Since its inception, the Manipal Institute of Virology (MIV) has been a stalwart in improving public health. In the year 2013, in a bid to further the same, MIV collaborated with the Centers for Disease Control and Prevention (CDC), Atlanta and respective State Health Departments, initiating the Hospital-Based Acute Febrile Illness (AFI) Surveillance in India under the Global Health Security Agenda (GHSA).
Using the AFI Surveillance platform, MIV contributed to disease surveillance in the country by providing case-based real-time surveillance data. Acute Febrile Illness (AFI) is caused by various infectious agents, including viruses, bacteria, and parasites, some of which are amenable to therapeutic and/or preventative interventions. Advances in laboratory diagnostics greatly enhanced our understanding of the infectious aetiologies of Acute Febrile Illness (AFI).
However, significant gaps remained in the knowledge and understanding of the burden, etiologic spectrum, and risk factors associated with AFI in India. The project was launched to bridge this gap and generate evidence for public health action.
Implemented first in the district of Shimoga, Karnataka, in June 2014, the project grew enormously, with over 33 sentinel hospitals under its wing. With its presence in over ten states of India, including Karnataka, Kerala, Assam, Goa, Gujarat, Maharashtra, Jharkhand, Tripura, Tamil Nadu, and Odisha, MIV, MAHE maintained close coordination and collaboration with the respective state health services.
The study aimed to characterise the infectious causes of Acute Febrile Illness (AFI) among patients in India's District/Sub-District Hospitals/PHCs. It focused on identifying pathogens, including parasites (limited to malaria), bacteria, viruses, and other unknown causes of AFI. Using serology and modern molecular diagnostic assays, clinical samples were tested for unknown pathogens using PCR-sequence-based pathogen discovery techniques.
Apart from the project's innate ability to detect various pathogens, its systematic yet highly efficient logistic system was also highlighted. Clinical samples were transported to MIV daily under a cold chain system. The results were communicated within 48 hours to the treating doctor under intimation to the State and District Health officials. This eliminated wastage of time in the diagnosis chain, assisting speedy detection and thereby helping with faster recovery.
The AFI surveillance project recruited over 40,000 cases and generated valuable epidemiological data on infectious diseases in the country. This helped take evidence-based public health action and generated evidence-based health policy for preventing and controlling infectious diseases. It also aimed to strengthen the public health laboratories by providing necessary equipment and protocols to enable onsite diagnosis of common diseases.
Further, it helped the country's public health infrastructure identify emerging disease trends early, which, in turn, resulted in detecting outbreaks in the early stages and implementing effective control measures.