Nipah virus Infection

Lavina Desai
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Patient Education
What is Nipah virus Infection?
Nipah Virus Infection (NiV) is a newly emerging infection acquired mainly form fruit bats which causes severe disease in humans and animals. The virus was initially isolated from samples of bat urine and partially eaten fruits in Malaysia.

When did Nipah virus first affect humans?
Nipah outbreaks have been reported in Malaysia (1998), Singapore (1999), Bangladesh (2004) and India (2001, 2007, 2018). Evidence of the virus has also been found in Cambodia, Laos, Thailand. India reported two outbreaks of Nipah virus encephalitis in the eastern state of West Bengal, bordering Bangladesh, in 2001 and 2007. Seventy one cases with 50 deaths (70% of the cases) were reported in these two outbreaks. During January and February 2001, an outbreak of febrile illness with neurological symptoms was observed in Siliguri, West Bengal. Clinical material obtained during the Siliguri outbreak was retrospectively analysed for evidence of NiV infection. The U.S Centres for disease control and prevention (CDC) says that Nipah virus outbreaks occur almost yearly in Bangladesh and there have been many such in India. The death rate from Nipah virus is estimated to be 75%.
In 2018, an outbreak was reported in the Kozhikode district of Kerala. Ten deaths have been reported so far, including one health care worker with 9 more severely affected who have been quarantined. Those who came in contact with affected individuals are also under surveillance.

How do humans acquire Nipah virus infection?
The virus is transmission can occur by direct contact with infected bats, pig or other people infected with the virus. The virus is present in bat urine, feces and birthing fluids which are also sources of infection. The symptoms appear 3-14 days after exposure.

What does "direct contact" mean?
• sleeping in the same household as a case
• direct physical contact with a case (alive or dead) during the illness.
• direct physical contact with the deceased case at the funeral or during burial.
• touching /contact with any body fluids of an infected person (saliva, urine, sputum, feces etc.)
• touching /contact with clothes or linens of a case.


What are the symptoms of Nipah virus infection?
• Headache
• Fever
• Nausea
• Dizziness
Nipah virus affects the brain and can cause encephalitis (swelling of the brain) which can present with several days of fever, confusion disorientation and persistent drowsiness. If not immediately treated these symptoms can progress to coma in 24-48 hours. Some patients may have pneumonia as well. Watching out for respiratory illness during the first few days is important. Symptoms can last for a total duration of 7-10 days.

How to diagnose Nipah virus infection?
Diagnosis of the viral infection is done by testing fluid samples from the patient such as from throat swabs, cerebrospinal fluid, urine and subjection them to special tests such as PCR. Blood analysis during acute and chronic stage of the disease will show antibodies (IgM and IgG) against the virus and this helps in confirming the diagnosis.

How to treat Nipah Virus infection?
Unfortunately there is no effective treatment currently for Nipah Virus infection. Management is focused on supportive care of the patient. Affected individuals should be isolated and given intensive supportive care. Standard infection control strategies are implemented to prevent spread of infection.

How to prevent infection with Nipah virus?
Since there is no specific treatment available yet, prevention is the mainstay of our approach.
• Avoid exposure to bats and sick pigs in endemic areas.
• Do not consume half eaten or bitten fruits,
• Do not consume new palm sap (palm toddy) contaminated with bat fluids. Bats are known to contaminate toddy kept in open containers with their saliva or urine.
• Especially if caring for a patient: Wash hands regularly, wear gown, mask, cap, gloves, whenever in contact with patient.

Nipah virus Infection Nipah virus Infection 5/25/2018
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