Nipah Virus: Centre issues advisory after boy’s death in Kerala – Check symptoms and risks

Nipah Virus: Indian Government’s advice to Kerala

Following the report of a death due to Nipah virus in Kerala, the Centre has advised the State Government to take the following immediate public health measures:

1. Active case finding in the family, neighbourhood and areas with similar topography of the confirmed case.

2. Active contact tracing (for any contacts) during the last 12 days.

3. People who came in contact with the case will be strictly isolated and suspects will be quarantined.

4. Collection and transportation of samples for laboratory testing.

In addition, a joint outbreak response central team will be deployed to assist the state for case investigation, identification of epidemiological linkages and technical support, the Union health ministry said.

What is Nipah virus and how did it spread?

The World Health Organization describes Nipah virus (NiV) as a zoonotic virus. This means that the virus spreads from animals to humans and can also be transmitted through contaminated food or directly between people.

Fruit bats are usually the reservoir of the virus, and humans can become infected by accidentally eating fruit contaminated by bats.

When outbreaks were first identified in Malaysia and Singapore, most human infections were through direct contact with sick pigs or their contaminated tissues. “Infection is believed to have occurred through unprotected contact with secretions from pigs or unprotected contact with tissues from a sick animal,” the WHO said.

Later, outbreaks in Bangladesh and India were probably caused by consumption of fruits or fruit products contaminated with the urine or saliva of infected fruit bats.

Human-to-human transmission of Nipah virus has also been reported among families and caregivers of infected patients. “During subsequent outbreaks in Bangladesh and India, Nipah virus spread directly from human-to-human through close contact with people’s secretions and faeces,” WHO reported.

Nipah virus: What are the symptoms?

People infected with the Nipah virus suffer a variety of illnesses – from asymptomatic (subclinical) infection to acute respiratory illness and fatal encephalitis. It can cause severe illness and death in people, making it a public health concern.

According to the WHO, people infected with the virus initially develop symptoms such as fever, headache, muscle pain, vomiting and sore throat. This may be followed by dizziness, drowsiness, changes in consciousness and neurological signs that indicate acute encephalitis.

Some people may also develop atypical pneumonia and severe respiratory problems, including acute respiratory distress. Severe cases can lead to encephalitis and seizures, which progress to coma within 24 to 48 hours.

How serious is the disease?

According to the WHO, the interval from infection to appearance of symptoms is believed to be 4 to 14 days. However, an incubation period of up to 45 days has also been reported.

Most survivors of acute encephalitis make a full recovery, but long-term neurological problems have been reported in survivors.

“About 20 percent of patients have residual neurological consequences, such as seizure disorder and personality changes. Some people who recover may later have a relapse of the disease or develop delayed-onset encephalitis,” the World Health Organization says.

Meanwhile, estimates of case fatality rates range from 40 percent to 75 percent. The WHO says rates can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.

The virus can also cause severe disease in livestock such as pigs, resulting in heavy economic losses for farmers.

Nipah Virus: Diagnosis and Challenges

The main tests used to diagnose Nipah virus infection are real-time polymerase chain reaction (RT-PCR) from bodily fluids and antibody detection through enzyme-linked immunosorbent assay (ELISA).

Other tests include polymerase chain reaction (PCR) assays, and virus isolation by cell culture.

The quality, quantity, type, timing of clinical specimen collection, and the time taken to transfer specimens to the laboratory can affect the accuracy of laboratory results.

Treatment of Nipah Virus

There is currently no drug or vaccine for Nipah virus infection, even though WHO has identified Nipah as a priority disease for the WHO Research and Development Blueprint. Treatment is mostly limited to supportive care and syndromic management of acute encephalitis syndrome.

Therefore, in the absence of a vaccine, the only way to reduce or prevent the infection is to increase awareness about the risk factors among people. People should be educated about the measures they can take to reduce the risk of Nipah virus.

Nipah virus: How to reduce the risk of infection in people?I

According to the World Health Organization, public health educational messages should focus on:

1: Bats are losing access to date palm sap and other fresh food products.

2. Gloves and other protective clothing should be worn when handling sick animals or their tissues, and during slaughter and sorting processes.

3. People should avoid unprotected physical contact with people infected with Nipah virus. They should wash their hands regularly after caring for or meeting sick people.

4. Healthcare workers caring for patients with suspected or confirmed infections, or handling specimens from them, should apply standard infection control precautions at all times

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Published: July 21, 2024, 04:47 PM IST