Nipah virus or NiV is a zoonotic virus. It is a member of the Paramyxoviridae family of Henipavirus genus. Nipah cases have the tendency to occur as an outbreak or in a cluster.

After the first outbreak of Nipah virus during September 1998 to May 1999 in Singapore and Malaysia affecting 276 people, in 2001 it was identified as the cause of encephalitis outbreak in Meherpur, Bangladesh.

In the same year, circumstantial evidence of transmission from human-to-human was seen in India as well. 33 people including hospital visitors and health workers reportedly became ill after being exposed to patients hospitalized in Siliguri with Nipah virus illness. 

In India, an outbreak was again reported in May 2018 in Kozhikode and Malappuram districts of Kerala. 17 people died out of 19 reported cases with 18 being lab confirmed. Although declared the outbreak to be officially over on June 10, 2018, a case was reported again towards the end of May 2019. It was confirmed to be Nipah infection on June 4, 2019, in Ernakulam, Kerala. More than 300 people are kept under observation as well. Due to early detection, the infection seemed to have been contained by the Kerala Government health department.

Transmission

The fruit bats of the genus Pteropus are the natural reservoir hosts of Hendra and Nipah viruses. The virus is found in bat urine and possibly in bat saliva, faeces and their birthing fluids. The first outbreak which occurred in Malaysia was possibly due to the pigs in farms coming in close contact with the bats. Pigs got infected with the virus after eating fruits that were partially eaten by the bats and dropped in pigsties. Furthermore, the transmission occurred due to fomites among various farms or carrying the virus on equipment, vehicles, clothing and boots.

 In Malaysia and Singapore, Nipah virus infection in humans occurred when they came in contact with the secretions and excretions of infected pigs.

The virus affected the people of Bangladesh when they drank contaminated raw palm sap or climbing the trees coated in bat excrement.

The human-to-human transmittion as reported in India and Bangladesh, was due to close contact with an infected person through their bodily fluids and excrement.

Signs and Symptoms

The signs and symptoms begin to manifest after 5 to 14 days from being exposed to the virus. The symptoms of Nipah virus infection include 

  • Headache
  • Fever
  • Muscle pain
  • Sore throat
  • Diarrhea
  • Severe weakness
  • Vomiting

The symptoms can escalate to:

  • Convulsion
  • Drowsiness
  • Dizziness
  • Mental confusion
  • Altered consciousness
  • Disorientation
  • Neurological signs indicating acute encephalitis. 

Some people may experience acute respiratory distress along with other severe respiratory problems and atypical pneumonia. Seizures and encephalitis can occur in severe cases, taking a fast turn in to coma within 24-48 hours. 

Diagnosis

Nipah virus infection can be diagnosed by running a combination of tests during the acute and convalescent phases of the ailment. Virus isolation attempts by cell culture and real-time polymerase chain reaction or RT-PCR from nasal and throat swabs, urine, cerebrospinal fluid, and blood has to be performed during the early stages of the infection. Antibody detection by ELISA can be done later on. 

Treatment

Unfortunately, there are no vaccines or medicines available to treat the Nipah virus infection specifically. The treatment is limited to supportive care for now. It is important to maintain the standard infection control practices along with following the proper barrier nursing techniques to prevent hospital-acquired infections since the Nipah virus encephalitis can be transmitted from one person to another. Any person suspected of having the infection must be put in isolation and monitored accordingly.

Prevention

Prevent Nipah virus infection by following the below-mentioned tips:

  • Avoid close contact with infected people
  • Wash hands with soap regularly
  • Wear N95 grade or higher masks
  • Avoid consumption of unpasteurized fruit juices or partly eaten fruits
  • Avoid being around animal enclosures
  • Consume freshly collected date palm juice only after boiling it
  • Wash thoroughly and peel fruits before eating
  • Maintain personal hygiene

How Nipah Virus Infection is Different from Swine Flu and Bird Flu?

The symptoms of Nipah infection, bird flu, and swine flu are quite similar. However, these differ in their way of impacting people and the mode of treatment. The basic difference between Nipah virus and swine flu is that there are vaccines and medicines available for the latter but nothing is available for the former.

If you are suffering from the symptoms of Nipah infection or know someone who is then reaching out to the experts for help immediately. To book an appointment visit us at https://www.nightingales.in/

Reference – https://www.who.int/csr/disease/nipah/en/

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