Nipah Virus

Context

The National Centre for Disease Control (NCDC) is investigating a sample from a man in Kerala who is suspected to be carrying the Nipah virus.

About

Nipah Virus

  • The virus can be transmitted to humans from animals (such as bats or pigs). The disease spreads through fruit bats or ‘flying foxes,’ of the genus Pteropus, who are natural reservoir hosts of the Nipah and Hendra viruses.
  • Nipah virus infection is an emerging zoonotic disease of public health importance in the WHO South East Asia region with a high case fatality rate estimated to range between 40 and 75 per cent.
  • It was first recognised in 1998-99 during an outbreak among pig farmers in Malaysia and Singapore.
  • Human-to-human transmission of this virus has also been reported among family and care givers of infected patients.

How does Nipah spread or get transmitted?

  • The virus is present in bat urine and potentially, bat faeces, saliva and birthing fluids.
  • Furthermore, transmission between farms may be due to fomites – or carrying the virus on clothing, equipment, boots, and vehicles.

Diagnosis

  • Initial signs and symptoms of Nipah virus infection are nonspecific, and the diagnosis is often not suspected at the time of presentation.
  • Nipah virus infection can be diagnosed with clinical history during the acute and convalescent phase of the disease.

Symptoms of Virus

  • The incubation period of the virus is 7-14 days.
  • Initial symptoms include fever, vomiting, sore throat, headaches and muscle pain.
  • Nipah-case patients who had breathing difficulty are more likely than those without respiratory illness to transmit the virus.

Prevention and Treatment

  • The infection can be prevented by avoiding exposure to bats in endemic areas and sick pigs.
  • Drinking of raw palm sap (palm toddy) contaminated by bat excrete, eating of fruits partially consumed by bats and using water from wells infested by bats should be avoided.
  • Bats are known to drink toddy that is collected in open containers, and occasionally urinate in it, which makes it contaminated with the virus.
  • Culling of infected animals – with close supervision of burial or incineration of carcasses – may be necessary to reduce the risk of transmission to people. Restricting or banning the movement of animals from infected farms to other areas can reduce the spread of the disease.
  • Surveillance and awareness are important for preventing future outbreaks.
  • There are currently no drugs or vaccines specific for Nipah virus infection although WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint. Intensive supportive care is recommended to treat severe respiratory and neurologic complications.
  • It is important to practice standard infection control practices and proper barrier nursing techniques to avoid the spread of the infection from person to person.

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