

Excellent

Satisfactory

Unsatisfactory

ND

 

 

 

 

 

 

 

1.

Urban environment:

 

 

 

 

 

 

Samples from different locations of flight kitchens of airline caterers serving VVIP flights. (RTW, MWB)

 

48

36

00

12

-

2.

Semi-Urban/Rural environment:

Samples collected during outbreak investigations of Cholera & GE in and around Delhi. (RTW, STW, RHPW, WW)

 

 

23

 

05

 

06

 

11

 

01

3.

Urban environment:

Samples from other institutions – hospitals, schools, offices etc.

(RTW, STW, SPW)

 

33

21

01

11

-

4.

Urban environment:

Miscellaneous (domestic sources etc.) (RTW, STW)

 

04

 

04

 

00

 

00

 

-

 

Total

108

66

07

34

01

          ND          =          Test not done due to insufficient sample;

          RTW          =          Running tap water, STW = Stored tap water;

          MBW          =          Mineral Water Bottle;

          RHPW          =          Running hand pump water;

          SHPW          =          Stored hand pump water; SPW = Swimming Pool Water

In the first category, samples from flight kitchens of airline caters which has ideal conditions of urban hygiene and water supply, only 75% of the samples tested proved satisfactory (“Excellent”). The remaining 25% of unsatisfactory samples included a large number of mineral water bottles. This needs to be further confirmed and the causes for the same be investigated, since the mineral water bottles are gaining popularity and wide usage, and hence might give a false sense of security to consumers.

50% of the water samples collected during the investigation of cholera and gastroenteritis outbreaks were found to be unsatisfactory. Large majority of these samples were from semi-urban and rural areas and from economically lower starta. It is also observed that the samples were from stored hand pump and stored tap water.

Even prominent hospitals and offices in the city yielded unsatisfactory water samples, indicating poor maintenance of supply lines or storage conditions. Accordingly, remedial measures were suggested.

13. Reliability checking of H2S-Strip vial water test kits

In recent years a simple and easy to perform (even by untrained personnel) “Yes-No” test for bacteriological quality of water has been devised. This method, which is called “H2S-Strip” method, is currently under field evaluation and quality standardization. It is expected to be adopted as the field test for water quality monitoring in the hands of peripheral health workers and community participants. Three batches of Commercially manufactured H2S-Strip vial kits from two manufacturers were referred by the UNICEF, Delhi, for reliability checking. The test kits were tested for false positivity, false negativity and sterility standards. While the kits from one manufacturer showed lot of false positivity, those from the other manufacturer showed false negativity (much delayed positivity). The sterility standards of all vials tested were, however, satisfactory. The results were sent to UNICEF for further action at their end.

14. Studies on Candidiasis and Candida spp. involved in patients of AIDS

Candidiasis is one of the common opportunistic infections in HIV infected persons. Oropharyngeal, oesophageal and vulvo vaginal candidiasis are the most prominent ones. However, the frequency of incidence of this disease in Indian AIDS patients is not clearly understood. Also, although candiadiasis is known to be caused mainly by Candida albicans, other specifies also have been encountered to cause this disease. Therefore, a study was undertaken to find out the frequency of this disease and the specifies involved in AIDS patients in collaboration with Dr. Ram Manohar Lohia Hospital, New Delhi and the National AIDS Control Organization. During the year under report, 16 AIDS patients have been investigated and out of which, I were found culture positive for oral candidiasis. Out of 9 positive cases 8 were positive for Candida albicans and the identity of one is yet to be established. The study is in progress.

15. Studies on the frequency of Opportunistic fungal infections in Kidney transplant patients

Owing to long duration of immunosuppressive therapy, an increasing number of patients with organ transplantations with T & B cell defects are prone to serious opportunistic infections. Since there is no detailed study on the frequency of various fungal infections in organ transplant recipient in India, the present study is initiated during the year in collaboration with the Nephrology/Transplantation Unit of Batra Hospital and Medical Research Centre, New Delhi. So far 9 transplanted patients were investigated and 2 were found positive for systemic Candidiasis and one to Aspergillosis. The study is in progress.

16. Studies on the incidence of fungal meningitis in Delhi

In view of the sharp increase in the incidence of fungal meningitis in immunocompromised patients in recent years, especially in patients of AIDS, a study was underway to find out the magnitude of this problem in Delhi. Out of 27 patients investigated this year, 3 were found positive for Cryptococcosis and one case was positive for Candidiasis. In the past, meningitis due to fungi other than Cryptococcus was rarely known, but in recent years, it is being frequently diagnosed in many parts of the world.

17. Incidence of pulmonary/systemic mycosis in Delhi

In an on-going diagnostic survey conducted to find out the incidence of pulmonary/ systemic mycosis in patients of various chest and other disorders, it was found that out of 49 patients investigated this year, 16 cases were found positive for systemic Candidiasis and 5 were positive for Aspergillosis. It is interesting to note that most of the cases diagnosed are from immuno-compromised patients.

18. Studies on the incidence of subcutaneous/cutaneous mycosis

In a collaborative study with various hospitals on the extent of prevalence and etiology of subcutaneous mycosis, out of 9 cases investigated, 4 cases of mycetomas were detected, (2 cases were due to Actinomycotic mycetoma, 2 cases was due to fungal mycetomas); one case was due to sporotrichosis. Regarding cutaneous infections, one case was diagnosed during the year and it was due to Trichophyton rubrum.

19. Studies on the distribution and epidemiological significance of the serotypes of Cryptococcus neoformans

Studies on the isolation of the strains of C.neoformans from clinical as well as environmental sources were continued. 3 strains of C.neoformans were isolated during the year and were added to the poor of isolates preserved for serotyping. Six isolates have been confirmed positive for C.neoformans var. gath out of the list and the rest are under investigation for confirmation.

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