NATIONAL INSTITUTE OF CHOLERA AND ENTERIC DISEASES

KOLKATA - 700010


(Established in 1962)

  NATIONAL INSTITUTE OF CHOLERA  AND ENTERIC DISEASES

Publications

Phone: 033 -23633373
Fax: 033 -23632398
Email : chakrabartis@icmr.org.in
Website :  http://www.niced.org.in
Scope of Activities:

  • Situated at Kolkata in West Bengal, the National Institute of Cholera and Enteric Diseases (NICED) conducts research on the
    • Epidemiological, parasitological, pathophysiological, virological, immunological, biochemical and microbiological aspects of the pathogens causing enteric diseases with special reference to cholera.
    • Development of vaccines for cholera / typhoid and diarrhoeagenic viruses.
    • Epidemiological and immunological aspects of HIV and its vaccine.
  • Antisera production and supply for the diagnosis of Vibrio cholerae O1 and O139.
  • Nationwide screening of phage types of Vibrio cholerae O1 biotype El Tor and Vibrio cholerae O139.
  • Clinical laboratory investigations for clinical research programmes, epidemic and outbreak investigations.
  • Training to assist in the development of skilled man power resource.

Thrust Areas:

The following are the thrust areas of NICED

  • The study of pathogens causing enteric diseases and HIV.
  • Bacteriology
    • Identification of enteric bacteria in and around Kolkata responsible for causing
      diarrhoea with special reference to V. cholerae.
    • Molecular typing of bacterial strains, detection of virulence genes, antimicrobial
      susceptible patterns and detection of resistance mechanisms and novel toxins.
      οο The study of bacterium Helicobacter pylori as a causative agent of gastro-duodenal
      diseases.
  • Biochemistry
    • Understanding host-pathogen relationship in molecular terms by characterization of
      microbial proteins that are involved in the pathogenesis of enteric diseases and host
      immune responses.
    • Pathogenesis of different diarrhoeagenic bacteria with special emphasis on receptor
      biology and signal transduction pathway involved in the mechanism of action of
      different bacterial toxins and molecular mechanisms.
  • Immunological
    •  Mucosal immune regulation by two proteins: porin (the major outer membrane protein
      of Gram negative bacteria, Shigella dysenteriae type 1) and hemolysin, (a pore-forming
      toxin released by V. cholerae).
  • Parasitology
    • Studies at the molecular and cellular levels with epidemiological studies and
      etiological role of different enteric parasites with focus on Giardia sp., Entamoeba sp.,
      Cryptosporidium sp. and helminths in diarrhoea.
  • Virology
    • Studies at the molecular and cellular levels with epidemiological studies and etiological
      role of different diarrhoeagenic viruses with focus on Rotavirus, Caliciviruses,
      Astroviruses, Picobirnaviruses and Adenoviruses and disease burden.
    • Studies on influenza viruses.
    • Analysis of host rotavirus interactions to understand virus pathogenesis.
  • Clinical and climate research
    • Improved management of different types of diarrhoea, dysentery and typhoid fever.
      Epidemiological research on different aspects of diarrhoea- observational, intervention
      and operational projects like micronutrient supplementation and Albendazole
      administration to children and its impact on their growth.
    • Seasonal effects and their relationship with the incidence of diarrhoeal cases and
      application of remote sensing and geographic information system (GIS) for identifying
      the risk factors.
  • Vaccines
    • Field trials of live oral cholera vaccine VA1.3, and VA1.4. Oral inactivated bivalent cholera
      vaccine, typhoid vaccine. Other vaccines include rotavirus vaccines and measles aerosol
      vaccine.
  • HIV studies
    • Identification of the magnitude of HIV epidemic among injecting drug users.
    • Documentation of the expanded horizon of HIV epidemic through the drug-sex
      interface.
    • Characterization of HIV genome in different risk groups and identification of
      recombinant strains.
    • Conduction of innovative intervention trial to reduce stigma around HIV/ AIDS and
      focusing on cross border issues linked with drug, HIV, human trafficking and in as well
      as out-migration.
    • Partnered modified vaccine candidate for HIV.
  • Other areas
    • The causative organisms for neonatal sepsis with special reference to Gram- negative
      bacteria and innate immune response of the gastrointestinal mucosa in response to
      pathogens.
International Recognition:

