Orientia tsutsugamushi (from Japanese tsutsuga “illness” and mushi “insect”) is the causative organism of scrub typhus, and the natural vector and reservoir is trombiculid mites (genus Leptotrombidium). The organism is an obligate intracellular pathogen, which needs to infect eukaryotic cells in order to multiply. Orientia tsutsugamushi is endemic to a part of the world known as the tsutsugamushi triangle. This extends from northern Japan and far-eastern Russia in the north, to the territories around the Solomon Sea into northern Australia in the south, and to Pakistan and Afghanistan in the west and Nepal falls inside the tsutsugamushi triangle. In Nepal, diagnosis of Typhus in clinical setting is recent although there might be cases from past. The clinical manifestation of Scrub Typhus is complex and no prognostic marker is yet available resulting in the mortality rate >10% if undiagnosed (Taylor et. al, 2015)*. We are studying the host immune markers associated with the severity of the infection and developing novel diagnostic platform for detection.
Human Immunodeficiency Virus
The history of the HIV and AIDS epidemic began in illness, fear and death as the world faced a new and unknown virus. However, scientific advances, such as the development of antiretroviral drugs, have enabled people with access to treatment to live long and healthy lives with HIV. Unfortunately, we do not have such treatment therapy that could eliminate the virus from body. Department of Infection & Immunology is working on the therapeutics for HIV; existing as well as futuristic. We aim to characterize virus circulating in Nepalese, so as to study how existing drug is impacting the host and how HIV is evolving alongside. We aim to answer this interplay between virus and the host as to define the possible therapeutic ground for “the drug of future”.
Hepatitis A,B,C,E Virus
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B and C usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Department of Infection & Immunology is working the mono and co infection of viral hepatitis within different clinical complications, so as to understand how the viral interplay occurs. We also study the host immune response alongside that complex interplay.
In 2015, an estimated 1 million children became ill with TB and 170 000 children died of TB (excluding children with HIV). TB is a leading killer of HIV-positive people: in 2015, 35% of HIV deaths were due to TB. Globally in 2015, an estimated 480 000 people developed multidrug-resistant TB (MDR-TB). Ending the TB epidemic by 2030 is among the health targets of the newly adopted Sustainable Development Goals. Diagnosing multi-drug resistant and extensively drug-resistant TB as well as HIV-associated TB can be complex and expensive. Department of Infection & Immunology is studying the molecular epidemiology of TB, meanwhile developing new tools for effective diagnosis of these resistance cases as per needed in our Nepalese community. We aim to study the complications with diagnosis and their answers.
Human papillomavirus is a group of more than 150 related viruses. Each HPV virus in this large group is given a number which is called its HPV type. HPV is named for the warts (papillomas), some HPV types can cause. Department of Infection & Immunology is studying the molecular epidemiology, virus genotype circulating in Nepal, the adversaries for its diagnosis and the clinical complications.