{"id":20908,"date":"2018-06-02T18:23:13","date_gmt":"2018-06-02T12:53:13","guid":{"rendered":"http:\/\/blog.forumias.com\/?p=20908"},"modified":"2020-12-29T17:51:25","modified_gmt":"2020-12-29T12:21:25","slug":"nipah-virus-all-you-need-to-know","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/nipah-virus-all-you-need-to-know\/","title":{"rendered":"Nipah Virus: All you need to know"},"content":{"rendered":"<p><span style=\"color: #ff0000;\"><strong><u>Context:<\/u><\/strong><\/span><\/p>\n<p>The recent spread and transmission of Nipah virus in the southern state of Kerala<\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>What is Nipah virus?<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Nipah Virus is a zoonotic virus- transmitted from animals to humans. Other examples include swine flu, bird flu<\/li>\n<li>Nipah virus is highly infectious<\/li>\n<li>The Nipah virus is a member of the genus <em>Henipavirus<\/em> in the family Paramyxoviridae<\/li>\n<li>The virus is an RNA (ribonucleic acid) virus and mutates very fast<\/li>\n<li>The disease was named after Kampung Sungai Nipah (Nipah River Village), Malaysia, where the first viral isolate was obtained<\/li>\n<li>Closely related to Hendra virus<\/li>\n<li>There is debate over whether the disease is air borne<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Outbreaks:<\/u><\/strong><\/span><\/p>\n<ol>\n<li>Malaysia 1998-1999- First documented appearance of the virus<\/li>\n<li>Singapore- 1999<\/li>\n<li>Siliguri, West Bengal, India- 2001<\/li>\n<li>Bangladesh- 2001-2013<\/li>\n<li>Nadia, West Bengal, India- 2007<\/li>\n<li>Kozikhode and Mallapuram, Kerala, India-2018- 19 people have died as of 1<sup>st<\/sup> June 2018<\/li>\n<\/ol>\n<p><span style=\"color: #ff0000;\"><strong><u>Host:<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Fruit bats (<em>Pteropus<\/em>), popularly known as flying foxes are natural reservoir hosts of Nipah Virus<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Transmission:<\/u><\/strong><\/span><\/p>\n<ol>\n<li>Direct contact with:<\/li>\n<\/ol>\n<ul>\n<li>infected bats,<\/li>\n<li>infected pigs,<\/li>\n<li>Other NiV infected people<\/li>\n<li><em>Transmission through respiratory droplets, saliva, contact with infected tissues, other bodily secretions<\/em><\/li>\n<\/ul>\n<ol start=\"2\">\n<li>Consumption of fruit or fruit products contaminated with urine or saliva of infected bats- Indirect transmission<\/li>\n<li>The secondary wave of transmission occurs from human-human contact and is most challenging for health authorities to combat<\/li>\n<li>Nipah virus infection generally has a stuttering chain of transmission- Once the virus moves from bats to humans; it generally spreads to people in close contact with the patients<\/li>\n<\/ol>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-20910 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/nipah.jpg?resize=643%2C414\" alt=\"\" width=\"643\" height=\"414\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/nipah.jpg?w=643&amp;ssl=1 643w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/nipah.jpg?resize=150%2C97&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/nipah.jpg?resize=300%2C193&amp;ssl=1 300w\" sizes=\"auto, (max-width: 643px) 100vw, 643px\" \/><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>Difference in transmission between Malaysia and Bangladesh-India<\/u><\/strong><\/span><\/p>\n<ol>\n<li>Malaysia:<\/li>\n<\/ol>\n<ul>\n<li>In the Malaysia outbreak, transmission occurred primarily through contact with infected pigs.<\/li>\n<li>No occurrence of person-to-person transmission was reported in this outbreak.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li>Bangladesh and India:<\/li>\n<\/ol>\n<ul>\n<li>The infection occurred directly from fruit bats without involvement of intermediate host (pigs).<\/li>\n<li>Exposure has been linked to consumption of raw date palm sap and contact with bats.<\/li>\n<li>Person-to-person transmission has been common. Most commonly seen in the family and caregivers of Nipah virus-infected patients.<\/li>\n<li>Similar pattern observed in current outbreak<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Signs and Symptoms in Humans<\/u><\/strong>:<\/span><\/p>\n<ul>\n<li>Infection associated with inflammation of brain<\/li>\n<li>Initial symptoms include fever, headache, respiratory problem followed by drowsiness, disorientation and mental confusion<\/li>\n<li>These could progress to coma and ultimately to death<\/li>\n<li><u>Mortality rate:<\/u> High; 40-75%<\/li>\n<li>Long term effects in those who survive: persistent convulsions, personality changes<\/li>\n<li>Latent infections with subsequent reactivation of Nipah virus and death have also been reported<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Diagnosis<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Viral isolation from throat and nasal swabs, cerebrospinal fluid, urine, and blood using Real Time Polymerase Chain Reaction (RT-PCR)<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Treatment:<\/u><\/strong><\/span><\/p>\n<ul>\n<li>No vaccine or antiviral drug available for either people or animals.