BSL-3 lab for Nipah confirmation

• Truenat will be used for testing Nipah virus at five government medical colleges that have a BSL-2 facility with BSL-3 practices.
• Private medical colleges that have similar facilities will also be allowed to use Truenat.

What is TrueNat Test and How Does It Work?

• TrueNat is a chip-based, battery-operated RT-PCR kit.
• Earlier, it could only identify the E-gene in the virus that causes infections.
• E-gene helps the virus build a spherical envelope around it.
• But the current devices are now equipped to detect the RdRp enzyme found in the virus RNA.
• Therefore, ICMR has ruled that these tests can be treated as a confirmation for the presence of COVID-19 virus and Nipah Virus.

Why BSL-2 facility is essential for testing Nipah virus?

A Biosafety Level 2 (BSL-2) facility is essential for testing the Nipah virus for several reasons:

• Safety for Laboratory Personnel: Nipah virus is a highly contagious and potentially deadly virus that can be transmitted from animals to humans and between humans.
• A BSL-2 facility provides a safe working environment for laboratory personnel by requiring appropriate protective equipment, containment measures, and strict protocols to prevent accidental exposure or infection.
• Containment of the Virus: BSL-2 laboratories have containment measures in place to prevent the escape of the virus into the external environment.
• These measures include controlled access, use of primary barriers like gloves and lab coats, and secondary barriers like biosafety cabinets and specialized equipment to handle infectious materials.
• Prevention of Cross-Contamination: BSL-2 facilities are designed to prevent cross-contamination between different samples and experiments.
• This is crucial when working with Nipah virus samples to ensure that the virus does not inadvertently infect other samples or laboratory materials.

Rules for Nipah Virus Testing:

• The WHO document mentions that Nipah can be confirmed by detection of the virus RNA or viral culture.
• For a reference laboratory setting, the “diagnostic options for confirmation can include laboratory NAT, NPT/POC NAT assays, virus isolation (if BSL-3/4 available), and serum neutralisation assays”.
• Of the diagnostic options for Nipah confirmation, WHO has included both near-patient testing (NPT) and point-of-care (POC) NAT testing.
• Truenat is a POC NAT test.

Nipah Virus:

• It is a zoonotic virus (it is transmitted from animals to humans).
• The organism which causes Nipah Virus encephalitis is an RNA or Ribonucleic acid virus of the family Paramyxoviridae, genus Henipavirus, and is closely related to Hendra virus.
• Hendra virus (HeV) infection is a rare emerging zoonosis that causes severe and often fatal disease in both infected horses and humans.
• It first broke out in Malaysia and Singapore in 1998 and 1999.
• Vectors: It first appeared in domestic pigs and has been found among several species of domestic animals including dogs, cats, goats, horses and sheep.
• Transmission:
  • The disease spreads through fruit bats or ‘flying foxes,’ of the genus Pteropus, who are natural reservoir hosts of the Nipah and Hendra viruses.
  • The virus is present in bat urine and potentially, bat faeces, saliva, and birthing fluids.
• Symptoms:
  • The human infection presents as an encephalitic syndrome marked by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death.