NIPAH Virus Outbreak: What you should know
Kerala is on high alert as the deadly virus called ‘NIPAH’ (NiV) which has already claimed 10 lives in the state including a nurse while providing care to infected patients.
The worrying aspect of the virus is that it has a 70 % mortality rate, and causes severe diseases in both animals and humans. Nipah Virus infection in humans can exhibit itself in different forms, from showing no symptoms of infection (asymptomatic) to acute respiratory syndrome and lethal encephalitis.
NIPAH virus was first identified in Malaysia and Singapore in 1998 and 1999. The pigs were the hosts of this virus but a fresh flare of Nipah Virus (NiV) has emerged in Kerala, in India where the hosts are fruit bats.
Previous Outbreak in India:
The disease was first reported in 2001 in Siliguri (West Bengal), claiming 45 lives out of 66 infected, and again six years later in 2007 in Nadia (West Bengal) where it claimed 5 lives out of 5 infected.
What is Nipah Virus?
Nipah virus (NiV) infection is a newly emerging zoonosis i.e. a disease which can be transmitted to humans from animals. The host of the virus is fruit bats of the Pteropodidae Family.
Nipah Virus is an RNA virus of the family Paramyxoviridae, genus Henipavirus, and is closely related to Hendra virus (reported in Australia) which is known to affect respiratory and nervous systems in horses and humans.
How it is transmitted?
The spread of Nipah virus to humans can occur in the following ways: –
– Upon direct contact with infected animals like bats or pigs
– By consuming fruits eaten by infected bats
– Infection can also occur upon drinking of raw date palm sap contaminated with infection-carrying bat excretions.
– Upon contact with NiV infected people
Key observations about NiV transmissions till now
– During the first Nipah Virus outbreak in Malaysia and Singapore, humans were infected with the virus only through close contact with infected pigs.
– The virus strain in this outbreak was found to have been transferred initially from bats to pigs, with consequent spread within pig populaces.
– Human infections occurred upon exposure to infected pigs, and there was no occurrence of virus transmission from person-to-person, in this outbreak.
– Person-to-person transmission of the virus is regularly reported in Bangladesh and India.
Signs and Symptoms
Nipah Virus is usually associated with inflammation of the brain. There are many patients who show respiratory and other organs signs as well. Therefore, do not ignore any such signs.
The symptoms start to appear within 3–14 days after exposure.
Symptoms are :
1. Fever, headache, drowsiness followed by disorientation and mental confusion.
2. These symptoms can progress into coma as fast as in 24–48 hours.
3. Encephalitis is the dreaded complication of nipah virus infection.
4. Respiratory illness can also be present during the early part of the illness.
Patients who had breathing difficulty are more likely to transmit the virus than those who doesn’t have respiratory illness
These symptoms can last up to 7-10 days.
The signs and symptoms alone are not enough to diagnose the disease. Confirmation can be made by prescribed laboratory tests done by testing body fluid like throat swab, urine, blood, brain fluid by PCR method during acute and recovery stage.
There is no specific treatment or vaccine available for NIPAH virus. The treatment is limited to intensive supportive care. As the disease is contagious, it is very important to follow standard infection control practices and make use of proper barrier nursing techniques to prevent hospital-acquired infections. All suspected cases of NiV infection should be isolated for a period of at least 15 days and given intensive supportive care.
Nipah Virus infection can be prevented by –
1. Avoiding any exposure to infected animals such as pigs and bats.
2. Do not eat fruits bitten by the animals.
3. Close unprotected physical contact with NIPAH virus-infected people should be avoided.
4. Regular hand washing should be carried out after caring for or visiting sick people.
5. Wear N 95 masks to prevent infection.
Surveillance and raising awareness about the Nipah Virus, NiV infection, its transmission and symptoms are important steps in controlling the disease and its transmission, which will also be helpful in preventing future outbreaks.
Blog written by
Dr. Manoj Goel, Director & Unit Head, Department of Pulmonology and Sleep Medicine, Fortis Memorial Research Institute, Gurgaon
Dr. Vikas Maurya, Sr. Consultant & Head, Department of Pulmonology and Sleep Medicine, Fortis Hospital, Shalimar Bagh, Delhi