<\/li>\n<li>Intensive supportive care with treatment of symptoms is the main approach to managing the infection in people<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Preventive Measures<\/u><\/strong><\/span><\/p>\n<p><strong>Guidelines from National Centre for Disease Control<\/strong><\/p>\n<p><strong style=\"font-size: 1rem;\"><u><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-20911 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/guidlines.jpg?resize=750%2C352\" alt=\"\" width=\"750\" height=\"352\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/guidlines.jpg?w=756&amp;ssl=1 756w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/guidlines.jpg?resize=150%2C70&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/guidlines.jpg?resize=300%2C141&amp;ssl=1 300w\" sizes=\"auto, (max-width: 750px) 100vw, 750px\" \/><\/u><\/strong><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>Status of the Nipah Virus<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Nipah is considered an &#8220;emerging&#8221; virus because it was discovered relatively recently- 1998-1999<\/li>\n<li>The virus figures in the WHO\u2019s list of epidemic threats in need of urgent research and development.<\/li>\n<li>Centre for Disease control and Prevention (CDC) lists it as a critical potential biological weapon. This is because of its availability, ease of production and dissemination and high rates of morbidity and mortality<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Government Response on Current Outbreak:<\/u><\/strong><\/span><\/p>\n<ol>\n<li>A multi-disciplinary team from the National Centre for Disease Control was sent to Kerala to investigate and respond to the disease outbreak.<\/li>\n<li>Infection prevention and control measures\u00a0have been strengthened in health care<\/li>\n<li>Acute fever and acute encephalitis syndrome (AES) surveillance upgraded across hospitals in Kerala<\/li>\n<li>Hospital and community surveillance\u00a0strengthened<\/li>\n<li>To confirm cases of Nipah Virus Manipal Centre for Virus Research (MCVR) and the National Institute of Virology have been conducting laboratory testing<\/li>\n<\/ol>\n<ul>\n<li>Since Nipah virus is considered to be a probable bioterrorism agent, in August 2017, MCVR was trained by US\u2019s CDC to test for Nipah Virus<\/li>\n<\/ul>\n<ol start=\"6\">\n<li>Isolation of patients; quarantines have been set up<\/li>\n<li>Kerala government has issued travel advisories<\/li>\n<li>Other state governments have also issued advisories on prevention. Example: Delhi<\/li>\n<li>Disease awareness among all stakeholders. The Ministry of Health and Family Welfare (MoHFW) shared guidelines drafted by the National Centre for Disease Control with all stakeholders.<\/li>\n<\/ol>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-20914 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/aaaaa.jpg?resize=711%2C452\" alt=\"\" width=\"711\" height=\"452\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/aaaaa.jpg?w=711&amp;ssl=1 711w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/aaaaa.jpg?resize=150%2C95&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/aaaaa.jpg?resize=300%2C191&amp;ssl=1 300w\" sizes=\"auto, (max-width: 711px) 100vw, 711px\" \/><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>WHO Response:<\/u><\/strong><\/span><\/p>\n<ul>\n<li>WHO has been in contact with the Indian authorities and has been monitoring the event<\/li>\n<li>WHO has shared various materials on preventive measures, risk communication materials on Nipah Virus<\/li>\n<li>Indian authorities may approach WHO for support for coordinating multi-dimensional investigations<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Risk Assessment by WHO:<\/u><\/strong><\/span><\/p>\n<ul>\n<li>WHO has assessed the risk to be low at regional and national levels<\/li>\n<li>Based on the present situation and low level of risk, WHO did not recommend application of any travel or trade restrictions on India<\/li>\n<\/ul>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-20915 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/ddddddd.jpg?resize=696%2C310\" alt=\"\" width=\"696\" height=\"310\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/ddddddd.jpg?w=696&amp;ssl=1 