Nipah Virus -The Brain Fever

NIPAH VIRUS INFECTION

Nipah Virus infection is a newly emerging zoonotic disease causing severe illness and high fatality in animals and humans. Nipah virus was initially discovered when it caused an outbreak of brain fever among pig farmers in Malaysia in 1998, where pigs were the intermediate hosts. In 2004, cases were reported in Bangladesh, people who consumed date palm sap contaminated by urine or saliva of infected fruit bat. There is no effective antiviral therapy for this infection.

Three years later, in 2001, a geographically- distinct NiV(Nipah Virus Infection) strain independently emerged in India as well as in Bangladesh, where human NiV outbreak events have been reported nearly every year since. To date, Nipah virus has caused more than 600 cases of human infection in Malaysia, Singapore, India and Bangladesh, with fatality rates ranging up to 100% for some outbreaks. Worryingly, human-to-human transmission has been observed in Bangladesh as well as in India.

Nipah Virus is transmitted from bats to humans by consumption of food contaminated by body fluids from infected fruit bats. Pigs are the intermediate host. Humans can contract the infection from a pig with active disease by coming in close frequent contact, handling raw meat from the infected animal or consuming poorly good meat. Human to human transmission has also been known to occur, mostly in family and caregiver of the infected patients.

Symptoms:

• ·         fever and headache
• ·         myalgia (muscle aches)
• ·         sore throat
• ·         vomiting
• ·         dizziness

Precautions:

•         Do not consume food contaminated by bat body fluid or bat urine/ feces.
•          Do no drink toddy brew in open containers near palm trees.
•     Avoid close and frequent contact with an infected person. Following good hygienic practices like washing hands before eating and regularly after the visit to public places and hospital is recommended
•      Avoid close physical contact with patients suspected to have Nipah virus infection. Do not share utensils, clothes, restrooms used by an infected person.
•    In the absence of vaccines, isolating and restricting the movement those infected and avoidance of the potentially contaminated sites and food is recommended.

Diagnosis:

Nipah virus infection diagnosed through Real-time polymerase chain reaction (RT-PCR) test is done on the throat and nasal swabs, cerebrospinal fluid, urine, and blood health with the diagnosis of infection in early stages. Diagnosis by detecting antibodies against the virus usually is possible in the 2nd week of illness, the test, however, is not commonly available. Tissue diagnosis by culture or immunohistochemistry is also possible through available only in select places.

Treatment:

The prognosis of NiV infections is fair to poor. The fatality rate is estimated by the World Health Organization (WHO) to range from 40%-75%, depending upon the local capabilities for surveillance and clinical management (supportive care). Survivors may have residual neurological problems such as seizures and/or personality changes. A few survivors who recover may subsequently relapse or develop delayed onset encephalitis.