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Journal of Postgraduate Medicine
Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
ISSN: 0022-3859 EISSN: 0972-2823
Vol. 46, Num. 3, 2000, pp. 231-232
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Journal of Postgraduate Medicine, Vol. 46, No. 3, July-September, 2000,
pp. 231-232
Looking Back
National Institute of Cholera and Enteric
Diseases
P-33, CIT Road, Scheme XM, Beliaghata, Calcutta - 700 010
Code Number: jp00079
Eastern India, notably the Gangetic belt is considered as the "homeland"
of cholera and a focal point of many of the epidemics and some of the pandemics.
A great deal of work had already been done but there were many unturned chapters
on cholera that motivated the Indian Council of Medical Research (ICMR) to establish
a renewable temporary set up of "Cholera Research Centre" (CRC) at
Calcutta in 1962. The Centre has been given the status of "International
Reference Centre for Vibrio Phage Typing" by the WHO in 1968 and later
on redesignated as the "WHO Collaborative Centre for Reference and Research
in Vibrios" in 1978 for providing referral services to the member countries.
With continuing advancement of the centre the ICMR changed this temporary research
Centre into "National Institute" and renamed as "National Institute
of Cholera and Enteric Diseases" (NICED) in 1979. The WHO recognised this
Institute as "WHO Collaborative Centre for Research and Training on Diarrhoeal
Diseases" in 1980.
Aims of the Institute
NICED deals with diarrhoeal diseases of diverge aetiologies, typhoid fever,
infective hepatitis and AIDS. Aims of this Institute are to conduct research
on those diseases on both basic and applied aspects. Institute aims to train
the professionals for better management and prevention of diarrhoeal diseases
and also for rapid and correct diagnosis. Epidemiological investigations of
epidemics of diarrhoeal diseases are being carried out in different parts of
India from time to time. Antisera of Vibrio cholerae is raised in this
Institute and supplied to national and International laboratories. Specific
monoclonal antiserum for detection of Vibrio cholerae O139 strains was
developed at NICED which has been supplied to WHO (SEARO), New Delhi for distribution
to various national and International laboratories. As WHO Phage Reference Centre,
Institute receives a large number of Vibrio cholerae strains from all
over the world for Phage typing.
National and International Collaboration
Though this Institute is principally financed by the ICMR, New Delhi, other
funding agencies are also financing the Institute for collaborative research
work.
The Japanese International Co-operative Agencies (JICA) has established a collaborative
research establishment in this Institute to work on in-depth molecular aspects
of different enteropathogens with special emphasis to Vibrio cholerae
O1 and O139. Department of Biotechnology (DBT), Government of India supports
different projects on basic research. The WHO and UNICEF also support the projects
on applied research.
Several workshops on management and preventive
aspects of diarrhoeal diseases and on rapid screening
methodology of different enteropathogens have been sponsored by
WHO, UNICEF, DBT and Ministry of Health and Family
Welfare, Govt. of India.
Teaching Activities
Each year 4-5 post-graduate students of this Institute
receive PhD degree from the different Universities of the
State. Post-graduate medical students also attend the Institute
for training on diarrhoeal diseases and also to get scientific
assistance from the scientists who work as co-guides for
their MD thesis. WHO and JICA send their international fellows
to receive training on diarrhoeal diseases.
Studies Conducted and Contribution
Studies on cholera
- Epidemiological differences between El Tor and classical varieties of cholera.
- Studies showed a lower incidence of cholera carriers among contacts of cholera
affected houses provided with narrow necked pitchers and demonstrated the
effectiveness of simple measures like hand washing with soap and water, coupled
with health education.
- Studies showed that chemoprophylaxis has little role in the control of cholera
carriers in endemic areas.
- Controlled field trials of conventional cholera vaccine and aluminium adjuvant
cholera toxoid vaccine were carried out by this Institute which revealed limited
protection.
- A new phage typing scheme for Vibrio cholerae biotype El Tor strains
has been developed at NICED, which is useful as an epidemic marker for tracing
the sources of infection.
- Studies showed for the first time that ORS if given in small quantity and
at regular frequent intervals, vomiting can be avoided. Further studies demonstrated
that ORS of WHO formula is safe and effective in the treatment of dehydrating
acute diarrhoea in neonates and severely malnourished children.
- Studies on newer forms of ORS: Glycine fortified ORS showed no added advantage
over standard ORS. Cereal based ORS showed reduction of stool volume and duration
of diarrhoea. Presently studies are continuing with "hypo-osmolar ORS"
in cholera and non-cholera diarrhoea.
- Scientists at NICED showed that single dose of doxycycline (300 mg) is effective
alternative to tetracycline for the treatment of adult El Tor cholera. It
was documented that norfloxacin is as effective as tetracycline for the treatment
of cholera in adults. The WHO has recommended doxycycline for adult cholera.
- Purification and molecular characterisation of Vibrio cholerae lectins
was done. A cell free hemagglutinin (HA) was isolated and purified. The cell
associated HA has also been characterised biochemically, morphologically and
antigenically.
- During 1992-93, when a new toxigenic non-O1 cholera strains, designated
as Vibrio cholerae O139 Bengal appeared, scientists of NICED have the
credit of bringing this information to the notice of global scientific community.
The NICED has done substantial research related to Vibrio cholerae
O139 in the areas of microbiology, clinical medicine and epidemiology.
Studies on Shigella
- The NICED has done epidemiological research during epidemics of shigellosis
in different parts of the country and has also shown the efiicacy of various
antimicrobials in the treatment of shigellosis.
- The humoral immune response of patients convalescing from shigellosis, against
bacterial components like lipopolysaccharide (LPS) and outer membrane proteins
has been analysed.
Studies on Rotavirus
- Studies conducted at NICED documented that Rotavirus was detected as sole
pathogen in 22% of hospitalized children suffering from diarrhoea in Calcutta.
However, in Manipur, the detection rate of Rotavirus was as high as 90% in
the winter months. Long electropherotype but subgroup 1 Rotavirus was detected
from cases which suggested the zoonotic transmission of Rotavirus in Manipur.
Genetically this strain was related to the human VP 7G serotype 2 strain but
antigenically reacted to bovine VP 7G serotypes 6 and 10 but not with any
known major human VP 7G serotypes 1 to 4. This study suggested that the strain
might have developed by in vivo reassortment between human and bovine
Rotavirus.
- Recently, a human group B Rotavirus, CAL strain was detected for the first
time outside China by the scientists of NICED.
Apart from these the NICED has conducted large
number of studies dealing with epidemiology, clinical aspects
and microbiology including the molecular basis of diarrhoeal
diseases due to Vibrio parahaemolyticus, E.coli, intestinal
parasites and other enteropathogens and enteric fever.
Awardee and His Original Contribution
For discovery of a novel epidemic strain of Vibrio cholerae serogroup
O139, synonym Bengal and non-membrane damaging cytotoxin (NMDCY) among Vibrio
cholerae strains, Dr. G. Balakrish Nair, Deputy Director of this Institute
was awarded the prestigious Shanti Swarup Bhatnagar Award for excellence in
Medical Sciences for the year 1998 by the Council of Scientific and Industrial
Research (CSIR).
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Copyright 2000 - Journal of Postgradate Medicine
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