  • NICED is a declared WHO Collaborating Centre for
    • Reference & Research in Vibrios.
    • Research & Training in diarrhoeal diseases.
  • Focal Research Laboratory of the Asia Pacific PulseNet Molecular Electronic surveillance.
  • Collaborative Research Centre for Studies on Emerging and Reemerging Infections, Okayama University, Okayama, Japan.
  • One of the study sites of the Global Enteric Multicentric study supported by Bill and Melinda Gates Foundation.
  • Multi vaccine based collaborations with International Vaccine Institute, Seoul, Korea.
Human Resource Development :

  • The Institute has been enrolling PhD students having registrations in different leading State Universities like Calcutta University, Jadavpur University, Burdwan University, and Kalyani University and also in Central University like Visva Bharati University since late 1970s.
  • Several trainings are being conducted from the Institute for the development of skilled man power resource viz.
    • Training on diarrhoeal diseases with a focus on diagnostics and management.
    • Training programmes on HIV sentinel surveillance and good laboratory practices.
    • Project specific training on development of questionnaire, intervening skills, field implementation of project activities, data management and analysis
    • Summer/Winter training of students of different universities and Institutions all over India.
Recognition for Doctorate/Masters by a University:

The following Universities have recognised NICED for enrolling students for PhD work

  • Calcutta University
  • Jadavpur University
  • Burdwan University
  • Kalyani University
  • Visva Bharati University

Major Achievements:

  • Significant achievements of NICED are the following Successful demonstration, based on results of the 2-years old study that about 60% of all diarrhoea cases could be successfully treated with ORS and none had to be referred to the hospital.
  • Establishment of the strategy based on the results of a pilot study, that in the first tier mothers (or child caretakers) are required to give adequate amount of locally recommended homeavailable- fluid (HAF) to the child with diarrhoea. This resulted in HAF becoming along with ORS a key strategy in the global CDD programme.
  • Establishment of the superiority of hypo osmolar ORS over conventional ORS both in terms of reducing stool volume and duration of diarrhoea. This led to the acceptance and widespread use of this solution to combat dehydration in all types of diarrhoea.
  • Identification of multi-drug resistant S. dysenteriae type 1 (Shiga bacillus) as the causative agent of epidemic of bacillary dysentery that affected thousands of people in West Bengal in 1984 with a considerable number of recorded deaths, and establishment of the superiority of Norfloxacin to Nalidixic Acid in the treatment of Shigellosis caused by Shigella sp.
  • Discovery of a new toxigenic non-O1 strain designated as V. cholerae O139 Bengal.
  • Development of a recombinant oral cholera vaccine along with the Institute of Microbial Technology, Chandigarh and the Indian Institute of Chemical Biology, Kolkata.
  • Development of a new PCR-based method using genes encoding colonization factor antigens of enterotoxigenic E. coli (ETEC) as a supplement to serotype-based detection protocol.
  • Demonstrated that cholera toxin (CT) and heat–labile toxin of Escherichia coli (LT) markedly suppressed expression of cationic antimicrobial peptides by intestinal epithelial cells. Thus, CT and LT, in addition to their enterotoxigenic effect, play a role in survival of the pathogens in the gut by down-regulating the innate immune response of the host.
  • Identification of an HIV epidemic among injecting heroin users in the north-eastern states of India bordering Myanmar. This research drew the attention of the HIV programme planners towards the intervention design for injection drug use related HIV transmission in the country.
  • Identification of outreach to the community before reaching out to the injection drug users (IDUs) as the key element in harm reduction approach for HIV prevention among IDUs. These findings played a key role in getting harm reduction accepted in the National AIDS Policy of India.
  • Provided the first convincing evidence of progression of HIV from the male IDUs to their wives, none of whom had ever injected drug. This helped in shaping the National HIV intervention operational guideline which ensures coverage of IDUs and their female regular sex partners under National AIDS Control Programme.
  • Pioneering clinical work in the north eastern states of India regarding HIV related morbidity among IDUs and recognition that multi-dermatome Herpes Zoster served as a very useful surrogate clinical marker for HIV infection in these community settings.
  • Studies on archived V. cholerae O1 strains portrayed emergence and progression currently prevailing Vibrio cholerae O1 El Tor variants from strains that existed in Kolkata between 1989 and 1994. This El Tor variant has been detected in recent cholera outbreaks in India. These V. cholerae O1 El Tor variants produce much more cholera toxin (CT) than did prototype El Tor strains.
  • Introduction of a new cholera vaccine in February 2010, based on the results (>65% efficacy) of Phase III randomized double blind placebo controlled trial among 110,000 urban slum populations in Kolkata. This effective, cheap, safe, vaccine produced according to WHO and international norms can be effectively implemented either preemptively in cholera prone areas or as reactionary measures for combating epidemics. The vaccine will make a dramatic change in reducing the burden of cholera worldwide.
  • Establishment of the Global V. cholerae data-base (GVD) with the collaboration of Centers for Disease Control and Prevention, Atlanta, USA and the PulseNet Asia Pacific PFGE network. The main aim of GVD is to establish pulsed-field gel electrophoresis (PFGE) profiles of this pathogen generated by the participating countries and to have a real-time linked system for the early recognition of clusters of cholera that may flare into outbreaks. The PFGE profiles of V. cholerae isolated from many cholera outbreaks occurred during 2009-10 have been uploaded by NICED.
  • The double-blind, randomized, controlled field trial involving 3758 children aged 1-5 years in an urban slum community in Kolkata, suggested that daily intake of a probiotic drink can play a role in prevention of acute diarrhoea in young children in a community setting.
  • Evaluation of immuno-chromatographic dipstick crystal VC revealed 92 and 73% sensitivity and specificity respectively. The use of a rapid detection test will improve surveillance and thus reduce the burden of disease estimates, especially in remote and resource poor settings.
  • Development and application of ompW PCR based method for species specific identification of V. cholerae. This PCR based assay is currently being practiced in many laboratories in India and abroad for identifying V. cholerae from both clinical and environmental specimens. Application of this PCR helped in differentiating V. fluvialis from non-O1, non-O139 V. cholerae as these subspecies share very closely related biochemical phenotypes.
  • Development and use of culture independent Real-Time PCR (RT-PCR) assay for detecting bacterial enteropathogens directly from stool specimens. Application of this RT-PCR showed high degree of polymicrobial infection among hospitalized diarrhoea cases.
  • Establishment of community-based surveillance system for diarrhoeal diseases in rural West Bengal to fill lacunae of information in rural settings.
  • Establishment of WHO GCLP compliant Immuno-monitoring laboratory for analysis and monitoring of vaccine trials.
  • Identification and characterization of New Delhi metallo β-lactamase (NDM-1) in E. coli and Klebsiella pneumoniae in gut and blood isolates of neonates with sepsis in a neonatal intensive care unit.
  • Rotavirus- host interaction studies confirmed importance of cellular proteins PI3K/Akt and Hsp90 during initial stages of infection, to delay virus induced apoptosis suggesting possibility of targeting cellular chaperones for developing new anti-rotaviral strategies.
  • Identification and functional characterization of a novel adhesion protein (T2544) of Salmonella typhi and demonstration of its potential as a subunit vaccine against human salmonellosis.
  • Characterization of a 34 kDa outer membrane protein as a potential subunit vaccine against shigellosis since 100% protection may be achieved by oral administration of heat killed S. flexneri 2a in rabbit model.
  • NICED was designated the regional laboratory for providing rapid laboratory services for pandemic H1N1 in Eastern India.
  • HPV infections among the HIV positive patients from Kolkata were found to be more compared to HIV seronegative individuals. Increase in recombinant HIV strains among the IDUs in Manipur has been observed and its biological consequences are being studied.

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