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Health officials in India face an outbreak of the Nipah virus about every other year. The virus, spread by fruit bats, is often fatal to humans. Authorities scrambled to prevent a new outbreak after a 14-year-old boy died of the Nipah virus in the southern Indian state of Kerala on Sunday, July 21, 2024 – exactly one year after the last outbreak in 2023. Kerala state Health Minister Veena George said the boy died of a heart attack apparently caused by the virus. She said 60 more people had been identified as high-risk people.
Nipah is most commonly found in fruit bats, which live in forested areas near the densely populated state of Kerala. It is also found in pigs. Humans can acquire the infection directly from animals, via droplets, or indirectly through contaminated surfaces. Human-to-human transmission is also possible. Infection can cause encephalitis and mild to severe illness, but can also lead to death. The World Health Organization classifies Nipah as a priority pathogen, meaning it has the potential to trigger an epidemic.
How does the virus spread?
The Nipah virus is typically found in fruit bats (Pteropodidae), which feed on nectar and pollen, while vampire bats eat insects and drink animal blood. Fruit bats are much larger and use their eyes, not ultrasound, to orient themselves.
Scientists still don’t know how the virus spreads from bats to pigs, cattle or even humans. However, there are indications that both humans and animals can become infected through contact with the contaminated saliva and urine of bats.
The outbreak that occurred in Kerala in 2018 was probably caused by contamination of the drinking water source. Dead fruit bats were later found in the well of the house of an infected family in Changaroth. First, several members of the family fell ill. Later, their acquaintances also fell ill.
Why is this virus so dangerous?
The Nipah virus causes aggressive inflammation in the brain. The U.S. Centers for Disease Control has cited an incubation period of five days to two weeks. Early symptoms are flu-like: fever, nausea and severe headache. Some patients develop breathing problems. Later, disorientation, dizziness and confusion set in. Within one to two days, patients can go into a coma and die. The mortality rate for Nipah disease is 70%.
How can this disease be treated?
There is no vaccine or medicine against the Nipah virus – neither for animals, nor for humans. Medications are so far only able to alleviate the symptoms. In principle, patients should be immediately isolated and taken to the intensive care unit, where vital body functions can be supported. Contact persons or suspected cases must be quarantined to prevent the spread of the infectious disease.
Where does Nipah virus come from?
The Nipah virus was first discovered in 1998 in the village of Sungai Nipah in Malaysia. 229 individuals developed febrile encephalitis – the disease caused when the virus enters the brain – and, in some cases, severe respiratory infections. Men working in slaughterhouses were the first to contract the infection. It became clear that the disease could also be spread by animals.
Around the same time, a comparatively mild outbreak of a respiratory infection caused by an unknown pathogen was reported in pigs in Malaysia. Only later did scientists discover that the workers and pigs were infected with the same virus. As a precaution, more than 1 million pigs were culled in Malaysia – half of the country’s total pig population. Since then, cases of the virus have been reported in Bangladesh in 2001 and 2003, and in Kerala in 2018, 2021 and 2023.
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