India may even have had early warnings. Two years ago a team from the National Institute of Virology had isolated the measles virus from five adults in Bombay with acute renal failure and neurological symptoms. Four of the patients died, but none had a rash. The institute had also isolated the measles virus in two highly fatal outbreaks of encephalitis among children aged under 12 years in three states Haryana, Gujarat, and Andhra Pradesh during 1998. The National Institute of Virology had said last year that the absence of a rash and unusual symptoms may mean that measles was re-emerging in India despite widespread vaccination coverage.
Virologists say that genetic studies of the virus are necessary.