Nipah virus: A new challenge for Kerala's health system


Nipah Virus Kerala


The Nipah virus is a rare and deadly disease that can cause severe respiratory and neurological symptoms in humans. It has a high mortality rate of around 70%. The virus can be transmitted from animals to humans, through contaminated food, or directly between people. There is no vaccine or specific treatment for the infection, only supportive care.

The latest update on the Nipah virus outbreak in Kerala is as follows:

- One more person, a 39-year-old resident of Cheruvannur in Kozhikode district, tested positive for the virus on Friday, September 15, 2023, taking the number of active cases to four.

- India is importing monoclonal antibodies from Australia to treat the infected patients. The drug, m102.4, was initially developed for treating Henipavirus. Early-stage trials have shown its effectiveness against Nipah virus. The drug is expected to arrive in Kerala on Thursday, September 16, 2023.

- All educational institutes in Kozhikode district will remain shut for a week as a precautionary measure. Seven villages have been declared as containment zones and more than 700 people have been identified as close contacts and are being tested for the virus.

- Kerala High Court has asked the state government to issue guidelines for Sabarimala pilgrimage, which is expected to start in November, in view of the Nipah virus outbreak.

Symptoms :

the symptoms of Nipah virus are:

- Fever
- Headache
- Breathing difficulties
- Cough and sore throat
- Diarrhea
- Vomiting
- Muscle pain and severe weakness
- Disorientation, drowsiness, or confusion
- Seizures
- Coma
- Brain swelling (encephalitis)

These symptoms typically appear in 4-14 days following exposure to the virus. The illness initially presents as 3-14 days of fever and headache, and often includes signs of respiratory illness, such as cough, sore throat, and difficulty breathing. A phase of brain swelling (encephalitis) may follow, where symptoms can include drowsiness, disorientation, and mental confusion, which can rapidly progress to coma within 24-48 hours. Death may occur in 40-75% of cases.


Can nipah spread through air? 

 the Nipah virus (NiV) can spread to people from direct contact with infected animals, such as bats or pigs, or their body fluids, such as blood, urine or saliva. It can also spread from consuming food products that have been contaminated by body fluids of infected animals, such as palm sap or fruit contaminated by an infected bat. Additionally, it can spread from close contact with a person infected with NiV or their body fluids, including nasal or respiratory droplets, urine, or blood.

However, there is no evidence that the Nipah virus is airborne, meaning that it can spread through the air over long distances or remain suspended in the air for a long time. The virus spreads through respiratory droplets, which are larger and heavier than airborne particles and tend to fall to the ground within a few feet of the source. This means that the risk of infection is higher when a person is in close proximity to an infected animal or person, or touches a contaminated surface.

Therefore, to prevent the transmission of NiV, it is important to avoid contact with sick animals or people, or their body fluids. It is also advisable to refrain from consuming raw or partially cooked fruits or fruit products that may be contaminated by bats. Furthermore, practicing good hygiene and wearing protective equipment can help reduce the exposure to the virus.


How can we protect from nipah virus? 

To protect yourself from Nipah virus, you should take the following precautions:

- Practice handwashing regularly with soap and water.

- Avoid contact with sick bats or pigs. Pigs can become infected with the Nipah virus, making it essential to avoid direct contact with them. Farmers and those working with pigs should take additional precautions.

- Avoid areas where bats are known to roost. Reducing the risk of contact with fruit bats by securing living spaces to prevent their entry, is crucial.

- Avoid eating or drinking products that could be contaminated by bats, such as raw date palm sap, raw fruit, or fruit that is found on the ground. Fruits that have come into contact with fruit bat excreta or saliva can pose a risk of contamination. Therefore, it is advisable not to consume fruits that have fallen on the ground in areas where fruit bats are prevalent.

- Avoid contact with the blood or body fluids of any person known to be infected with Nipah virus. Because Nipah virus can be spread from person-to-person, standard infection control practices and proper barrier nursing techniques are important in preventing hospital-acquired infections (nosocomial transmission) in settings where a patient has confirmed or suspected Nipah virus infection.

- Wear a mask and gloves when caring for someone who is suspected or confirmed to have Nipah virus infection

Cure:

Unfortunately, there is no cure for Nipah virus infection as of now. There are no licensed treatments or vaccines available for this disease. The only way to treat Nipah virus infection is to provide supportive care, which includes rest, hydration, and treatment of symptoms as they occur.

First patient in Kerala of nipah virus :

The first patient of the current Nipah outbreak in Kerala was a 12-year-old boy from Kozhikode district, who died on September 5, 2023. He was admitted to a private hospital on August 31 with symptoms of fever, headache, and vomiting. His samples were sent to the National Institute of Virology (NIV) in Pune, where they tested positive for Nipah virus¹. The boy had no history of travel or contact with animals or fruit bats. The source of his infection is still unknown.



History:

Animals and humans can both contract the fatal Nipah virus (NiV). It and the Hendra virus, another agent of disease outbreaks, are both members of the genus Henipavirus.

When an outbreak among pig farmers occurred in Malaysia and Singapore in 1999, the virus was first identified. Fruits, bats transferred the virus to pigs, who subsequently passed it on to humans through contact with sick pigs or their tissues. More than 100,000 pigs were killed to stop the virus' spread during the outbreak, which resulted in roughly 300 human infections, over 100 fatalities, and a significant economic loss.

Since then, multiple outbreaks of the Nipah virus have occurred in Bangladesh and India, primarily as a result of eating contaminated fruits or fruit derivatives.By coming into intimate touch with the excretions and secretions of infected people, the virus can easily pass from one person to another.


The World Health Organization (WHO) has listed Nipah virus as one of the priority diseases that need urgent research and development.