696w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/ddddddd.jpg?resize=150%2C67&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/ddddddd.jpg?resize=300%2C134&amp;ssl=1 300w\" sizes=\"auto, (max-width: 696px) 100vw, 696px\" \/><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>Challenges before India:<\/u><\/strong><\/span><\/p>\n<ol>\n<li>India has a poor record of outbreak investigations- timely detection and early warning of outbreaks is a major challenge to health authorities For example- In Muzzaffarpur, Bihar and Gorapkpur, Uttar Pradesh witnessed thousands of deaths in repeated annual outbreaks before causes were established<\/li>\n<li>Inadequate and often dysfunctional public health infrastructure; shortage of health workforce<\/li>\n<li>Large population dispersed across vast geographical area. The high density of population in most parts of the country makes disease control and prevention difficult and poses larger public health risk<\/li>\n<li>Lack of virology institutes<\/li>\n<\/ol>\n<p><strong style=\"font-size: 1rem;\"><u><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-20916 size-full\" src=\"https:\/\/i0.wp.com\/blog.forumias.com\/wp-content\/uploads\/2018\/06\/wwwwwwww.jpg?resize=711%2C213\" alt=\"\" width=\"711\" height=\"213\" srcset=\"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/wwwwwwww.jpg?w=711&amp;ssl=1 711w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/wwwwwwww.jpg?resize=150%2C45&amp;ssl=1 150w, https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/wwwwwwww.jpg?resize=300%2C90&amp;ssl=1 300w\" sizes=\"auto, (max-width: 711px) 100vw, 711px\" \/><\/u><\/strong><\/p>\n<p><span style=\"color: #ff0000;\"><strong><u>Lessons learnt from Kerala:<\/u><\/strong><\/span><\/p>\n<ul>\n<li>Kerala has successfully handled Nipah virus outbreak and holds important lessons for India<\/li>\n<li>Prompt diagnosis- the detection of the virus on the very second day of outbreak is commendable<\/li>\n<li>Further, the government\u2019s quick response in tackling the virus is appreciated.<\/li>\n<li>The infection control measures, measures to strengthen hospital and community surveillance have been successful in controlling the spread of disease.<\/li>\n<\/ul>\n<p><span style=\"color: #ff0000;\"><strong><u>Way Ahead:<\/u><\/strong><\/span><\/p>\n<ol>\n<li>Research is needed to better understand the ecology of bats and Nipah virus.<\/li>\n<li>Research for development of intervention strategies- prevention and therapy (vaccines, anti-viral drugs). Research into development of vaccines has been ongoing in Australia and France.<\/li>\n<li>The key to controlling any disease outbreak and reducing mortalities is early detection of the outbreak in communities and livestock<\/li>\n<li>Effective disease surveillance system, functioning across the country including in rural areas, is the need of the hour for disease preparedness and mitigation<\/li>\n<li>International collaboration on disease surveillance needs to be further strengthened<\/li>\n<li>Enforcing standard infection control practices to avoid human-to-human infections<\/li>\n<li>Awareness of transmission and symptoms among all stakeholders<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Context: The recent spread and transmission of Nipah virus in the southern state of Kerala What is Nipah virus? Nipah Virus is a zoonotic virus- transmitted from animals to humans. Other examples include swine flu, bird flu Nipah virus is highly infectious The Nipah virus is a member of the genus Henipavirus in the family&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/nipah-virus-all-you-need-to-know\/\">Continue reading <span class=\"screen-reader-text\">Nipah Virus: All you need to know<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":20917,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[27],"tags":[],"class_list":["post-20908","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured-editorials","entry"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2018\/06\/Nipah-Virus-1-784x441.jpg?fit=1004%2C564&ssl=1","views":{"total":0,"cached_at":"","cached_date":1704394233},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/20908","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=20908"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/20908\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media\/20917"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=20908"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=20908"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=20908"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}